Dr. Randal J. Thomas

More forward-thinking third-party payers that are covering primary prevention rehabilitation, particularly for people with diabetes. So that's happening. And there are some demonstration projects through Medicare, too, that have looked at this. But a lot of the private insurers are doing this more and more.

More forward-thinking third-party payers that are covering primary prevention rehabilitation, particularly for people with diabetes. So that's happening. And there are some demonstration projects through Medicare, too, that have looked at this. But a lot of the private insurers are doing this more and more.

Yeah, absolutely. So when patients graduate from our program, at that three month mark, you know, we remind them that their rehabilitation doesn't stop. In fact, I like to remind people at that point, they're graduating, And now you're going to graduate school. You're going to be working on your PhD and getting a healthy heart.

Yeah, absolutely. So when patients graduate from our program, at that three month mark, you know, we remind them that their rehabilitation doesn't stop. In fact, I like to remind people at that point, they're graduating, And now you're going to graduate school. You're going to be working on your PhD and getting a healthy heart.

And so connecting to silver sneakers, connecting to other groups in the community are a key part to that. There are churches that help with this too. The Princess Brewer, who I think you know from our group, has helped to do that too, and many of the churches in the area. And that's a great connection too. So we look for those connections. Some programs actually do provide a longer-term option.

And so connecting to silver sneakers, connecting to other groups in the community are a key part to that. There are churches that help with this too. The Princess Brewer, who I think you know from our group, has helped to do that too, and many of the churches in the area. And that's a great connection too. So we look for those connections. Some programs actually do provide a longer-term option.

It's called a maintenance program where people pay out of their pocket to come in. They don't get quite the same level of attention as they did during the earlier part. but they're there to exercise and ask questions and check their blood pressure and so forth. So that does exist in some centers too.

It's called a maintenance program where people pay out of their pocket to come in. They don't get quite the same level of attention as they did during the earlier part. but they're there to exercise and ask questions and check their blood pressure and so forth. So that does exist in some centers too.

So that's a great question. That gives a nice segue into the question of, you know, what are the challenges and the barriers to rehabilitation? I've already mentioned, if you look at any outcomes, if you look at things like recurrent heart attacks, cholesterol control, blood pressure control, smoking rates, medication adherence, re-hospitalization, death rates, all better.

So that's a great question. That gives a nice segue into the question of, you know, what are the challenges and the barriers to rehabilitation? I've already mentioned, if you look at any outcomes, if you look at things like recurrent heart attacks, cholesterol control, blood pressure control, smoking rates, medication adherence, re-hospitalization, death rates, all better.

You know, depression scores, all better. So why then don't we have 100% participation, right? It seems like it'd be a slam dunk. It's actually not too surprising, though, that we don't. If you look at almost any therapy, Almost anything we do in medicine, it's not perfect.

You know, depression scores, all better. So why then don't we have 100% participation, right? It seems like it'd be a slam dunk. It's actually not too surprising, though, that we don't. If you look at almost any therapy, Almost anything we do in medicine, it's not perfect.

In fact, if you look at cholesterol control, something like 25% to 30% of people who need to have their cholesterol controlled have their cholesterol controlled at the appropriate level. So it's not unusual that we have gaps. It's unfortunate, though. So in cardiac rehabilitation, it's been studied a lot.

In fact, if you look at cholesterol control, something like 25% to 30% of people who need to have their cholesterol controlled have their cholesterol controlled at the appropriate level. So it's not unusual that we have gaps. It's unfortunate, though. So in cardiac rehabilitation, it's been studied a lot.

the percentage of people, this is in the Medicare population, the percentage who participate in cardiac rehabilitation of those who are eligible, about 25%. That's among all comers. And if you look among women, it's about half that. Among social and racial minority groups, about 7 to 10%.

the percentage of people, this is in the Medicare population, the percentage who participate in cardiac rehabilitation of those who are eligible, about 25%. That's among all comers. And if you look among women, it's about half that. Among social and racial minority groups, about 7 to 10%.

And this has been, this has been pointed out and this has been worked on for many, many years and been part of many groups who've been working on this.

And this has been, this has been pointed out and this has been worked on for many, many years and been part of many groups who've been working on this.

So we do see, so for example, I mentioned the buy-in in recent years, the major organizations, the CDC and Medicare have formed something called Million Hearts, which is an organization that is aimed to save a million lives per year from heart problems. And cardiac rehabilitation is a major focus of that group.

So we do see, so for example, I mentioned the buy-in in recent years, the major organizations, the CDC and Medicare have formed something called Million Hearts, which is an organization that is aimed to save a million lives per year from heart problems. And cardiac rehabilitation is a major focus of that group.