TAKEheart Training Module 1 Welcome and Benefits of Increasing Cardiac … · 2020. 3. 4. ·...

Welcome to the TAKEheart Initiative and the Benefits of Increasing Cardiac Rehabilitation Participation L e a r n i n g C o m m u n i t y W e b i n a r S e r i e s : R a n d a l T h o m a s , M D M S K a r e n L u i , R N , M S G r e g M e r r i t t , P h D

Module 1

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American Hospital Association (AHA)/Health Research and Education Trust (HRET): TAKEheart AHRQ’s Initiative to Increase Use of Cardiac Rehabilitation

TAKEheart Initiative and the Benefits of Increasing Cardiac Rehabilitation Participation: Learning Community Webinar Series: Module 1

January 30, 2020

The planners and faculty of TAKEheart Initiative Module 1 indicated no relevant financial relationships to disclose in regard to the content of their presentations with the exception of: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and American Hospital Association (AHA)/Health Research and Education Trust (HRET). ABQAURP is accredited by the ACCME to provide continuing medical education for physicians. The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

Today’s Webinar Presenters

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PARTICIPANTS INTRODUCTIONS

Randal Thomas

MD, MS Director, Cardiac Rehab Program - Division of Preventive Cardiology, Mayo Clinic

Karen Lui

RN, MS GRQ Consulting, Legislative analyst for AACVPR

Greg Merritt

PhD Founder, Patient Is Partner and CR graduate

Patient Story

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PARTICIPANTS Greg Merritt

What is TAKEheart?

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TAKEheart applies strategies from the Million Hearts®/AACVPR Cardiac Rehabilitation Change Package (CRCP) to help hospitals increase cardiac

rehabilitation (CR) participation for more of their eligible patients.

Agency for Healthcare Research and Quality (AHRQ) and Centers for Disease Control and Prevention (CDC)

Cardiac Rehabilitation Change Package

Increase referral, enrollment, and adherence to cardiac rehabilitation

Improve cardiac health

PresenterPresentation NotesTAKEheart is an Agency for Healthcare Research and Quality (AHRQ) initiative designed to enable hospitals and health systems to increase cardiac rehabilitation referrals, enrollment and adherence, based on evidence.

This webinar presents strategies and specific interventions Partner Hospitals will be undertaking in TAKEheart and evidence for why they are effective.

Citations from this slide: Centers for Disease Control and Prevention US Dept of Health and Human Services. Cardiac Rehabilitation Change Package. 2018. Available at: https://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.html

Welcome to TAKEheart!

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automatic referral care coordination increased use of cardiac rehabilitation

TAKEheart Training

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WEBINARS

• Overall: Walk through the steps and considerations to implementing automatic cardiac rehabilitation referral with care coordination (liaison)

• Today: • First of 10 webinars • Focus on the evidence and making

the case for CR implementation

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Overview of Presentation

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PARTICIPANTS Learning Goals Learning Goals

What is CR?

Importance of CR and Opportunity to Close the Gap

Barriers to Patient Participation in CR

Evidence for CR: Making the Case

Summary and Discussion

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Learning Goals

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PARTICIPANTS Learning Goals Upon completion of this module, you should be able to:

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Understand the evidence base on the benefits of cardiac rehabilitation and the gaps in access and uptake, especially among underserved populations.

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Make the case to your leadership for taking active steps to increase CR participation by implementing automatic referral and care coordination support and begin to build buy-in among other members of your implementation team

3 Feel confident that the TAKEheart curriculum will provide you with practical tips and tools to implement an automatic referral and care coordination plan for cardiac rehabilitation patients and their families

PresenterPresentation NotesThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical education through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the American Hospital Association (AHA). ABQAURP is accredited by the ACCME to provide continuing medical education for physicians and nurses. The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

What is Cardiac Rehabilitation?

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PARTICIPANTS DEFINITION

Cardiac rehabilitation (CR) is a comprehensive secondary prevention program used to improve cardiovascular health and prevent subsequent cardiovascular events.

PresenterPresentation Notes

Citations from this slide:American Association of Cardiovascular and Pulmonary Rehabilitation. Vital Conversations with Medical Teams & Hospital Administrators About Cardiac Rehabilitation Services Delivering Value Based Care. 2018. Available at: https://www.aacvpr.org/Portals/0/Million Hearts Change Package/4.24.2018 Files/SC-2-5-CRCP-Crucial Conversations with Med Providers and Hosp Admins.pptx

Importance of CR

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PARTICIPANTS THE GAP

• Overwhelming evidence has led to numerous national guidelines and specialty societies supporting the use of CR.

• Yet, there is a large gap between recommended enrollment and actual participation rates in CR.

• According to a 2019 study, 24.4% of beneficiaries eligible for CR participated, of whom 24.3% participated in CR within 21 days and 26.9% completed 36 or more sessions

The purpose of TAKEheart is to close the gap between CR evidence and practice.

PresenterPresentation NotesNote: Figures cited above are based on 2016-2017 Medicare fee-for service data

National guidelines indicate that CR is a class 1a recommendation (AHA/ACC) for MI & CABG Mean CR referral rates are the lowest of all the secondary prevention measures that were assessed for patients with diagnoses of PCI Only 50-70% of referred patients actually participate in CR

Citations from this slide:Centers for Disease Control and Prevention. Million Hearts: Costs & Consequences. Available at: https://millionhearts.hhs.gov/learn-prevent/cost-consequences.html. Balady, G.J. et al. AHA/AACVPR Scientific Statement: Core Components of Cardiac Rehabilitation/ Secondary Prevention Programs: 2007 Update. Journal of Cardiopulmonary Rehabilitation and Prevention. 2007;27:121/129Ritchey et al. Cardiac Rehabilitation Use Among Eligible Medicare Fee-For-Service Beneficiaries, 2016-2017. Journal of the American College of Cardiology. 2019. Volume 73, Issue 9.

Additional references:Chui, P.W. et al. Hospital Performance on Percutaneous Coronary Intervention Process and Outcomes Measures. J Am Heart Assoc. 2017; 6:e004276. DOI: 10.1161/JAHA.116.004276.Spertus et al. Cardiac Performance Measure Compliance in Outpatients. Journal of the American College or Cardiology. 2010; Vol. 56, No. 1, 2010Beatty, A. L et al. Geographic Variation in Cardiac Rehabilitation Participation in Medicare and Veterans Affairs Populations Opportunity for Improvement. J Am Heart Assoc. 2018;137:1899–1908. DOI: 10.1161/CIRCULATIONAHA.117.029471

The Opportunity: How to Close the Gap

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EVIDENCE-BASED APPROACH


Increasing CR participation from 20% to 70% could save 25,000 lives and prevent 180,000 hospitalizations annually in the United States.

PresenterPresentation NotesCitations from this slide:Ades PA, Keteyian SJ, Wright JS, et al. Increasing cardiac rehabilitation participation from 20% to 70%: a road map from the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clin Proc. 2017;92(2):234–42.


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PARTICIPANTS EVIDENCE-BASED APPROACH


• Automatic referral: EMR based referral built into order set, default, opt-out model where ALL patients with qualifying diagnoses are referred and relevant providers are notified


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PARTICIPANTS EVIDENCE-BASED APPROACH


• Care coordination support (“liaison”): Can be dedicated staff or someone in- house taking on role with appropriate training on program. Meets with patient to introduce CR and coordinate referral.


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PARTICIPANTS

• In a 2011 study, implementing automatic referral to CR increased participation to 70% compared to control (32%). Automatic referral with care coordination support increased participation to 86%.


PresenterPresentation NotesCitations from this slide: Grace, S.L. et al. Effect of cardiac rehabilitation referral strategies on utilization rates: a prospective, controlled study. Arch Intern Med. 2011 Feb 14;171(3):235-41. doi: 10.1001/archinternmed.2010.501.

Barriers to CR Participation: Why So Low?

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PARTICIPANTS FOR PATIENTS FOR PROVIDERS

• Fail to promptly and consistently identify and refer patients who are eligible for CR

• Focus on inpatient care • Do not understand the importance, benefits, and

operations of CR


Ritchey et al. Cardiac Rehabilitation Use Among Eligible Medicare Fee-For-Service Beneficiaries, 2016-2017. Journal of the American College of Cardiology. 2019. Volume 73, Issue 9.


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PARTICIPANTS FOR PATIENTS FOR PATIENTS

• Do not get referred to CR; lack of care coordination for CR even if referred.

• Lack of understanding of importance, scope and

benefits of CR • Significant patient barriers to attending CR – time,

motivation, support, financial (co-payments), transportation – especially for up to 36 separate sessions.


Ritchey et al. Cardiac Rehabilitation Use Among Eligible Medicare Fee-For-Service Beneficiaries, 2016-2017. Journal of the American College of Cardiology. 2019. Volume 73, Issue 9.


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DISPARTITIES FOR PATIENTS- SIGNIFICANT DISPARITIES

• Lack of CR referral disproportionally affects women, people of color and non-native English speakers. In a recent study • 18.9% of women participated in CR compared to 28.6% of men • Non-Hispanic Whites participated at a rate of 25.8% compared

to < 17% for other races/ethnicities

• In areas of the country where cardiac events are disproportionately high, CR uptake is lower

• Individuals with multiple chronic conditions are also less likely to be referred to CR.

PresenterPresentation NotesCitations from this slide:Ritchey et al. Cardiac Rehabilitation Use Among Eligible Medicare Fee-For-Service Beneficiaries, 2016-2017. Journal of the American College of Cardiology. 2019. Volume 73, Issue 9.

Moghei, M. et al. Cardiac Rehabilitation Quality Improvement: A Narrative Review. Journal of cardiopulmonary rehabilitation and prevention. 2019;39:226-234.

Castellanos, LR et al. Disparities in Cardiac Rehabilitation Among Individuals from Racial and Ethnic Groups and Rural Communities-A Systematic Review. J Racial Ethn Health Disparities. 2019 Feb;6(1):1-11

Additional references:Allen JK, Scott LB, Stewart KJ, Young DR. Disparities in women’s referral to and enrollment in outpatient cardiac rehabilitation. J Gen Intern Med. 2004;19(7):747–53.

Menezes AR, Lavie CJ, DeSchutter A, Milani RV. Gender, race and cardiac rehabilitation in the United States: is there a difference in care? Am J Med Sci. 2014;348(2):146–52.

Valencia HE, Savage PD, Ades PA. Cardiac rehabilitation participation in underserved populations. Minorities, low socioeconomic, and rural residents. J Cardiopulm Rehabil Prev. 2011;31(4):203–10.


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PARTICIPANTS FO SYSTEMS FOR HOSPITALS/HEALTH SYSTEMS

• Outpatient CR is challenging to coordinate and sustain from an inpatient referral: without an automatic referral patients not as easily identified

• Lack of coordinated operational and IT (electronic medical record) platforms and staff serving both settings.

• Need for hospital leadership support; CR not traditionally seen as acutely important.

PresenterPresentation NotesCitations from this slide:Centers for Disease Control and Prevention: Million Hearts. Cardiac Rehabilitation: Saving Lives, Restoring Health, Preventing Disease” 2018. Available at: https://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdf

American Association of Cardiovascular and Pulmonary Rehabilitation. “Vital Conversations with Medical Teams & Hospital Administrators About Cardiac Rehabilitation Services Delivering Value Based Care: Lower Cost, Higher Quality, Great Value!” https://www.aacvpr.org/Portals/0/Million Hearts Change Package/4.24.2018 Files/SC-2-5-CRCP-Crucial Conversations with Med Providers and Hosp Admins.pptx

Additional references:Russell KL, Holloway TM, Brum M, Caruso V, Chessex C, Grace SL. Cardiac rehabilitation wait times: effect on enrollment. J Cardiopulm Rehabil Prev. 2011;31(6):373–7.

Making the Case for Cardiac Rehabilitation

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PARTICIPANTS FOR PATIENTS • CR reduces mortality over 1-3 years. CR participation is

associated with a 13-24% reduction in total mortality over 1-3 years

• CR reduces avoidable re- hospitalization, up to 30%

• CR is clinically effective for people who have or have had:

• A heart attack • A percutaneous coronary intervention (PCI) • CABG surgery, heart valve replacement or repair, or a heart

or heart-lung transplant • Chronic stable angina • Chronic stable heart failure

PresenterPresentation NotesThe following slides review what evidence can support CR teams/champions to MAKE THE CASE to their team, their patients and their leadership to increase CR participation.

Citations from this slide:Hammill BG et al. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation. 2010 Jan 5;121(1):63-70

Centers for Disease Control and Prevention: Million Hearts. Cardiac Rehabilitation: Saving Lives, Restoring Health, Preventing Disease” 2018. Available at: https://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdf

American Association of Cardiovascular and Pulmonary Rehabilitation. “Vital Conversations with Medical Teams & Hospital Administrators About Cardiac Rehabilitation Services Delivering Value Based Care: Lower Cost, Higher Quality, Great Value!” https://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdf.


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PARTICIPANTS FOR PATIENTS • Care coordination role of CR is central to this

patient-centered service

• CR can help patients with medication adherence; management of weight loss, smoking cessation, hypertension, diabetes, depression, mental stress and improves quality of life after an adverse event.

• What matters the most to the patient?

• Help the patient (& family) find the motivating factor that drives participation in CR

• CR focuses on each patient’s behavior change goal(s)

PresenterPresentation NotesThe following slides review what evidence can support CR teams/champions to MAKE THE CASE to their team, their patients and their leadership to increase CR participation.

Citations from this slide:Hammill BG et al. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation. 2010 Jan 5;121(1):63-70

Centers for Disease Control and Prevention: Million Hearts. Cardiac Rehabilitation: Saving Lives, Restoring Health, Preventing Disease” 2018. Available at: https://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdf

American Association of Cardiovascular and Pulmonary Rehabilitation. “Vital Conversations with Medical Teams & Hospital Administrators About Cardiac Rehabilitation Services Delivering Value Based Care: Lower Cost, Higher Quality, Great Value!” https://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdf.


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PARTICIPANTS FOR SYSTEMS AND SOCIETY

FOR SYSTEMS & SOCIETY

FOR HOSPITALS/HEALTH SYSTEMS

• National guidelines indicate that CR is a class 1a recommendation (AHA/ACC) for MI & CABG

• CR promotes better quality, care management and limits avoidable adverse events

− CR has reduced emergency department, avoidable hospitalizations and long-term care utilization

• CR is a relatively low-cost intervention compared to inpatient treatments for acute cardiac conditions, and provides a high return on investment given the impact of its benefits

PresenterPresentation NotesCitations from this slide:Hammil, B.G. et al. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation 2010 Jan 5;121(1):63-70Grace, S. L., et al. Cardiac rehabilitation delivery model for low-resource settings. Heart. 2016. https://doi.org/10.1136/heartjnl-2015-309209


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PARTICIPANTS REIMBURSEENT FOR HOSPITALS/HEALTH SYSTEMS: Reimbursement Overview

• Medicare Part B (Medical, vs. Inpatient Hospital, Insurance) and most private insurance provide coverage for cardiac rehabilitation.

• CMS has increased reimbursement over time.

• Two CPT codes for CR:

93798

93797

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PresenterPresentation NotesCR is an outpatient service, covered by Medicare Part B in 2 setting only: hospital outpatient service (primarily) or physician practice (MD owned-very rare because reimbursement is too low to be financially viable). See: https://www.medicare.gov/coverage/cardiac-rehabilitation-programs for more information

The two CPT codes include exercise and education, both important (and required by Medicare) components of a comprehensive CR program.

Because CR is the standard of care for selected cardiac diagnoses/events, private insurers typically cover CR.

Early outpatient CR, historically referred to as “Phase II”, is typically up to 36 sessions over 3-9 months (individualized delivery paradigm determined by patient need).

CR continues as a long-term maintenance (“Phase III-IV”) program, designed as a self-pay supervised CR program, emphasizing continued exercise and self-managed risk factor management through learned and practiced healthy lifestyle choices.


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PARTICIPANTS Data Tracking for Quality Improvement

FOR HOSPITALS/HEALTH SYSTEMS: Data for Quality Improvement, Reporting

− Tracking data as part of TAKEheart can support quality improvement

− Increasingly, CR metrics (referral, enrollment,

adherence rates; time to refer, etc.) are also being incorporated into quality performance programs and can drive reimbursement

− Reporting performance and quality metrics promotes health systems’ ability to work in a value-based, risk-taking environment, increasingly prevalent among payers.

PresenterPresentation NotesAutomating referrals is part of the TAKEheart intervention and that electronic prompt in patient records can jump start or accelerate electronic clinical data tracking more broadly for CR participants. Ongoing tracking of referrals as well as CR participation/completion rates, and general but related metrics such as readmissions, can all be part of a health system’s quality improvement and reporting strategy.

Improved data tracking promotes quality improvement, specifically improving CR referral and participation rates, because data can illuminate any gaps and areas to concentrate on to improve those outcomes. Better collection and tracking of data may also support reporting of performance and quality metrics (more, better data can increase reliability of measures reported) and can improve those rates (better quality data increases ability to report complete measures; and improved processes can lead to better outcomes).

Reporting performance and quality metrics promotes health systems’ ability to work in a value-based, risk-taking environment, increasingly prevalent among payers. To the extent payment is tied to reporting of QMs in your health system, improved quality scores can be tied to reimbursement– this is the underlying ethos of ‘pay for performance’ and ‘value based payment’ models. . Insurers are showing interest in referral rates as quality measure and factor in value-based payment. Payers increasingly looking at referral rates—for example, closed referral loop measures, emphasizing importance of referral and adherence in CR

In sum, delivery reform efforts bode for better care management, quality

Additional references:There are numerous CR measures in quality performance/measurement programs, (referral, enrollment, adherence rates; time to refer, etc.) so completing these can contribute to gains in those reporting programs For Medicare: QPP for outpatient settings (Medicare Part B), IPPS for inpatient settings (Medicare Part A) : https://qpp.cms.gov/; https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/index.html. Measure repositories across payers can be found through the National Quality Forum, http://www.qualityforum.org/Measures_Reports_Tools.aspx,. The National Cardiovascular Data Registry (NCDR), https://cvquality.acc.org/NCDR-Home/about-ncdr, can support data collection measurement, and benchmarking of cardiovascular care.Recent cardiac related measures: Randal J. Thomas, Gary Balady, Gaurav Banka, Theresa M. Beckie, Jensen Chiu, Sana Gokak, P. Michael Ho, Steven J. Keteyian, Marjorie King, Karen Lui, Quinn Pack, Bonnie K. Sanderson, Tracy Y. Wang. 2018 ACC/AHA Clinical Performance and Quality Measures for Cardiac Rehabilitation. J Am Coll Cardiol. 2018 Apr, 71 (16) 1814-1837.


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PARTICIPANTS HOW TO DEMONSTRATE TO YOUR TEAM THAT CARDIAC REHAB IS WORTH INVESTING IN

FOR HOSPITALS/HEALTH SYSTEMS: Preparing for Value-Based Care

• Payers recognizing importance of managing cardiac care, while highlighting the importance of CR:

− One example of a value based program that incentivizes better outcomes and reducing unnecessary expenditures in cardiac care is the CMS Bundled Payments for Care Improvement (Advanced) [BPCI-A]

− While improving cardiac care overall is incentivized, CR is not counted as a cost for the BPCI payment calculations. That means that hospitals get the benefit of better outcomes when they more often refer to CR, without the costs showing up in the BP cost calculation. − CMS recognizes that CR utilization incentivizes good outcomes.

PresenterPresentation NotesEpisode based care is a type of pay for performance model, which incentivize managing services for patients over the course of an “episode” for a fixed payment amount

For more information on BPCI-Advanced, see: https://innovation.cms.gov/initiatives/bpci-advanced; https://www.acc.org/latest-in-cardiology/articles/2018/10/09/15/32/cms-announces-first-bpci-advanced-cohort. Of the 32 episodes of care included in the program, 29 are inpatient and include AMI, cardiac arrhythmia, cardiac defibrillator, cardiac valve, congestive heart failure, coronary artery bypass grafting, pacemaker and percutaneous coronary intervention. Additionally, BPCI-A includes three cardiac outpatient clinical episodes, including cardiac defibrillator and PCI.

Meanwhile, BPCI and other CMS innovation models EXCLUDE CR from episodes, limiting any disincentive from utilization. CMMI acknowledges CR- so much so that CR is carved out of BPCI. Takes away unintended consequence/incentive to minimize utilization in context of an episodic or global payment.

Putting it All Together: The Value Equation

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PARTICIPANTS CARDIAC REHABILITATION IS WORTH INVESTING IN CARDIAC REHABILITATION IS WORTH INVESTING IN

increase in CR

participation

improved quality,

outcomes

increased overall value to

patients, clinicians, health systems, and

payers

Putting it All Together

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NEXT STEPS NEXT STEPS

• Action step: Prepare to make the case to your team and your leadership about why CR is worth investing in, using evidence presented here.

Putting it All Together

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NEXT STEPS RESOURCES (Abridged)

• Refer to the Module 1 Implementation Guide and Fact Sheet that may be used to communicate the value of CR to different stakeholders. See the Module 1 page on the TAKEheart website.

• Some key resources are linked below:

Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. Cardiac Rehabilitation Change Package. 2018. Available at: https://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.html Centers for Disease Control and Prevention: Million Hearts. Cardiac Rehabilitation: Saving Lives, Restoring Health, Preventing Disease” 2018. Available at: https://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdf

American Association of Cardiovascular and Pulmonary Rehabilitation. Vital Conversations with Medical Teams & Hospital Administrators About Cardiac Rehabilitation Services Delivering Value Based Care. 2018. Available at: https://www.aacvpr.org/Portals/0/Million Hearts Change Package/4.24.2018 Files/SC-2-5-CRCP-Crucial Conversations with Med Providers and Hosp Admins.pptx

https://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/tools-protocols/action-guides/cardiac-change-package/index.htmlhttps://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdfhttps://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdfhttps://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdfhttps://millionhearts.hhs.gov/files/Cardiac_Rehab_Infographic-508.pdfhttps://takeheart.ahrq.gov/takeheart-initiative/training/welcome-takeheart-initiative-and-benefits-improving-cardiachttps://takeheart.ahrq.gov/takeheart-initiative/training/welcome-takeheart-initiative-and-benefits-improving-cardiac

Future TAKEheart Training Topics

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WEBINARS

In future webinars, we will discuss: • change-management strategies • developing an action plan • modifying workflows • developing the role of a care coordinator • engaging ALL patients • ensuring access to ALL patients • & more!

Questions and Comments

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WEBINARS

To Ask a Question, Please Use the Comment Box

WelcomeAHRQ's InitiativeToday’s Webinar PresentersPatient StoryWhat is TAKEheart?Welcome to TAKEheart!TAKEheart TrainingOverview of PresentationLearning GoalsWhat is Cardiac Rehabilitation?Importance of CRThe Opportunity: How to Close the GapThe Opportunity: How to Close the GapThe Opportunity: How to Close the GapThe Opportunity: How to Close the GapBarriers to CR Participation: Why So Low?Barriers to CR Participation: Why So Low?Barriers to CR Participation: Why So Low?Barriers to CR Participation: Why So Low?Making the Case for Cardiac RehabilitationMaking the Case for Cardiac RehabilitationMaking the Case for Cardiac RehabilitationMaking the Case for Cardiac RehabilitationMaking the Case for Cardiac RehabilitationMaking the Case for Cardiac RehabilitationPutting it All Together: The Value EquationPutting it All TogetherPutting it All TogetherFuture TAKEheart Training TopicsQuestions and CommentsTAKE

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