By Robert Pedowitz, DO
Heart disease is the leading cause of death in the United States, with a staggering one in three deaths caused by heart attacks and strokes–according to the Centers for Disease Control and Prevention (CDC).
As a result, the CDC in conjunction with the Centers for Medicare and Medicaid Services (CMS) set a goal to reduce the amount of cardiovascular diseases and prevent one million heart attacks and strokes by 2017. To accomplish this, they launched the Million Hearts Cardiovascular Disease Risk Reduction Model program, which aims at diminishing both the incidence of and any complications from heart disease in men and women through education and prevention.
When we at Family Practice of CentraState heard about the Million Hearts program, we realized that it was in line with our model of providing comprehensive care, largely through prevention and direct contact with our patients. There are several similar programs in existence designed to lower heart disease, but we were impressed by such a large initiative backed by CMS and the CDC that directly gives physicians the opportunity to participate and make a difference.
We applied to be a part of the Million Hearts program and were chosen as one of 516 physician practices throughout the country to participate.
The program is based on Medicare patients who meet the following criteria:
- Between the ages of 40 and 79
- Not enrolled in a hospice program
- No history of end-stage renal disease
- No history of heart attack or stroke
- Enrolled in a Medicare fee for service, either Part A or Part B, with Medicare being their primary payer (participants are ineligible if they have Medicare Advantage insurance)
For eligible patients, we use a heart disease risk calculator to determine their risk of heart disease and stroke within 10 years. The calculator takes into account the patient’s gender, age, cholesterol, and high density lipoprotein (HDL) levels, and also if the patient is a smoker or has diabetes. A patient that has a more than 30 percent probability of heart disease over the next 10 years is considered high risk and encouraged to have a consultation with me or one of the other physicians in the practice.
To identify those in danger of heart disease in our patient population, we monitor the data from the risk calculator on a routine basis. We partner with and engage our patients because we believe that a face-to-face conversation is the best way to convey methods to help lower their risk, including improving cholesterol, lowering blood sugar, quitting smoking, and improving diet. We value instruction and coaching to enhance a patient’s wellness in an effort to avert heart disease, rather than simply dispensing medications after a problem arises. We want to get to the root of the problem to reduce potential complications.
Other factors that we take into account that are not measured by the risk calculator, include family history, poor diet, lack of exercise, elevated low density lipoprotein count (LDL), and previous personal history of heart disease or heart blockages. While these factors may not be included in the Million Hearts program, they are all pieces of a puzzle that we examine when creating a patient-specific plan to reduce risk and achieve overall health.
Family Practice of CentraState chose to participate in the Million Hearts initiative because our goal is to improve the lives of our patients and reduce their risk of heart disease and stroke. We have helped both low- and high-risk patients prevent heart attacks and strokes by ordering additional diagnostics—including electrocardiograms, stress tests, cholesterol profiles and other laboratory studies—closely monitoring blood pressure, and referring patients to a cardiologist when necessary. It is an honor to be included in such a valuable program.
Dr. Robert Pedowitz is a board-certified osteopathic family physician and the medical director of Family Practice of CentraState, which has offices in six locations, including Freehold Boro, Freehold Township, Colts Neck, Jackson, Monroe, and East Windsor. Dr. Pedowitz sees all types of patients, from pediatrics to geriatrics. For more information or to contact Dr. Pedowitz, call 866-CENTRA7 (866-236-8727).