HHS & Public-Private Partners Aim to Prevent 1 Million Heart Attacks & Strokes in 5 Years

By Editor, on September 14th, 2011

Prevent Heart Disease and Stroke The U.S. Department of Health & Human Services (HHS) yesterday announced a new “Million Hearts” campaign being launched by a public-private partnership of several government and private sector organizations, with the aim of preventing 1 million heart attacks and strokes within the next five years by implementing proven, effective, inexpensive preventive strategies.

Among the organizations joining in the initiative with HHS are the Centers for Medicare and Medicaid Services (CMS), the U.S. Centers for Disease Control and Prevention (CDC), the American Heart Association (AHA), Walgreens, United Healthcare, America’s Health Insurance Plans, YMCA, American College of Cardiology, American Medical Association (AMA), American Nurses Association (ANA), The American Pharmacists’ Association and Foundation, The National Alliance of State Pharmacy Associations, the Alliance for Patient Medication Safety, and others.

“Heart disease causes 1 of every 3 American deaths and constitutes 17-percent of overall national health spending,” said HHS Secretary Kathleen Sebelius in a release issued by HHS. The release also said that “Currently, cardiovascular disease costs $444 billion every year in medical costs and lost productivity in Americans.”

According to an article by Thomas R. Frieden, M.D., M.P.H., Director of the CDC, and Donald M. Berwick, M.D., M.P.P, Administrator of CMS, which was published in the New England Journal of Medicine on September 13, 2011, to coincide with the launch of the Million Hearts campaign:

“Each year, more than 2 million Americans have a heart attack or stroke, and more than 800,000 of them die; cardiovascular disease is the leading cause of death in the United States and the largest cause of lower life expectancy among blacks. Related medical costs and productivity losses approach $450 billion annually, and inflation-adjusted direct medical costs are projected to triple over the next two decades if present trends continue.”

Focus of the Million Hearts Campaign

According to the referenced article by the heads of CDC and CMS published in the New England Journal of Medicine and as stated in the press release issued by HHS in launching the Million Hearts Campaign, this initiative will be focused on two overall goals:

Empowering Americans to make healthy choices such as preventing tobacco use and reducing sodium and trans fat consumption. This can reduce the number of people who need medical treatment such as blood pressure or cholesterol medications to prevent heart attacks and strokes.

Improving care for people who do need treatment by encouraging a targeted focus on the “ABCS” – Aspirin for people at risk, Blood pressure control, Cholesterol management and Smoking cessation – which address the major risk factors for cardiovascular disease and can help to prevent heart attacks and strokes.”

According to HHS, Million Hearts aims to achieve the following specific goals within the next five years:

Indicator	Baseline	2017 goal
Aspirin use for people at high risk	47%	65%
Blood pressure control	46%	65%
Effective treatment of high cholesterol (LDL-C)	33%	65%
Smoking prevalence	19%	17%
Sodium intake (average)	3.5g/day	20% reduction
Artificial trans fat consumption (average)	1% of calories/day	50% reduction

“If we succeed in achieving our Million Hearts goals, 10 million more Americans with high blood pressure will have it under control, 20 million more Americans with high cholesterol will have it under control, and 4 million fewer Americans will smoke by 2017,” said CDC Director Thomas Frieden.

“The treatment of heart disease and stroke account for about $1 of every $6 spent on health care in this country,” according to CMS Administrator Donald Berwick. “By shifting our focus from paying for how much care is provided to how to get the best health for Americans and putting more tools into the hands of health care providers and patients, CMS can help prevent strokes, heart attacks and avoidable human suffering,” he said.

Private-Public Partnership Contributions to the Initiative

The several private sector partners in the public-private partnership of organizations launching the Million Hearts campaign have announced several community and public service initiatives through which each of them will help improve Americans’ diets, reduce tobacco use, improve medication adherence, and otherwise help meet the goals of the Million Hearts campaign.

All of the current public and private sector participants in the campaign and their proposed contributions and initiatives are listed on the Million Hearts website launched by HHS for the campaign.

HHS said that it will “target more than $200 million in new and refocused investments to achieve the goals of Million Hearts.”

Several new programs dedicated to meeting the goals of the Million Hearts campaign by the CDC, CMS, the FDA, and other government agencies, and their funding, are listed in the HHS release announcing the campaign.

Among the programs announced by HHS toward the Million Hearts goals are:

* “Enhancing focus on cardiovascular disease prevention

Federal agencies and private sector partners will focus and align measurement strategies which will both improve ABCS care and simplifying reporting for providers. For example, the Physician Quality Reporting System, which provides bonus payments, and in the future, payment reductions, based on the reporting of quality information by eligible professionals, CMS plans to enhance its focus on the ABCS.

Beginning in 2012, HRSA will require all community health centers to report annually on the ABCS measures to track and improve performance, including new measures for 2012 for aspirin use and cholesterol screening. These efforts will help to improve ABCS care for more than 20 million patients.

* Focusing HIT [Health IT] efforts to prevent heart attacks and strokes

Ongoing HIT [Health IT] improvements will increase focus on cardiovascular prevention and give providers improved tools for their delivery of lifesaving ABCS care. Regional extension centers, which reach nearly 100,000 primary care doctors, and Beacon Communities will reach more than 100 million patients within the next few years.

* Improving the delivery of ABCS care through clinical innovations, including:

Quality Improvement Organizations (QIOs). A network of 53 Medicare-funded organizations nationwide to improve healthcare quality at the community level, QIOs will work with physician offices, clinics and other providers to create Learning & Action Networks focused on achieving the elements of ABCS as part of each QIO’s tasks and goals.

Learning from Local Innovators (Healthcare Innovations Exchange). The HHS Agency for Healthcare Research and Quality’s Healthcare Innovations Exchange supports efforts to identify and disseminate innovative efforts to improve health care led by local communities and leaders.”

Made possible by the Patient Protection & Affordable Care Act

According to the article by the Doctor Thomas R. Frieden, Director of the CDC, and Doctor Donald M. Berwick, Administrator of CMS, published in the September 13, 2011 issue of The New England Journal of Medicine, “The Affordable Care Act (ACA) provides a strong foundation for Million Hearts by increasing coverage and facilitating improved care.”

The authors wrote:

“[The Affordable Care Act] waives patient cost sharing for preventive services, including blood-pressure and cholesterol screening and smoking-cessation counseling and treatment, for enrollees in new private insurance plans. The new annual wellness visit for Medicare beneficiaries will help physicians focus on reducing cardiovascular risk and target interventions appropriately. Eliminating Medicare’s “doughnut hole” in prescription-drug coverage will increase access to blood-pressure, cholesterol-lowering, and smoking-cessation medications. Covering 32 million currently uninsured Americans will reduce financial barriers to preventive care, and expanding community health centers will increase access to care and reduce health disparities. In addition, electronic health records (EHRs) will support improved clinical decision making.”

Million Hearts Campaign Will Refocus Current Government Spending and Generally Not Require New Public Spending

As stated by Doctors Frieden and Berwick in conclusion:

“Million Hearts will leverage, focus, and align existing investments and generally not require new public spending. Voluntary initiatives will simplify, harmonize, and automate clinicians’ reporting requirements, decrease administrative burden, improve the quality of prevention and care, and inform the public more fully. Improvements in control of the ABCS, nutrition, and smoking are projected to prevent more than a million heart attacks and strokes over the initiative’s first 5 years. By focusing our initial efforts where they will save the most lives, we aim to make progress toward a health system that will serve Americans’ needs in the 21st century.”

More Information

For more information on the Million Hearts public-private partnership campaign, see MillionHearts.hhs.gov, the website launched by HHS for the campaign.

See also the CDC’s website on Million Hearts: Preventing Heart Attacks and Strokes

And see the American Heart Association’s website on its role in the Million Hearts campaign.

See the HelpingYouCare™ resource pages on Heart Disease & Stroke, including