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Chronic Care Management 101: Target the Right Age Group for Heart Disease Prevention

Recent trends have shown that chronic care management programs focused on heart disease prevention could have a significant impact on healthcare spending as well as our nation’s wellbeing:

  • One in every three deaths in the US is related to cardiovascular disease.
  • The economic burden due to lost productivity and health costs total more than $320 billion.[1]
  • Four of the five most costly chronic health conditions in the US, including, diabetes, hypertension, heart disease, and stroke, are related to cardiovascular disease risk.
  • With modest improvements in prevention strategies and effective early treatment of these five diseases, we could cut treatment costs by $220 billion and increase the Gross Domestic Product by $900 billion.

What’s contributing to the epidemic?

Cardiac risk factors (smoking, high blood pressure, diabetes, and obesity) represent the most significant impact to cardiovascular health. Managing (or preventing) these risks from an early start can have a significant impact on an individual’s future health status, but many of today’s population health management programs are simply not targeting the right age groups for prevention and intervention.  Case in point, the US Preventive Services Task Force (USPSTF) has multiple recommendations to support chronic care management programs that target cardiac risk in younger populations, including: screening and treatment for hypertension; smoking cessation behavioral and pharmacotherapy interventions; and intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention.  However, despite these recommendations,many people are not being screened for early warning signs and are not being effectively educated on their current and future risks for chronic disease.

Let’s talk about heart age

At the heart of the problem (excuse the pun), is the ineffective engagement and education of individuals who are at risk for heart disease but are not yet seeing many of the symptoms associated with this chronic condition. Talking about “heart age” can be one way to open this discussion. Two out of every five women and 50% of men age 30-74 have a calculated heart age much older than their chronological age (average 8 years older for men and 5 years older for women).  Being told you have the heart of a 78 year old if you are only 56 can be a motivating wake up call for many people.

How do we improve patient education?

Increasing public awareness of heart risks can help to facilitate a conversation on chronic care management and behavior change strategies to improve heart health. Once people are aware of their own personal risks it is easier to introduce education strategies to improve health. Using a tool like the Center for Disease Control and Preventions (CDC) Heart Age Calculator can be a launching pad for this discussion and can help move your population towards better heart health:

  • Providers
    • Explore opportunities directly with patients by using the CDC Heart Age Calculator during routine physical exams to help emphasize how their personal risk factors impact their heart age.
    • Partner with community health resources, such as the Rite Aid Health Alliance program, which provides access to health and wellness services to patients in a retail setting.
  • Employers
    • Increase awareness of the concept of heart age through providing the Heart Age Calculator at health fairs.
    • Refer to onsite or provide access to chronic care management education programs to support cardiovascular behavior change.
  • Health Plans
    • Facilitate early awareness through health plan coverage of recommended preventive services with no out-of-pocket costs (such as co-pays or deductibles).
    • Provide incentives for health management solutions that include expanded workplace wellness programs or reimbursement for lifestyle change programs.

Many of these solutions could be discussed in a separate topic, but to engage your population and get them motivated to change, they first have to recognize the risk.

How old is your heart? Use the CDC Heart Age Calculator to find out.

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