Since 2019, the MVC Coordinating Center has emphasized the value and importance of cardiac rehab with its member hospitals, offering claims-based data reporting, workgroup presentations by experts and peers, incentive-based metrics, and other resources to drive improvement. MVC distributed refreshed cardiac rehab push reports this month that continued to benchmark utilization among MVC member hospitals—reports that complement the multi-payer registry pages by incorporating adherence and completion metrics not available on the registry.
The primary motivator behind this work is the ever-growing cohort of patients with cardiovascular disease. Every year in the US, for example, nearly 6.7 million adults manage congestive heart failure (CHF) and more than one million patients undergo cardiac surgical procedures. Cardiac rehab can help patients regain strength and confidence, manage their cardiovascular health, and return to a healthier, more active life. It also has a dose-response relationship—attending more cardiac rehab sessions is associated with lower mortality and morbidity.
The evidence of benefit is clear in the literature, and patient stories affirm its impact and benefit.
“In a sense, the initial heart surgery saved my life the first time, but cardiac rehab saved it a second time,” shared John, a former cardiac rehab participant. “The rehab people performed a small miracle by restoring my self-confidence.”
Another patient, Belinda, shared that her cardiac rehab care at Henry Ford Hospital in Detroit helped her to improve across a variety of health behaviors. “They are so supportive… it encourages you to be faithful in every area with your medication, the exercise. And plus, it helps to elevate your attitude too. It makes you just feel better; it makes you feel more alive… and then you do have something to look forward to.”
Patients like John and Belinda have continued to inspire the MVC Coordinating Center to continually support quality improvement in cardiac rehab utilization. With its latest push report, MVC continued to focus on eligible patients treated for heart attack (AMI), percutaneous coronary intervention (PCI), heart valve repair or replacement (SAVR or TAVR), or coronary artery bypass grafting (CABG), collectively referred to as the “Main 5,” as well as patients with CHF.
The report included MVC 90-day and 365-day episodes of care for adult patients with index cardiac care encounters for Main 5 or CHF conditions. MVC included all its available payer claims between Jan. 1, 2022, and March 31, 2025 (through Sept. 30, 2024 for Medicare). The report provided hospitals with benchmarking data, allowing comparisons in cardiac rehab performance with other eligible MVC hospitals across the state.
Each eligible hospital’s report included a dedicated page highlighting cardiac rehab rates across different patient populations (Figure 1). This table provided an opportunity to examine variation in cardiac rehab participation by race, insurance payer, and Distressed Community Index (DCI) categories to help hospitals better understand which patient populations were experiencing utilization gaps and may benefit from additional support.
Figure 1. Sample Blinded Table Describing Hospital’s Cardiac Rehab Rates Among Different Patient Populations
Following the patient population snapshot, MVC also provided benchmarking figures for the Main 5 and CHF patient cohorts, allowing hospitals to compare their cardiac rehab enrollment rates with those of other eligible MVC hospitals. For the Main 5 conditions, the collaborative-wide average 90-day enrollment rate during the reporting period was 34%, below the statewide goal of 40%. Hospital-level enrollment rates ranged from nearly 0% to nearly 60% (Figure 2). For CHF, the collaborative-wide average 365-day enrollment rate was 6%, also below the statewide goal of 10%, with hospital-level rates ranging from 0% to 16% (Figure 3).
Figure 2. 90-Day Cardiac Rehab Enrollment Rate After Discharge from Main 5 Cardiac Care Encounter (Blinded Report)
Figure 3. 365-Day Cardiac Rehab Enrollment Rate After Discharge from CHF Cardiac Care Encounter (Blinded Report)
In addition to traditional reporting of enrollment rates, MVC incorporated two new measures in the report—adherence and completion—to provide a more comprehensive view of patients’ engagement with cardiac rehab over time. Adherence is an AACVPR performance measure defined as the percentage of enrolled patients who completed at least 12 cardiac rehab sessions within 365 days of the index cardiac care encounter. Completion was defined as the percentage of enrolled patients who completed at least 36 sessions within 365 days of the index cardiac care encounter. Together, these measures provided insight into whether patients continued participating in cardiac rehab after their initial enrollment.
During the reporting period, the statewide average among Main 5 patients was 75% for adherence, meaning that three in four patients completed at least 12 sessions (Figure 4). The statewide average completion rate was 24%, meaning that nearly one in four enrolled Main 5 patients completed at least 36 sessions. Among patients with CHF, 68% completed at least 12 sessions, while 24% completed at least 36 sessions (Figure 5).
Figure 4. Cardiac Rehab Adherence and Completion Rates Within 365 Days After Discharge from Main 5 Cardiac Care Encounters (Blinded Report)
Figure 5. Cardiac Rehab Adherence and Completion Rates Within 365 Days After Discharge from CHF Cardiac Care Encounter (Blinded Report)
For hospitals with insufficient case counts, some figures and tables were omitted from the report. Hospitals interested in exploring their cardiac rehab enrollment data further can use the MVC Registry to analyze their hospital’s enrollment rates over time, average number of sessions completed within 90 days, and average time to enrollment (mean days to cardiac rehab). Hospitals interested in examining their cardiac rehab data beyond the information included in the report and the registry can reach out to MVC to request a custom report.
In addition to providing data on cardiac rehab, the MVC Coordinating Center offers a cardiac rehab workgroup where members and partners share strategies and insights to help improve performance. The next workgroup will take place on Tues., Oct. 20, from 12-1 p.m., focused on the content and applications of this push report. More information about upcoming MVC events can be found on the MVC events page.
MVC is a contributing partner of the Michigan Cardiac Rehab Network (MiCR), which is co-led by MVC and the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2). MiCR aims to increase statewide 90-day cardiac rehab enrollment rates to 40% among Main 5 patients, and 365-day cardiac rehab rates to 10% among eligible CHF patients. To learn more about MiCR and its resources visit https://michigancr.org/.
