Federal health officials on Tuesday announced an ambitious plan to refocus health priorities in an effort to prevent one million heart attacks and strokes within five years. They plan to achieve the goal through partnership with organized medicine, health plans, pharmacists and a large drug store chain.
Called "Million Hearts," the effort seeks to create what Centers for Medicare & Medicaid Services administrator Donald Berwick, MD, called a new "alignment" between providers and others to get people to lose weight, stop smoking, control blood pressure, reduce cholesterol, and manage diabetes.
"There's hardly an American today who won't, without doubt, know somebody – a loved one, a friend, maybe even yourself – who will gain from this call to arms," Berwick said during a news briefing. "(This is) someone who will not have a heart attack or disabling stroke or another form of cardiovascular disability and therefore will live longer and a fuller and more joyous life" because of this campaign.
Added Health and Human Services Secretary Kathleen Sebelius: "With two million heart attacks and strokes a year, 800,000 deaths, just about all of us have been touched by someone with heart disease, heart attack, or stroke." But the cost of treatment is "a huge drain on our economy. Cardiovascular disease costs our country $444 billion every year in medical costs and lost productivity," or one of every six healthcare dollars.
"Yet we know that most heart attacks and strokes can be prevented with simple, low-cost care that's available today, but that sad truth is too any people who need that care don't get it."
Thomas Frieden, MD, director of the Centers for Disease Control and Prevention, also commented during the campaign rollout. "This will not cost a lot of new money but it will greatly increase our focus on getting value for our investments," he said. "We aim to reduce the number of people who need treatment and improve the quality of treatment for those who do."
The administration is focusing on what it calls the ABCs of heart disease and stroke:
• A – To make sure that everyone who is at high risk for cardiovascular disease takes an aspirin a day. At present, only 47% do, but the campaign's goal is to raise that to 65%.
• B – To make sure patients at high risk for high blood pressure maintain control. At present only 46% do. The goal is to raise that to 65%.
• C – To make sure people who need treatment for high cholesterol receive it. Currently, only 33% receive it but the Million Hearts drive seeks to raise that to 65%.
• S – Reduce smoking prevalence, currently at 19% of the population to 17%.
Additionally, the campaign seeks to reduce sodium intake by 20% from its current per person average of 3.5 grams per day, and cut by half the average American's consumption of calories from artificial trans fat.
HHS officials said they intend to "focus and align" measurement tools to simply reporting for healthcare providers on how well disease prevention benchmarks are being met. CMS plans to expand the role of the Physician Quality Reporting System (or PQRI), which provides bonus payments, and in the future payment reductions based on the reporting of quality information related to the ABCS. Currently no new reporting measures are planned but officials said that may change as the program gains momentum.
Additionally, they hope to use health information technology and electronic record systems to improve providers' tools to make sure patients receive appropriate care.
To learn new ways to prevent heart disease and stroke, the administration intends to focus on clinical innovations, perhaps through Medicare's 53 Quality Improvement Organizations or QIOs.
Other efforts tagged with the campaign include:
• The release by the CDC of $40 million total state health departments to find ways to improve cardiovascular health
• Efforts by the U.S. Food and Drug Administration and the Food Safety and Inspection Service to find ways to reduce sodium in processed and restaurant foods "to put more control into consumers' hands."
• A $2 million pharmacy outreach project from the CDC to help pharmacists provide additional advice to patients with high blood pressure.
• CMS is releasing $85 million for Medicaid Incentives for Prevention of Chronic Diseases, a project set forth by the Patient Protection and Affordable Care Act, for 10 states.
• $4.2 million from the CDC to seven national community-based organization networks.
The administration touted "alignment and support" from the following organizations and companies:
• Walgreens is offering free blood pressure testing and consultations with a company pharmacist or nurse practitioner.
• The American Heart Association will monitor progress of the initiative's goals and help patients access heart disease management tools online.
• The YMCA or The Y plans to expand diabetes prevention program and other efforts to address population risks for diabetes and cardiovascular disease.
• The American Pharmacists' Association and its foundation "will encourage its more than 62,000 members to engage in the Million Hearts Campaign by raising awareness with their patients and their communities." The National Alliance of State Pharmacy Associations and the Alliance for Patient Medication Safety will encourage state pharmacy association to plan supportive activities, according to an HHS news release.
Karen Ignagni, president of America's Health insurance Plans, said her group strongly supports the Million Hearts initiative and is "eager to collaborate with other stakeholders."