04 Nov 2026
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MVC October Workgroup Highlights MVC Cardiac Rehab Push Report

MVC October Workgroup Highlights MVC Cardiac Rehab Push Report

November 4, 2026 | Comments Closed | , , , , , , , , , , , ,

In October, the Michigan Value Collaborative (MVC) hosted a cardiac rehab workgroup featuring MVC’s newly released cardiac rehabilitation (CR) push report. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including cardiac rehab, post-discharge follow-up, rural health, preoperative testing, sepsis, and health in action. View the full MVC event calendar with registration links here.

Cardiac Rehab Workgroup: MVC’s Refreshed Cardiac Rehab Push Report 

Since 2019, MVC has prioritized cardiac rehab as a value coalition campaign providing members with focused workgroups, site visits, and data resources to support quality improvement. Since then, MVC has continuously offered multi-payer reporting and benchmarking on a variety of cardiac rehab focused measures, first by offering dedicated push reports refreshed twice each year, followed by the launch of multi-payer reports on the MVC registry and the incorporation of cardiac rehab measures in the MVC Component of the BCBSM Pay-for-Performance (P4P) Program.

MVC continued to update data for its members by refreshing cardiac rehab push reports in September (read September 2026 blog for report details). MVC shared a stand-alone cardiac rehab push report this year, whereas recent years incorporated these data within a larger process measures push report.

During this month’s cardiac rehab workgroup, MVC Associate Program Manager Jana Stewart, MPH, provided a report walkthrough to familiarize MVC members with its data and changes relative to prior versions. In addition to traditional measures of enrollment, the latest report included measures of adherence and completion, in alignment with AACVPR performance measures.

Stewart said this expanded approach highlighted important opportunities for quality improvement along the patient care journey, from initial referral and enrollment processes to downstream retention strategies and patient barriers to participation. The measures were defined as:

  • Enrollment: The percentage of eligible patients who attend at least one cardiac rehab session within 90 days (Main 5 patients) or 365 days (CHF patients) of hospital discharge
  • Adherence: The percentage of enrolled patients who completed at least 12 cardiac rehab sessions within 365 days of discharge
  • Completion: The percentage of enrolled patients who completed at least 36 cardiac rehab sessions within 365 days of discharge

Together, Stewart described how these measures can help hospitals and cardiac rehab partners identify where patients may be falling out of the care pathway, starting with initial referral and enrollment through continued program participation and completion. Stewart encouraged members to use the provided patient characteristics table (Figure 1) to assess differences in cardiac rehab outcomes between different patient groups as well as identify patient gaps driven by non-medical drivers of health. The report also provided hospital-level comparisons with statewide averages, allowing members to assess their performance relative to their peers.

Figure 1. Slide highlighting Table 1 patient characteristic data from September 2026 cardiac rehab push reports

Table infographic titled “Your Hospital’s Cardiac Rehab Rates Among Different Patient Populations,” comparing cardiac rehabilitation metrics across patient categories. Rows cover race/ethnicity, payer, and residence in an at-risk ZIP code, with columns for distribution, 90-day enrollment, 365-day enrollment, adherence, and completion; blue table and orange-on-blue title panel emphasize population differences.

After reviewing the specifics of the updated push report, Stewart provided a brief look at statewide performance on each of these measures for the Main 5 and CHF patient populations. Overall, the findings demonstrated some progress in enrollment while highlighting opportunities to strengthen adherence and completion.

The Michigan Cardiac Rehab Network (MiCR) reported on cardiac rehab adherence and completion rates one year ago at its fall 2025 meeting, which compared participant adherence and completion rates across CR programs. This data presentation revealed a positive association between adherence rate and completion rate, with more consistently higher adherence rates observed amongst sites with higher completion rates (Figure 2). However, there were also sites with high adherence rates and low completion rates, suggesting a high adherence rate does not guarantee a high completion rate.

Figure 2. Cardiac Rehab Adherence and Completion Rates at Centers Across Michigan

Scatter plot compares adherence rate across 12 sessions with completion rate across 36 sessions, using gray filled dots and red open circles against a 0%–100% completion-rate axis. Gray adherence values remain mostly 60%–85%, while red completion values rise steadily from 0% to about 52%, with labels and legend identifying each series.

Benchmarking Statewide Enrollment, Adherence, and Completion

The statewide cardiac rehab enrollment rate provided for Main 5 conditions was 34%, up from approximately 24% when focused improvement efforts began in 2019. However, this remains below the MiCR statewide goal of 40% and well below the Million Hearts goal of 70% for all eligible cardiac rehab participants.

For patients with CHF, the statewide enrollment rate of 6% also still falls short of MiCR’s 10% goal. Unlike enrollment for the Main 5 conditions, CHF enrollment rates have seen little improvement over the last few years. These findings reinforced the importance of an effective referral process, patient education, and continued engagement on the initiation of cardiac rehab for CHF patients. During the discussion, participants emphasized that heart failure patients may need additional time and repeated referrals before they initiate cardiac rehab.

Stewart emphasized how the additional measures of adherence and completion rates offered further insight into patient participation and full benefit from the program after enrollment. For the Main 5 conditions, the statewide adherence rate was 75% for the report's timeframe, meaning that approximately three-quarters of enrolled patients completed at least 12 sessions. However, the statewide completion rate among Main 5 patients was just 24%, reflecting the proportion of enrolled patients who completed 36 sessions within one year. For CHF, rates were similar to those of the Main 5 population—the statewide CHF adherence rate was 68%, while the completion rate was 24%.

Identifying Barriers and Supporting Patient Participation

During the workgroup discussion, members explored several factors that may affect enrollment, adherence, and completion. Common themes of the discussion included:

  • Provider endorsement and patient education: A clear recommendation from a physician can help patients understand why cardiac rehab is an important part of their recovery journey.
  • Financial and transportation barriers: Copays and the challenges of traveling to multiple appointments are known barriers for certain patient populations that may show up as low adherence or completion rates. Further analysis of cardiac rehab performance across payer and demographic groups could help better understand where additional support may be needed.
  • Flexible scheduling and delivery options: Flexible appointment times and hybrid cardiac rehab delivery models may help patients overcome scheduling and transportation challenges to improve adherence and completion.
  • Patient stories and testimonials: Participants discussed that patients may not feel ready to participate in cardiac rehab immediately after discharge, making continued outreach and education especially valuable. For patients with CHF in particular, the timing of referrals and reminders can be important. MiCR’s newest Heart-to-Heart initiative offers patient-story videos and testimonials that programs can use to help recruit patients for cardiac rehab, available on MiCR’s YouTube page.

These strategies offer starting points for local quality improvement. Stewart encouraged members to use their new cardiac rehab report findings to identify opportunities, engage relevant clinical and operational partners, and determine which approaches may be most appropriate for their patient populations. Members can also use the MVC registry to explore additional breakdowns of their data. For hospitals interested in more detailed analyses, MVC is available to discuss custom report opportunities.

MVC Cardiac Rehab Workgroup: Oct. 20, 2026

MVC welcomes workgroup presenters from across Michigan to share their expertise, success stories, initiatives, and solution-focused ideas with MVC members. Please reach out to the Coordinating Center by email if you are interested in being a workgroup presenter or submit a presentation proposal here.

01 Jul 2026
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MVC June Workgroups Highlight Cardiac Rehab Telehealth & Using AI for Physician Feedback and QI in the ED

MVC June Workgroups Highlight Cardiac Rehab Telehealth & Using AI for Physician Feedback and QI in the ED

July 1, 2026 | Comments Closed | , , , , , ,

In June, the Michigan Value Collaborative (MVC) hosted two virtual workgroup presentations. The first was a cardiac rehabilitation (CR) workgroup that doubled as a Michigan Cardiac Rehab network (MiCR) telehealth forum focused on virtual group CR programming with a live action demonstration. The second workgroup, health in action, focused on how artificial intelligence (AI) can be utilized to improve follow-up care for patients. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including CR, post-discharge follow-up, sepsis, rural health, preoperative testing, and health in action.

Cardiac Rehab – MiCR Telehealth Forum

MVC and the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) co-lead MiCR, an initiative to improve CR utilization across Michigan. In April, MiCR launched a new virtual forum series to help programs implement and sustain telehealth services under recently extended Medicare reimbursement policies. MVC’s June workgroup hosted the second MiCR telehealth forum in the series, this time featuring a demonstration of group virtual CR by Henry Ford Health’s Steven Keteyian, PhD, Director of Cardiac Rehabilitation & Preventive Cardiology, and Robert Berry, MS, ACSM-CEP FAACVPR, Clinical Coordinator for Cardiac Rehabilitation. The demonstration was followed by a discussion led by MiCR’s Co-Directors, Jessica Golbus, MD, MS, and Mike Thompson, PhD, MPH.

Telehealth Group Example

The workgroup began with a live mock CR telehealth session led by Berry and Keteyian. Three actors representing patients (played by MVC’s Jessie Souva, MSN, RN, C-ONQS; Emily Woltmann, PhD, MSW; and Rachel Folk, MHA) were guided through a simulated telehealth group CR session.

After presenter introductions, Berry began the group CR class greeting the patient actors, who each represented a specific patient profile and common cardiac condition (Figure 1).

Figure 1. Patient Profiles for Cardiac Rehabilitation Mock Session

Illustration featuring three female characters representing patients with heart conditions, each accompanied by brief medical histories and personal details. Key information includes ages, specific diagnoses like myocardial infarction, coronary artery bypass surgery, and chronic heart failure, along with lifestyle notes and emotional states, presented with distinct colors and icons for clarity.

To begin the session, Berry checked in with each patient on the Zoom session to document the type of exercise or equipment they would be using. As Figure 2 shows, the group session looked similar to a Zoom meeting with all patients exercising simultaneously from locations they established with their instructor in advance. Each patient confirmed their exercise modality, weight, and heart rate as they engaged in their chosen activity. Throughout the exercise process, patients were asked questions about how the exercise was feeling and whether it was causing any pain or discomfort. If a patient was having symptoms, Berry would follow up with more specific questions to help pinpoint the problem area and would give advice for either modifying the exercise, utilizing intentional breathing techniques, or taking a break.

Figure 2. Screenshot of Mock Telehealth CR Session

Screen capture showing what a virtual cardiac rehabilitation group session looks like. Shows three female participants and one clinical professional.

The patients had an opportunity to ask Berry follow-up questions before the end of the session such as:

  1. How will I know when it’s safe to push harder?
  2. Should I continue with CR exercises if my energy level is low today?
  3. When/how do I share my tracked vitals and symptoms with my providers?
  4. How do I get in touch with you between sessions?
  5. Can I still participate in virtual sessions if I’m at my home in Florida?

Following the live demonstration, Golbus and Thompson led participants in a question-and-answer discussion that further clarified how virtual and telehealth CR programs can work. Keteyian and Berry shared that patients must be at their home address for certain payers (Medicare/Medicaid), but patients with other insurance such as Blue Cross Blue Shield of Michigan (BCBSM) can be at any location within the state of Michigan.

Some attendees wondered about confidentiality considerations during the group session. Henry Ford Health said their programming has not required participants to sign an additional Health Information Portability Insurance Portability and Accountability Act (HIPAA) release form; however, they do remind patients to be aware of what information they share in the presence of others during the group session. For people who may be uncomfortable sharing personal information such as weight, different wording can be used. For example, “has your weight changed since your last visit?”

For patients who are unsure about participating in a virtual setting, Keteyian pointed out that they often have the patient come into the facility for the first session to participate as if they were at home in a virtual environment. This often alleviates any concerns about fully participating in a telehealth setting in the future. For those patients who do not have exercise equipment at home, Berry shared that patients can usually find some form of exercise equipment to borrow from a family member, church, or neighbor, or will choose to walk during their session.

A poll of participants showed the current state of CR programming for sites represented at the forum (Figure 3-4), with most sites indicating an interest in exploring both group and individual telehealth CR.

Figure 3. Polling Question: What format of virtual CR is your site considering?

Polling bar chart showing frequency of four formats of virtual cardiac rehab being utilized: Both, Group, Individual, and Neither. Both has highest value near 19, followed by Neither at 13, Group at 8, and Individual at 7, with vertical axis ranging from 0 to 20.

Figure 4. Polling Question: What best describes your site's status on starting a virtual CR program?

Pie chart displays stages of virtual cardiac rehabilitation (CR) implementation among organizations. Largest segment (21) represents organizations considering virtual CR, followed by 12 having conversations with staff or leadership, and smaller segments of 3 each for program development and piloting or delivering virtual CR, with color-coded legend for clarity.

According to the polls, most workgroup participants are still considering CR program development and starting to have conversations with staff and leadership. The MiCR team encouraged participants to take these poll questions back to their teams and leadership to inspire discussion on developing a hybrid or telehealth CR program.

MiCR Telehealth Virtual Forum: June 9, 2026

Health in Action Workgroup – Michigan Medicine

MVC was joined by the University of Michigan’s Alexander Janke, MD, MHS, MSc, Assistant Professor of Emergency Medicine, and Florian Schmitzberger, MD, MS, Clinical Assistant Professor of Emergency Medicine, for the health in action workgroup. Their presentation focused on how AI can be used for clinical feedback and quality improvement workflows in various healthcare settings.

Janke shared that emergency clinicians often make high-stakes clinical decisions when treating patients but then have limited feedback on how their patients do as they move through their care pathway. The rapid patient traffic through the emergency department (ED) continuously pulls these providers into new patient cases, preventing them from having the time to manually review past patient charts. A feedback loop project was intended to help address practice variation, missed learning opportunities, and potential quality blind spots. In preparation for the launch of the project, Michigan Medicine sought approval from the institutional review board (IRB), utilized a large language model (LLM) that is HIPAA compliant, and completed a health information technology services review. They also gathered clinical intelligence committee input, Epic database integration support, and input from the division of clinical informatics.

Methods

Previous approaches to reviewing patient progress included manual chart reviews (time consuming), self-imposed reminders via Epic’s in-basket messaging system, or by hearing about a patient’s follow-up by word-of-mouth. With the introduction of AI as a feedback tool, clinicians would have access to LLMs that can read charts faster than a human reviewer, create tailored summaries for the emergency medicine context, and provide another means for learning by supporting clinicians within their limited time. The AI feedback process follows this flow:

  1. Flag the case – A clinician marks a patient of interest during the shift via a health education research (HER)-integrated workflow
  2. Wait – A specified time later—three to 14 days—the platform queries downstream documentation
  3. AI summary – The University of Michigan generative pre-trained transformer (GPT) Toolkit (HIPAA-compliant LLM) generates a tailored clinical summary with a structured prompt
  4. Deliver – An email arrives in the clinician’s institutional inbox and includes a patient identifier for recall, an emergency medicine-focused summary, and answers to any free-text questions
  5. Reflect – The clinician reviews, learns from the outcome, and adjusts future practice enabling the adaptive learning cycle

The process begins with the provider flagging a patient case they would like educational feedback on in the future. Flagging a case is done in the “Disposition View” of the clinician decision tree in Epic (Figure 5). After the waiting period of the patient progressing through levels of care and finally discharging from the hospital, the HIPAA compliant UM GPT will send the provider a summary directly to their institutional email.

Figure 5. Disposition View in Epic MyChart

Screenshot of a medical software interface showing a disposition view with color-coded task categories and a follow-up order section. Tasks include work/school/sport excuses and patient portal letters in green and blue boxes, with a follow-up question form on the right allowing email summary timing selection and additional patient questions.

To validate that the AI summary was providing impactful and meaningful patient information, Schmitzberger and Janke developed a structured validation procedure for 200 AI-generated case summaries measuring for accuracy, conciseness, helpfulness, and completeness. The initial scoring showed that the AI summaries were quite accurate and helpful (Figure 6). This early positive feedback has prompted continued work on developing the use of this program in other areas of the institution.

Figure 6. Structured Validation of 200 AI-Generated Case Summaries

A table displays four performance metrics for validation of 200 AI-generated case summaries with scores out of 5: Accuracy (4.79), Conciseness (4.86), Helpfulness (4.60), and Completeness (4.28). Each metric is labeled in red text below the blue numerical scores.

Results

Currently the program includes 170+ unique users including faculty, residents, and physician assistants, who are averaging approximately 40 – 70 requests each week, and 30+ power users (a clinical or other staff member who maximizes Epic electronic health record (EHR) efficiency using advanced tools and navigation).

The top three case follow up themes for requested summaries included diagnosis/etiology (~40%), disposition/course/ICU (~17%), and test/imaging results (~10%). With strong approval in the emergency department and endorsement from other committees, the goal is to expand this feedback program to multiple areas within the institution.

Next Steps & Discussion

Janke presented two pathways in which they would like to proceed with expanding the AI feedback program. The first would be horizontal scaling across the institution, including integration into the graduate medical education program for internal medicine/hospitalist care. Second, they would like to apply their approach to a quality measure from the Michigan Emergency Department Improvement Collaborative (MEDIC).

The presenters addressed participant questions about sharing learnings between providers, patient record privacy, and potential applications in other areas like pediatric care and fall prevention, with participants suggesting connections with the Michigan Hospital Medicine Safety Consortium (HMS) metrics and exploring CEUs as incentives for provider participation.

MVC Health in Action Workgroup: June 25, 2026

MVC welcomes workgroup presenters from across Michigan to share their expertise, success stories, initiatives, and solution-focused ideas with MVC members. Please reach out to us by email if you are interested in being a workgroup presenter or submit a presentation proposal here.

24 Jun 2026
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MVC Thanks Presenters from the First Half of 2026

MVC Thanks Presenters from the First Half of 2026

June 24, 2026 | Comments Closed | , , ,

The MVC Coordinating Center wishes to express its heartfelt appreciation for the 39 generous healthcare professionals who stepped forward to present during MVC’s first and second quarter virtual workgroups, spring collaborative-wide meeting, and Michigan Cardiac Rehabilitation network (MiCR) virtual forums on telehealth rehabilitation. The MVC Coordinating Center would not be able to deliver the variety of high-quality educational opportunities without the contribution of these dedicated volunteer presenters. We know that MVC’s members and partners have many demands on their time from within their own organizations and beyond. Nonetheless, these 39 guest speakers shared their data, innovative approaches, best practices, and insights to support our shared goals of peer learning and high-value care delivery for Michigan patients. We appreciate you contributing in this important way. You DO make a difference!

Join us in giving these folks a well-deserved round of applause:

Cardiac Rehab Workgroup

  • Robert Berry, MS, ACSM-CEP, FAACVPR, Clinical Coordinator Cardiac Rehabilitation, Henry Ford Health Henry Ford Hospital
  • Zach Johnson, BS, ACSM-CEP, Lead Exercise Physiologist for Cardiac and Pulmonary Rehab Programs, Corewell Health
  • Steven Keteyian, PhD, Bioscientific Clinical Staff, Division of Cardiovascular Medicine, Henry Ford Health Henry Ford Hospital
  • Laura Meiste, RN, BSN, Manager of Cardiac and Pulmonary Rehab, Holland Hospital
  • Greg Scharf, BS, CEP, CCRP, Cardiopulmonary Rehab System Manager, MyMichigan Health
  • Mike Thompson, PhD, FAHA Associate Professor of Cardiac Surgery, Michigan Medicine
  • Tyelor Wymer, CEP, BS, Cardiology Supervisor, University of Michigan Health-Sparrow

Health in Action Workgroup

  • Jennifer Hengy, BSN, RN, Internal Quality Improvement Specialist Sr., Corewell Health Farmington Hills
  • Alexander Janke, MD, MHS, MSc, Assistant Professor of Emergency Medicine, University of Michigan
  • Eugene Laveroni, MD, Chief of Surgery, Corewell Health Farmington Hills
  • Florian Schmitzberger, MD, MS, Clinical Assistant Professor of Emergency Medicine, University of Michigan
  • Leslie Smith, RPh, JD, BCPS, BCIDP, Clinical Pharmacist Specialist, Corewell Health Farmington Hills

Post-Discharge Follow-Up Workgroup

  • Steven Frazier, BA, RN, ACM-RN, Director of Quality and Patient Safety Post-Acute, MyMichigan Health System
  • John Hagan, DO, Medical Director - Care Coordinating Center, MyMichigan Health System

Rural Health Workgroup

  • Heather Baumeister, BSN, RN, CRHCP, Director of Healthcare Practices, McKenzie Health System

Sepsis Workgroup

  • Tami Garcia, MSN, RN, Sepsis Process Lead, Michigan Medicine
  • Carly Redstone, MSN, RN, Sepsis Coordinator, Michigan Medicine

Spring Collaborative-Wide Meeting Panelists

  • Alex Callaway, MBA, CPHQ, CPPS, Regional Quality Director, Munson Health System
  • Emily Nerreter, MBA, CPC, CRC, Pay for Performance & Registries Manager, Henry Ford Health System
  • Stephanie Pins-Schallip, MSA, CPHQ, Director of Value Analysis & Enhancement, MyMichigan Health

Spring Collaborative-Wide Meeting Breakout Session Speakers

  • Belinda Dokic, CPhT, BA, MBA, Post-Acute Care Manager, Trinity Health Alliance of Michigan
  • Cindy Ingersoll, RN, BSN, CCM, Post-Acute Care Manager, Trinity Health Alliance of Michigan
  • Adrien Ross, MSN, RN, CPHQ, Lead, Quality Improvement Specialist, Corewell Health
  • Heidi Steinhebel, RN, BSN, CCM, Senior Associate Director of Care Management, Trinity Health IHA Medical Group
  • Caitlin Valley, MHA, MPH, CHES, Director of Quality and Population Health, Trinity Health IHA Medical Group
  • Larrea Young, MDes, Multimedia Design Project Manager, Healthy Behavior Optimization for Michigan

Spring Collaborative-Wide Meeting Poster Presenters

  • Jennifer Bennett, MBA, BSN, RN, Lead Quality and Patient Safety Coordinator, Henry Ford Health Madison Heights-Warren Hospital
  • Sara Hagerman, BSN, RN, Community Hospital Quality Lead, University of Michigan Health – Sparrow Carson
  • Ginger Johnson, OTR, Manager Post-Acute Care, Populance, Henry Ford Health System
  • Mike Johnson, Primary Care Practice Administrator, Munson Healthcare East Region
  • Liz Monk, System Director of Patient Care Manager, Munson Healthcare
  • Gloria Rey, PA-C, MPH, Director Post-Acute Care, Populance, Henry Ford Health System
  • Audra Stoker, PMP, Manager Post-Acute Care Network Development, Populance, Henry Ford Health System

Virtual Networking Event

  • Richard Wylde, MSc, Deputy Director of Improvement at Leeds and York Partnership NHS Foundation Trust

MiCR Virtual Forums on Telehealth Cardiac Rehabilitation

  • Robert Berry, MS, ACSM-CEP FAACVPR, Clinical Coordinator of Cardiac Rehabilitation, Henry Ford Health
  • Samantha Fink, BS, Administrative Manager, Domino’s Farms Cardiology, Michigan Medicine
  • Steven J. Keteyian, PhD, Bioscientific Clinical Staff, Division of Cardiovascular Medicine, Henry Ford Hospital
  • Diane Perry, MS, ACSM-CCEP, CHWC, Certified Clinical Exercise Physiologist, Michigan Medicine
  • Kat Steenson, MS, Clinical Exercise Physiologist, Henry Ford Health
Graphic design featuring silhouettes of eight business people standing above bold text reading "THANK YOU" on a blue bokeh background. Two circular shapes contain Michigan Value Collaborative logo on left and text "From all of us at MVC" on right, expressing gratitude from the organization.

The MVC members and partners who attend MVC events appreciated these presenters, too. Here are just a few of the many glowing survey responses MVC received about presenters and their content in the first half of 2026.

Screenshot of five positive testimonial quotes about MVC workgroups and collaborative-wide meetings, displayed in white text with orange quotation mark icons on a blue background. Quotes highlight benefits such as insightful content, flexible conversation, valuable information sharing, and practical application for sepsis process development in emergency department triage.

As a reminder, past workgroups and virtual networking event recordings can be viewed on MVC’s YouTube channel, and presentation slides and materials from MVC’s spring collaborative-wide meeting can be viewed here.

Do you have valuable information to share?

Whether you are new to presenting or a seasoned pro, the MVC Coordinating Center is here to support you every step of the way. From exploring topic ideas to preparing information and managing event logistics, our team makes the experience of presenting easy and comfortable. The P4P points you can earn as a presenter are a great benefit to your organization, too. For more information about presenting, contact the MVC Coordinating Center or submit a proposal here.

20 May 2026
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Key Takeaways from MiCR’s First Telehealth Cardiac Rehab Forum

Key Takeaways from MiCR’s First Telehealth Cardiac Rehab Forum

May 20, 2026 | Comments Closed | , , , , , ,

Since 2019, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) and the Michigan Value Collaborative (MVC) have worked together to improve cardiac rehabilitation utilization in Michigan. This collaboration led to the founding of the Michigan Cardiac Rehabilitation network (MiCR) in 2022, a partnership that endeavors to increase participation in cardiac rehab for all eligible individuals in Michigan through clinical practice sharing, networking, data benchmarking, and the dissemination of resources.

On April 17, MiCR invited practitioners from across Michigan to discuss the evolving role of virtual and hybrid cardiac rehabilitation programming amidst recent legislative wins. In February, Congress advanced the Consolidated Appropriations Act, 2026 (H.R. 7148), which extends Medicare telehealth and in-home cardiopulmonary rehabilitation flexibilities through December 31, 2027. With this extension, cardiac, intensive cardiac, and pulmonary rehab programs in both hospital outpatient and physician office settings can continue delivering services virtually using two-way audio and video technology through the end of 2027. This two-year window gives programs the opportunity to launch or expand hybrid rehab models, try new approaches to reach patients who have difficulty attending in-person sessions, and plan with greater confidence while longer-term policy solutions are explored.

MiCR kicked off the forum emphasizing its mission and the progress made to date in statewide enrollment, with participation rates for eligible cardiac patients across the collaborative increasing from 24% in 2020 to 35% in 2024. Despite progress being made, the state is still short of the MiCR goal of 40% enrollment within 90 days of discharge from eligible procedures (Figure 1), as well as the Million Hearts goal of 70% enrollment.

Figure 1. Trends in cardiac rehab enrollment within 90 days of discharge from AMI, CABG, PCI, SAVR, or TAVR encounter

Line graph showing yearly trends in cardiac rehab participation within 90 days of discharge from various cardiac procedures between 2020 and 2024. The graph compares actual MVC participation rates, increasing from 24% in 2020 to 35% in 2024, against a constant MiCR goal of 40%, highlighting a gradual upward trend.

MiCR conducted a short survey in 2025 about telehealth programming in cardiac rehab to better understand opportunities to close the enrollment gap using telehealth, and how leaders and care teams feel about offering telehealth options. Of the 27 cardiac rehab sites that responded, only two were currently offering some form of virtual cardiac rehab, while some others expressed interest in launching or further investigating virtual service options.

Defining Cardiac Rehab Delivery Models

Prior to initiating a discussion, MiCR reviewed several key definitions to clarify terminology surrounding evolving cardiac rehab delivery models:

  • Traditional in-center delivery: synchronous, in-person care
  • Virtual delivery: synchronous, real-time, audio-visual communication
  • Remote delivery: asynchronous communication between patients and providers
  • Hybrid delivery: use of more than one of the methods noted above.

The forum focused primarily on virtual and hybrid delivery approaches given insurance reimbursement stipulations. MiCR emphasized how hybrid models may offer optimal opportunities for organizations to balance flexibility, patient engagement, and clinical oversight.

Health Systems Share Real-World Virtual Cardiac Rehab Experiences

The forum next featured presentations from two Michigan hospitals currently offering virtual or hybrid cardiac rehab programming.

Henry Ford Health

Steven Keteyian, PhD, Bioscientific Clinical Staff in the Division of Cardiovascular Medicine, and Kat Steenson, MS, Clinical Exercise Physiologist, shared insights into Henry Ford Health’s hybrid cardiac rehab model, including their group virtual session structure.

Dr. Keteyian spoke to the importance of designing a virtual program as similar to current in-center facility programming as possible – including using the same forms, outcome measures, even times that the classes are offered. He noted that this simple mindset may help to streamline implementation and workflows. Additionally, Dr. Keteyian encouraged programs considering virtual care to engage physician champions and optimize internal billing support when getting started.

Steenson discussed her experience delivering both traditional in-center and virtual cardiac rehab care and highlighted the important opportunity virtual delivery offers to extend services to patients facing transportation, scheduling, or geographic barriers. She also encouraged sites to develop virtual programming in line with current in-person practices, noting that this makes it easier on the staff ultimately delivering the services.

Michigan Medicine

Next, Samantha Fink, Administrative Manager of Domino’s Farms Cardiology, and Diane Perry, MS, ACSM-CCEP, CHWC, Certified Clinical Exercise Physiologist, outlined Michigan Medicine’s participation in a research pilot for virtual cardiac rehab delivery over the last two years.

Fink highlighted the importance of combining operational planning, process improvement, and patient accessibility initiatives when initially building virtual programs. She noted that while their patients expressed significant interest in virtual options, not all were set up for success—lacking reliable technology, exercise equipment, or appropriate health screenings prior to starting virtual cardiac rehab. Fink also encouraged sites to establish clear emergency protocols and steps for assessing the appropriateness of virtual care.

Perry then shared her perspective as an exercise physiologist on adapting patient support, exercise guidance, and engagement strategies for the virtual environment. She also endorsed a hybrid program, and she spoke in more detail about the importance of in-person initial assessments to confirm the appropriateness of virtual cardiac rehab.

Telehealth as a Tool to Improve Access

After introducing example programs, MiCR Co-Directors Jessica Golbus, MD, MS, and Michael Thompson, PhD, MPH, facilitated a panel discussion on future implementation opportunities, reimbursement considerations, and collaborative learning across Michigan programs.

Throughout the discussion, the panelists repeatedly emphasized that virtual cardiac rehab is not intended to replace traditional in-center rehab but rather enhance access and reduce long-standing barriers to participation. The panelists pointed out that virtual and hybrid approaches may help programs better serve patients with access barriers, such as rural patients, individuals with transportation limitations, working adults, caregivers, and patients with scheduling challenges. Discussion also reinforced that flexibility in care delivery models may improve patient adherence and completion rates. Lastly, the panelists underscored that successful digital transformation in healthcare is less about chasing trends and more about building practical, individualized programs that improve visibility, efficiency, and accessibility.

The webinar concluded with a call for continued innovation and collaboration as health systems explore new ways to improve cardiac rehab participation. With the extension of federal telehealth flexibilities through the end of 2027, presenters encouraged hospitals to consider this time as an opportunity to pilot, expand, and evaluate virtual cardiac rehab programs. For those interested in learning more about virtual cardiac rehab, the following resources may assist your organization’s journey:

Additionally, you can reference the recording of this forum via YouTube.

MiCR will host a second virtual forum discussion on Tues., June 9, from 12-1 p.m. featuring a demonstration of Henry Ford Health’s group virtual cardiac rehab programming. Registration is available now.

04 Mar 2026
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February Workgroup Highlights Increasing Cardiac Rehabilitation Utilization with a Member Panel and MVC Data

February Workgroup Highlights Increasing Cardiac Rehabilitation Utilization with a Member Panel and MVC Data

March 4, 2026 | Comments Closed | , , , , , ,

In February, the Michigan Value Collaborative (MVC) hosted a virtual cardiac rehabilitation workgroup presentation featuring a panel of cardiac care specialists. The panel focused on discussing chronic heart failure metrics related to the pay for performance (P4P) program and how cardiac rehabilitation (CR) can play a vital part in the recovery process for congestive heart failure (CHF) patients. The MVC Coordinating Center hosts workgroup presentations once or twice per month, covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action.

Cardiac Rehabilitation Workgroup – MVC and Member Panel 

For this workgroup MVC was joined by panelists Tyelor Wymer, CEP, BS, Cardiology Supervisor at University of Michigan Health (UMH) Sparrow-Clinton; Laura Meiste, RN, BSN, Manager of Cardiac and Pulmonary Rehabilitation at Holland Hospital; Zach Johnson, BS, ACSM-CEP, Lead Exercise Physiologist for Cardiac and Pulmonary Rehabilitation Programs at Corewell Health; Greg Scharf, BS, CEP, CCRP, Cardiopulmonary Rehabilitation System Manager at MyMichigan Health; and Mike Thompson, PhD, MPH, Associate Professor of Cardiac Surgery at Michigan Medicine

CHF Goals and Metrics

MVC’s Site Engagement Coordinator Emily Bair, MS, MPH, RDN, CSP, began the workgroup by reviewing CHF P4P metrics for program years 2026 – 2027, which is part of MVC’s Cardiac Rehabilitation Value-Based Initiative. These included an episode spending metric focused on CHF episodes of care and a value metric that tracks the 7-day follow up care for CHF episodes of care. In addition to discussing the P4P CHF metrics, Bair reviewed current CR standards that MVC uses for measuring the CR value-based initiative, including Michigan Cardiac Rehabilitation Network (MiCR) standards and the Million Hearts Campaign CR goal for CHF patients (Figure 1).

Figure 1. MVC, MiCR and Million Hearts CR Goals for CHF Patients

Presentation slide titled "Goals & Metrics" outlining cardiac rehabilitation follow-up and start rate targets. It lists MVC P4P Metrics with a 7-day follow-up after CHF, Michigan Cardiac Rehab Network aiming for 10% of CHF patients to start CR within 365 days, and Million Hearts with ACC and AHA targeting 70% of eligible patients to start CR within 365 days.

MVC Registry and Data Reports Resources

Bair highlighted some of MVC’s relevant data reports and how the episodes of care are built within the MVC data registry. Bair noted that MVC episodes of care have a slightly different post-discharge window for CHF patients in CR, 365 days (Figure 2), versus the 30 – 90-day windows for patients with cardiac conditions such as percutaneous coronary intervention (PCI)/coronary artery bypass grafting (CABG). The MVC data registry has several useful cardiac related reports including,

Multi-payer CR reports which evaluate CR utilization and other metrics provided in MVC’s hospital-level reports:

  • CR Utilization Rates
  • CR Utilization Rankings
  • Mean Days to First CR Visit
  • Mean Number of CR Visits

Payer specific reports which allow registry users to investigate utilization, readmissions rates, and cost of care including:

  • Episode Payment Report
  • Episode Utilization Rate Report
  • Readmissions Report
  • CR Report

Figure 2. Example of MVC Registry CR Utilization Rate within 365 Days After Discharge for CHF, Jan. 2024 – Mar. 2025 (MVC All, blinded):

Dotted line graph

The graph above shows that from Jan. 2024 – Mar. 2025, the MVC All average was  6% for CR participation within 365-days post-discharge for CHF patients. With the MiCR goal being a 10% CR utilization for CHF patients and the overall utilization range being 0% to 19%, it is clear there is room for improvement across the MVC member portfolio.

Push reports are another useful resource offered by MVC. The Process Measures Report that MVC shared with members in January 2025 had helpful visuals of site and system 7-day follow up data for CHF episodes of care (Figure 3).

Figure 3. MVC Process Measures Report – 7-day follow up after CHF

example of MVC Process Measures Report for 7-Day Follow-Up After CHF content including vertical bar charts and line graphs

Panel Discussion

The focus for the panel discussion centered around how CR services can be utilized to support rehabilitation of CHF patients who may not be able to participate in rehabilitation as quickly as those that have conditions such as PCI or CABG. Bair began the discussion by leading participants through a common care pathway for CHF patients who utilize CR (Figure 4).

Figure 4. CHF Follow-Up and Cardiac Rehabilitation Typical Patient Pathway

Diagram illustrating the typical CHF patient pathway with five key stages: Admission, Discharge, Follow-Up, Cardiac Rehab, and Readmission. Annotations highlight transitions such as patient diagnosis, care shift from inpatient to outpatient, appointment scheduling, referral placement, and follow-up care including rehab and emergency department utilization.

CHF Barriers to Care and Change Concepts

To help organize a solutions-based approach, Bair went on to introduce the Change Concepts Model, 2nd Ed. (Figure 5) adapted from the Million Hearts Initiative to address some of the common barriers seen in CHF care.

From the Million Hearts Change Package, 2nd Ed., some notable barriers to care for CHF follow-up in CR include:

  • Patient or provider lack of awareness
  • Lack of clear and consistent communication
  • No integration of CHF cardiac rehabilitation needs into cardiovascular services or workflows
  • Limited capacity of CR programs
  • Patient transportation, financial burden, competing responsibilities or cultural/language barriers

Figure 5. Million Hearts Change Concepts

Flowchart illustrating four stages of a process: Systems Change, Referrals, Enrollment and Participation, and Adherence.

Systems Level Change

Bair shared some of the ways systems change could be implemented including establishing a hospital CHF champion, engaging hospital administrators and senior staff, securing and maintaining a multidisciplinary workforce, engaging the cardiac care team in the follow-up care and rehabilitation planning, tracking follow-up/CR referrals, enrollment rates, and patient participation as quality-of-care indicators.

UMH Sparrow-Clinton’s Tyelor Wymer shared that they have had success with appointing CHF champions in their centralized cardiac care team. Team members rotate through four to five different UMH Sparrow hospitals, fostering consistent care practices across the health system. MyMichigan Health System’s Greg Scharf shared that they have a similar system wide collaborative team for heart failure care, and they have had great success as well.

At Holland Hospital, Laura Meiste shared that they have a care transitions team that works in the cardiology department and focuses specifically on patient follow-up within seven days of discharge, while also working on maintaining consistent communication with the administrative staff that schedules patient appointments.

Optimizing Referrals

Another opportunity to reduce barriers to care is by improving the referral process itself. This can be done by using data to drive improvements and incorporating referrals into standardized processes. Some examples include:

  • Adding CHF cardiac rehabilitation language to echo reports for patients with reduced ejection fraction (EF) that meet the appropriate criteria for CR
  • Including a referral to CR in order sets for patients with CHF
  • Adding CR to guideline-directed medical therapy algorithms for patients with CHF

Scharf shared that optimizing referrals is an ongoing challenge in MyMichigan Health’s system where there might be a standardized best practice advisory (BPA) for CHF in general, but there is no built-in trigger for flagging a CHF case as CR appropriate. Working in the Epic electronic health record (EHR) program, they can create custom BPAs for this, but it takes time and education.

Meiste shared that at Holland Hospital, an auto-referral process through an order set triggers a case in the system to be sent to clinical staff for CR eligibility screening. If the case meets eligibility criteria, the staff will set up an in-person visit with the patient. Similarly, workgroup participant Karolina Kaser, BSN, RN, MBA, CIC, Quality, Safety and Experience Director for Corewell Health Dearborn, shared that their site utilizes standardized clinical pathways for their cardiac cases. Included in the pathway is an order set that automatically includes a CR referral even for CHF cases. Some other effective processes have been to utilize the cardiac nurses to ensure CHF patients have CR offered if they meet criteria, as well as training administrative and call center staff on the importance of scheduling these follow-up appointments.

Enrollment and Participation

Increasing enrollment is a key goal in the Million Hearts change concept. This may include methods of optimizing care coordination for patients by promoting enrollment into CR at follow-up appointments and reducing delay from discharge to their first CR appointment. This can be done by using data to drive improvement in follow-up appointments and enrollment numbers, and by developing flexible delivery models such as hybrid CR programs. MiCR tools and resources also help to boost CR enrollment.

Supporting Adherence and Reducing Non-Medical Barriers

The next step in the change concept process is finding ways to reduce inconsistent adherence to a CR program. Some recommendations to address this issue included identifying populations at risk for low engagement, accounting for patient needs such as lack of transportation, incorporating motivational incentives, and utilizing automated communications and reminders.

Zach Johnson from Corewell Health System shared that they have a successful support group established that meets quarterly. The group includes a range of patients who have either completed the CR program or those who are just beginning their journey to recovery. To address some of the common barriers for patients, Corewell has partnered with Michigan Rehabilitation Services to help cover a patient’s copay with a contingency that the patient plans to return to work for a minimum of 20 hours per week in the future.

To address transportation barriers, Corewell has partnered with True North which is funded by a family donation fund. If a patient meets the criteria for being at or below poverty level, they will qualify to receive financial assistance to cover the cost of transportation to and from visits. Holland Hospital’s Meiste shared they have utilized a mini grant awarded from the MiCR initiative to fund their heart failure orientation and to offer copay assistance to patients in need.

Opportunities for Further Improvement

Bair rounded out the panel discussion by asking panelists to describe unique challenges they identified when trying to incorporate CHF patients into CR programs. In response to Scharf’s inquiry about strategies to connect with patients who have CHF but have not yet met the 35% EF criteria, MVC Faculty Advisor, Mike Thompson shared that cardiac clinicians at Michigan Medicine are having CR conversations with CHF patients earlier in the disease process.

Additionally, lack of a standardized approach to discussing cardiac rehab for patients at 40% - 35% EF range is a common concern. Wymer shared that UMH Sparrow-Clinton addressed this by encouraging clinicians to urge patients who fall within the 35 – 40% EF range to begin participating in CR before their condition deteriorates further. MVC members can raise awareness by following and reposting BMC2 and MVC on LinkedIn.

MVC Cardiac Rehabilitation Workgroup: Feb. 10, 2026

MVC welcomes workgroup presenters from across Michigan to share their expertise, success stories, initiatives, and solution-focused ideas with MVC members. Please email us if you are interested in being a workgroup presenter or submit a presentation proposal online.

25 Feb 2026
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Cardiac Rehabilitation Awareness Week Spotlighted Resources and Tools Improving Cardiac Rehab Enrollment

Cardiac Rehabilitation Awareness Week Spotlighted Resources and Tools Improving Cardiac Rehab Enrollment

February 25, 2026 | Comments Closed | , , , , ,

MVC and BMC2 took to LinkedIn recently to celebrate Cardiac Rehab Awareness Week, spotlighting the importance of cardiac rehabilitation for patients recovering from cardiovascular events. MVC and BMC2 collaborate to lead the Michigan Cardiac Rehab network (MiCR) and its related offerings. Across multiple posts, both teams highlighted stories, tools, collaborations, and insights designed to support providers, patients, and programs working to improve cardiac rehab outcomes in Michigan.

One of the central themes of the week was the voice of the patient. MiCR shared the first completed patient story from a new storytelling initiative called Heart-to-Heart, developed with the Healthy Behavior Optimization for Michigan (HBOM) team. This initiative amplifies real patient experiences, bringing to light why cardiac rehab matters — not just clinically, but personally — for those considering participation. Cardiac rehab week marked the launch of the first available patient story about a patient named Margaret from Covenant Healthcare.

Cardiac Rehab Week also offered opportunities for networking and knowledge exchange. MVC hosted a virtual cardiac rehab workgroup [view video] focused on optimizing congestive heart failure (CHF) follow-up and increasing rehab enrollment in this especially vulnerable patient population. Featuring panelists from Corewell Health, Holland Hospital, Michigan Medicine, MyMichigan Health, and University of Michigan Health-Sparrow, this session highlighted real-world strategies and insights for improving care transitions and referral practices.

Throughout the week, both organizations also shared posts featuring practical tools to strengthen cardiac rehab engagement, such as:

  • NewBeat Resources: BMC2 highlighted NewBeat materials — engaging, evidence-based education and referral tools designed to help care teams talk with patients about the benefits of cardiac rehab and support meaningful discussions that lead to enrollment (Figure 1). A new round of no-cost printing for MiCR sites was announced, offering flexible, ready-to-use materials that programs can request.
  • Cardiac Rehab Center Finder: Knowing “where to go” is a crucial earliest step. MVC and BMC2 reinforced the MichiganCR.org searchable directory that allows patients and providers to locate nearby rehab programs. This simple tool reduces a key barrier to engagement by connecting patients with access points across Michigan.
  • Resource Library Spotlight: The MiCR Resource Library was featured as a one-stop hub for tools — from evidence-based products to collaborative resources developed with partners throughout the state — supporting both providers and patients as they plan, refer, and participate in cardiac rehab sessions.

Figure 1. Cardiac Rehab Resource Materials

decorative

Recognizing the evolving landscape of cardiac rehabilitation delivery, MiCR also took the opportunity to highlight its newest strategic efforts throughout cardiac rehab week, including its explorations into the role of telehealth in cardiac rehab as well as medication management opportunities. Updates on these efforts and more were summarized and linked in a summary blog to the MiCR website. To learn more, read the MiCR summary.

As the week wrapped, the MiCR teams thanked everyone for their role in advancing cardiac rehab throughout Michigan, and invited their active participation going forward—either by trying a MiCR tool in their daily work or sharing their experiences and stories. As MiCR continues its work, the momentum from this week sets the stage for meaningful improvement in patient outcomes and program engagement statewide.

03 Dec 2025
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November Workgroups Highlight Mobile Health and Patient Storytelling

November Workgroups Highlight Mobile Health and Patient Storytelling

December 3, 2025 | Comments Closed | , , , , , , , , , , ,

In November, MVC hosted two virtual workgroup presentations – the first, a rural health workgroup, featured Hillsdale Hospital’s mobile health unit initiative. The second, a post-discharge follow-up workgroup, continued a presentation started at MVC’s February 2025 health in action workgroup on patient journey mapping and introduced a joint patient storytelling project by Healthy Behavior Optimization for Michigan (HBOM) and Michigan Cardiac Rehab Network (MiCR). The MVC Coordinating Center hosts workgroup presentations twice per month covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehab, rural health, preoperative testing and health in action.

Rural Health Workgroup – Hillsdale Hospital 

The first workgroup of the month provided a review of Hillsdale Hospital’s mobile health unit, which aims to deliver essential health services to patients living in rural communities who may otherwise struggle physically or financially to reach traditional care settings.

As Lindsey Crouch, Director of Outpatient Clinics, Home Care, and Durable Medical Equipment for Hillsdale Hospital explained, rural communities face higher health outcome variation, transportation issues, limited accessibility to primary care providers, and high unnecessary emergency department (ED) utilization (Figure 1).

Figure 1. Hillsdale County Community Health Needs Assessment (CHNA) Survey Data: Difficulty Finding or Getting Transportation to a Doctor in 2024, 2022, 2019, and 2016

vertical bar graph: Hillsdale County Community Health Needs Assessment (CHNA) Survey Data: Difficulty Finding or Getting Transportation to a Doctor in 2024, 2022, 2019, and 2016

During the Covid-19 pandemic, Hillsdale County’s health department purchased a mobile health unit in an effort to close the gap in healthcare access for their community. However, despite continued need, utilization of the mobile unit has waned in recent years.

Hillsdale Hospital aimed to revitalize the mobile health unit to:

  1. Bridge access gaps in rural areas. For many rural residents, distance to hospitals or clinics, limited transportation, and infrastructure challenges can hinder timely access to care. A mobile health unit can bring services to patients rather than requiring patients to travel long distances. This helps to reduce one significant non-medical barrier to care.
  2. Focus on preventive and ongoing care. The mobile unit’s design supports not just acute care, but preventive services — screenings, check-ups, chronic disease management — especially helpful for rural populations that may have higher chronic disease burden and less frequent access to routine care.
  3. Address gaps in health outcomes between communities. By delivering care directly to underserved communities, this model aligns with broader efforts to ensure that where a person lives does not determine whether they receive high-value, quality healthcare.

Throughout this program, Hillsdale Hospital aimed to improve health outcome variation with a goal to achieve a 15% improvement in selected chronic disease metrics (e.g., blood pressure control) while also establishing partnerships with local organizations for sustainability.

Throughout the presentation and follow-up discussion, participants addressed several key considerations related to implementing and operating the mobile health unit including:

  • Logistical planning & scheduling. Which rural towns or areas will be served? How often do visits occur? How to communicate the schedule to residents to maximize utilization?
  • Service offerings. What mix of services beyond basic triage should be included? Considerations may include screenings, chronic disease management, preventive care, and referrals when needed to ensure the mobile unit meaningfully supplements local rural healthcare capacity.
  • Coordination with local providers. What existing local hospitals, clinics, and community health organizations should be involved to ensure continuity of care? Consider these, especially follow-up and referrals, for more advanced services.
  • Addressing rural-specific challenges. What unique barriers impact your community? Consider transportation, limited staffing, and supply chain constraints.

Hillsdale Hospital’s mobile health unit embodies a vision for bringing high-value, high-quality care to rural Michigan. By lowering access barriers and delivering preventive and ongoing services directly to patients in their communities, this initiative can help improve health outcomes, reduce reliance on emergency services, and foster trust in healthcare among rural residents.

Insights from this workgroup have several practical implications for other rural hospitals and provider organizations across Michigan:

  • Expansion is possible through mobile care. Rural hospitals can leverage mobile health units as an extension of their current clinical outreach, helping to connect with populations that may rarely visit brick-and-mortar facilities.
  • Support chronic disease management. By delivery of routine care and screenings, mobile units can help stabilize chronic conditions earlier, reducing acute exacerbations and potentially reducing avoidable ED visits.
  • Enhance care coordination. Partnering with mobile health teams and community resources can help coordinate follow-up appointments, testing, and specialty referrals to create a more continuous care experience for rural patients.
  • Advance population health goals. Mobile services can function as a tool within a hospital’s broader population health strategy, align with value-based initiatives, community health needs assessments, and provide the opportunity for all people to achieve optimal health goals.
  • Gather meaningful community insights. Regular presence in rural communities can help hospitals better understand local barriers, non-medical drivers of health, and other care gaps which may inform program planning, grant proposals, and collaborative partnerships.

MVC Rural Health Workgroup: Nov. 4, 2025

Post-Discharge Follow-Up Workgroup – MVC and HBOM

The second MVC workgroup of November featured a joint presentation by MVC’s Associate Program Manager, Jana Stewart, MPH and HBOM’s Informatics Design Lead, Noa Kim, MSI. The workgroup kicked off with an overview of the rationale behind placing a greater emphasis on post-discharge follow-up – particularly how timely and effective follow-up care can reduce readmissions, improve patient outcomes, and ease transitions from inpatient to outpatient or home settings.

Next, as a continuation of the February 2025  health in action workgroup presentation on patient journey mapping, Stewart showed how mapping can be used to highlight key moments in a coronary heart failure (CHF) patient’s journey where there may be opportunities for post-discharge care coordination improvement – e.g., medication reconciliation, patient knowledge, frequent rehospitalization, low follow-up rates, and lack of social and community support.

An important strategy for combating these challenges for CHF patients is engagement in cardiac rehabilitation. And yet, patients rarely optimize this opportunity. Patient storytelling can help patients recall details, model scenarios a patient may experience in the future, and reduce the burden of information provided during a visit and may be a strategy to optimize cardiac rehab enrollment.

Under the umbrella of Michigan Cardiac Rehab (MiCR), a collaboration between the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2), MVC, and HBOM, several initiatives have been developed aimed at optimizing guideline-directed medical therapy including the development of NewBeat materials and now the Heart-to-Heart storytelling campaign (Figure 2).

Figure 2. Examples of MiCR Guideline-Directed Medical Therapy Campaigns

NewBeat materials and the Heart-to-Heart storytelling campaign

As Kim explained, the goals of the Heart-to-Heart project are to collect diverse first-person accounts of cardiac rehab in video, audio, and photo formats from patients and clinicians from across Michigan to produce a compelling, free, reusable story library for use by cardiac rehab advocates across Michigan and beyond.

For hospitals and health systems across Michigan seeking to improve post-discharge outcomes, insights from this workgroup offer the following next steps:

  1. Use journey mapping and storytelling in quality improvement. By mapping patient journeys and capturing patient experiences, providers can better identify and address systemic barriers to safe discharge and recovery.
  2. Adopt standardized discharge-to-follow-up workflows. Hospitals should ensure that discharge planning includes scheduling follow-up appointments, medication reconciliation, and clear communication of next steps before patients leave the hospital.
  3. Prioritize high-risk patients for post-discharge support. Patients with chronic illness, limited social support, or social determinants that might hinder recovery deserve extra attention during discharge planning and follow-up scheduling.
  4. Assign care coordinators or navigators. Especially for high-risk or complex patients, dedicated staff to oversee follow-up care – manage appointments, support communication, track adherence, and offer resources – may reduce readmissions and improve outcomes.
  5. Leverage post-discharge care as part of value-based care strategy. Effective follow-up after discharge supports long-term patient health, reduces avoidable costs, and aligns with goals of high-value care frameworks.

MVC Post-Discharge Follow-Up Workgroup: Nov. 20, 2025

If you are interested in pursuing a healthcare quality improvement project, MVC has data specialists available to help you navigate our data resources and create custom analytics reports to support your efforts. Please reach out to us by email [LINK] if you would like to learn more about MVC data or engagement offerings!

04 Sep 2024
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MVC, BMC2, HBOM Announce New Cardiac Rehab Materials & Opportunities at MiCR Meeting

MVC, BMC2, HBOM Announce New Cardiac Rehab Materials & Opportunities at MiCR Meeting

September 4, 2024 | Comments Closed | , , ,

In partnership with BMC2 and HBOM, the Michigan Value Collaborative recently co-hosted the Michigan Cardiac Rehab network (MiCR) virtual summer meeting, which brought together providers, quality improvement staff, rehab staff, and patients with a shared interest in improving participation in cardiac rehabilitation. Over 70 attendees from across the state joined the meeting on Aug. 9, where they heard updates from the MiCR leadership, previewed new MiCR resources, and heard from a panel of hospital representatives who discussed their experience using the MiCR NewBeat materials.

NewBeat Success and Re-Orders

One key announcement from the meeting included the launch of a second round for placing NewBeat material print orders [ORDER FORM LINK]. The MiCR team will accept submitted order forms through Tues., Sept. 24. Those who request the free printed materials can either pick them up at the fall in-person MiCR meeting in Midland or have them mailed to an address they designate. Early survey evidence suggests that implementation of the NewBeat program is associated with an increase in confidence across a number of metrics (Figure 1).

Figure 1. NewBeat Survey Results Pre- and Post-Implementation

Speaking to the value of these materials was a panel of representatives from Corewell Health South, Holland Hospital, and Michigan Medicine—three sites who ordered NewBeat materials in the first round at the start of 2024. Each shared their experience using the materials and advice on their integration. HBOM also recorded virtual interviews with the Corewell Health and Holland Hospital site contacts for use in a NewBeat success story video (Figure 2), which was played for the meeting’s attendees.

Figure 2. Implementing NewBeat Feedback Video

Those who wish to place an order for NewBeat materials in the current round will again have the opportunity to request the MiCR patient/provider educational handout (available in English, Spanish, and Arabic), the cardiac rehab liaison postcard, and the cardiac care cards. Some customizations are possible to the handout and postcard design to include local hospital or rehab center contact information. Additionally, there is a new offering included in this round of ordering that was launched at the meeting: a new discharge packet sticker. These new sticker designs (Figures 3 and 4) can be affixed to the outside of a patient’s discharge folder and are meant to stand out to patients and families who are often inundated with discharge paperwork. They alert the patient that their discharge paperwork includes a referral to cardiac rehab as the next step in their care.

Figure 3. NewBeat Sticker Journey Design

Figure 4. NewBeat Sticker Golden Ticket Design

MiCR Mini Grant RFP Opens for Second Round

The summer meeting also included an announcement that MiCR’s mini grant program to fund small, local cardiac rehab quality improvement projects will similarly be re-opened for a second round of submissions. The first round resulted in the funding of projects at MyMichigan Midland, DMC Huron Valley Sinai, and Ascension Rochester. MiCR is accepting new submissions through Fri., Sept. 13 for up to $5,000 per project. Full details on the RFP and application are available on the MiCR website.

MiCR Updates & Meeting Materials

Finally, the MiCR leadership team announced the development of a neutrally-branded, customizable patient education video that can be shared with hospitals or rehab programs to play on their own websites or waiting room monitors. The video was developed in response to feedback from partner sites that online materials need to be improved and that neutral video content about the value of cardiac rehab is limited. MiCR developed a video for use by network partners and also identified several existing videos published by MillionHearts, Mayo Clinic, and others.

The MVC and BMC2 teams are looking forward to the Michigan Cardiac Rehab Network's fall in-person meeting on Fri., Nov. 8, from 10 a.m. to 3 p.m., at the H Hotel in Midland. MyMichigan is serving as co-host for the event in collaboration with MiCR. Additional event details will be shared in the coming weeks. Those who were unable to attend the summer meeting can view the meeting recording [LINK] or meeting slides [LINK]. Please reach out to info@michigancr.org with any questions.

30 Jul 2024
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Using Human-Centered Design Thinking to Improve Healthcare

Using Human-Centered Design Thinking to Improve Healthcare

July 30, 2024 | Comments Closed | , , , ,

At its foundation, healthcare quality improvement is a process of systematically improving care to better meet the needs of patients. Similarly, the concept of human-centered design thinking asks us to put people at the center of processes meant to address problems and improve outcomes. Although people have leveraged the concept of design to develop innovative solutions for centuries, “human-centered design thinking” is a relatively new approach in healthcare settings that is gaining in popularity.

One leader in this space is IDEO, a global design and innovation company; they launched a series of resources and toolkits to implement design thinking into tangible projects and emphasized the mindset behind the theory—the notion that how one thinks about design directly affects the impact of the solution. Through their design kit, IDEO suggests a three-step guide to cultivate a practical and repeatable approach to arriving at innovative solutions: inspiration, ideation, and implementation. IDEO urges professionals to connect with the population they wish to serve to ensure a project’s goals align with the needs of the intended community, and then to generate tangible ideas and solutions to address identified issues. This connection to a specific community puts the individuals they are designing for in the spotlight.

As the use of human-centered design thinking continues to grow, innovators continue to generate different visualizations of the process. Similar to IDEO’s three steps, another popular approach has been the Design Council’s double diamond model. Created to convey the process of design to designers and non-designers alike, this model (Figure 1) highlights a balance between big-picture thinking and detail-oriented refinements while translating ideas into action. This double diamond model was the guiding framework for the development of the Michigan Cardiac Rehabilitation network (MiCR) NewBeat materials – a partnership effort between MVC, BMC2, and HBOM (Figure 2). Strategically understanding the perspectives and needs of patients after undergoing a major cardiovascular event was pivotal to the success of the project.

Figure 1.

Figure 2.

Leading the NewBeat project was Larrea Young, who works as a multimedia and human-centered design project manager at MCT2D and HBOM. In reflecting back on the success of the cardiac rehab NewBeat project, she said, “One of the first questions we ask people when we talk about design is, what does it mean to design? People’s answers often focus on aesthetics; design makes things pretty or more accessible. While aesthetics is an important aspect of design, it is only one small part. We define design as envisioning and building a preferred future. This is the essence of the human-centered design process, an approach that examines challenges through lenses of aesthetics, culture, society, technology, and economics to define what something should be. In this process, we gain a deep understanding of people’s lived experiences, challenge conventional norms, and pilot innovative solutions. In the realm of healthcare, this process helps us build solutions that contribute holistically to the health and well-being of our providers and patients.”

Further evidence of the value of design thinking can be found in the quality improvement projects that placed critical importance on understanding the population they wished to serve. Many of these also have a heightened focus on patient-centered in the context of social drivers of health. Taking this into account, a number of healthcare initiatives are now incorporating a design thinking framework to ensure the circumstances, needs, and desires of patient populations are understood; and the results are promising.

In another recent study published in JAMA Network, Dr. Alex Peahl and colleagues wanted to determine how prenatal care could be redesigned to improve access and quality for Black pregnant people with low income. Utilizing human-centered design thinking, they interviewed 19 patients and 19 healthcare workers at prenatal care clinics in Detroit, Michigan, focusing on the first two phases of IDEO’s process: inspiration and ideation. In conducting this series of personalized interviews, Dr. Peahl and colleagues not only collected data to prove that current care failed to meet patient needs, but they also gathered ideas from the patient population of ways to redesign prenatal care for pregnant people in the community. By placing the individuals affected by the redesign at the center of a project, the team ensured the solutions they developed would lead to improved outcomes and experiences (Figure 3).

Figure 3.

Recently, Dr. Alex Peahl, MD, MSc, Assistant Professor in Obstetrics and Gynecology at the University of Michigan, led the MVC Coordinating Center through a workshop on design thinking. Dr. Peahl outlined its principles, provided personal and professional examples from her work, and facilitated a space for MVC teammates to collaborate and practice design thinking with one another.

As the MVC Coordinating Center looks ahead, design thinking will be incorporated more frequently to improve the quality and impact of MVC offerings. If your team has successfully adopted human-centered design thinking or other patient-centered frameworks that can be shared with peers across the state, please contact MVC.

16 Feb 2024
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MVC Celebrates Heart Month, Annual Cardiac Rehab Week

MVC Celebrates Heart Month, Annual Cardiac Rehab Week

February 16, 2024 | Comments Closed | , ,

Throughout February’s American Heart Month, the Michigan Value Collaborative (MVC) has and will continue to provide cardiac rehab resources and information on behalf of the Michigan Cardiac Rehab Network (MiCR). This week, MVC also shared content as part of National Cardiac Rehabilitation Week, joining other organizations across the country to promote the benefits of the program and share information on statewide initiatives. As cardiac rehab week comes to a close, MVC is proud to highlight recent activity.

The MiCR partnership was established by MVC and the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2), who have partnered in recent years to support quality improvement and innovation around cardiac rehabilitation participation. Although the strategies and initiatives have changed and expanded over time, the key goal remains: to equitably increase cardiac rehabilitation utilization among eligible patients across the state of Michigan. This week, MiCR sought to educate providers within the BMC2 and MVC collaborative about the benefits of the program, current statewide participation rates, and novel initiatives in place to support improvement.

One product highlighted this week was the MiCR cardiac rehab hospital-level push reports, which benchmark cardiac rehabilitation participation across the collaborative. The 2023 report highlighted significant variation in performance and also demonstrated that several hospitals in Michigan are already successfully reaching or exceeding goals for utilization (Figure 1).

Figure 1.

Current MiCR resources, including both hospital-level cardiac rehab benchmarking reports and the MiCR Best Practices Toolkit, were designed to serve members in tracking hospital cardiac rehabilitation utilization and provide guidance to improve enrollment and adherence to the program; however, neither resource specifically investigated patient barriers to participation. To bolster successful referrals to cardiac rehabilitation in Michigan, MiCR recently partnered with Healthy Behavior Optimization for Michigan (HBOM) to launch a new program titled NewBeat. Designed to deliver heartfelt, pragmatic support to new cardiac rehabilitation patients, NewBeat is a multi-component intervention designed to address three common barriers to patient enrollment and participation: lack of education, unclear physician endorsements, and transportation access.

To address the first barrier, MiCR recently launched its website, which houses patient and provider-facing resources, MiCR event dates, and publications in one convenient location. The website already includes features such as a cardiac rehabilitation location finder and unified cardiac rehabilitation resources, but over the coming months will continue to expand.

There is research evidence that strong, personal physician referrals increase the likelihood of cardiac rehabilitation participation. For many patients, in fact, a personal referral is the only reason they sign up. Following the data, NewBeat’s second intervention component is its Cardiac Care Cards, which leverage the influence of cardiovascular providers in encouraging cardiac rehabilitation enrollment in a memorable and personal way. The cards, which can be saved and displayed on kitchen tables and refrigerators, serve as a reminder to patients that the care team understands their recovery process and supports them as they enter cardiac rehabilitation as the next step in their recovery (Figure 2). Hospitals and rehab program staff can request on the MiCR website.

Figure 2.

As the initiative continues to develop, NewBeat will grow to include patient success stories, provider-facing videos, and an informational handout on transportation resources.

One of MiCR’s key strategies in promoting the benefits of cardiac rehabilitation is fostering collaboration between providers and program staff. One of these opportunities is through an MVC workgroup series focused on cardiac rehabilitation, with the next session taking place at noon on Thurs., Feb. 22 (Figure 3). The workgroup will include a guest presentation by Devraj Sukul, MD, MSc, Co-Director of MiCR and Associate Director of BMC2 PCI. The presentation will feature recent findings about cardiac rehabilitation liaisons and their impact on patient enrollment. Register here to participate. MiCR also recently sent a save the date for its next stakeholder meeting, which will take place virtually on Fri., April 5, 10-11 a.m.

Figure 3.

MVC would like to thank everyone who contributed to Cardiac Rehabilitation Week this year. Advocating for cardiac rehabilitation continues to be a high priority for the MVC team, and the Coordinating Center is inspired by the recent growth and interest in this endeavor. Collectively, by promoting cardiac rehabilitation we can save lives and help patients in Michigan get back on their feet faster. Please contact the MVC team with any questions about attending future cardiac rehabilitation events or receiving related materials.