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Purpose: This study updates cardiac rehabilitation (CR) utilization data in a cohort of Medicare beneficiaries hospitalized for CR-eligible events in 2017, including stratification by select patient demographics and state of residence.
Methods: We identified Medicare fee-for-service beneficiaries who experienced a CR-eligible event and assessed their CR participation (≥1 CR sessions in 365 d), engagement, and completion (≥36 sessions) rates through September 7, 2019. Measures were assessed overall, by beneficiary characteristics and state of residence, and by primary (myocardial infarction; coronary artery bypass surgery; heart valve repair/replacement; percutaneous coronary intervention; or heart/heart-lung transplant) and secondary (angina; heart failure) qualifying event type.
Results: In 2017, 412 080 Medicare beneficiaries had a primary CR-eligible event and 28.6% completed ≥1 session of CR within 365 d after discharge from a qualifying event. Among beneficiaries who completed ≥1 CR session, the mean total number of sessions was 25 ± 12 and 27.6% completed ≥36 sessions. Nebraska had the highest enrollment rate (56.1%), with four other states also achieving an enrollment rate >50% and 23 states falling below the overall rate for the United States.
Conclusions: The absolute enrollment, engagement, and program completion rates remain low among Medicare beneficiaries, indicating that many patients did not benefit or fully benefit from a class I guideline-recommended therapy. Additional research and continued widespread adoption of successful enrollment and engagement initiatives are needed, especially among identified populations.
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http://dx.doi.org/10.1097/HCR.0000000000000675 | DOI Listing |
J Manipulative Physiol Ther
September 2025
Clinical & Health Services Research, Southern California University of Health Sciences, Whittier, California.
Objective: The purpose of this study was to evaluate the risk of selected adverse outcomes for older adults with a new episode of neck pain (NP) receiving chiropractic care compared to those receiving primary medical care with Prescription Drug Therapy (PDT) or primary care without medication.
Methods: Through analysis of Medicare claims data, we designed a retrospective cohort study including 291 604 patients with a new office visit for NP in 2019. We developed 3 mutually exclusive exposure groups: the Chiropractic Manipulative Therapy (CMT) group received spinal manipulative therapy from a chiropractor with no primary care visits; the PDT group visited primary care and filled an analgesic prescription within 7 days without chiropractic care, and the Primary Care Only (PCO) group visited primary care without chiropractic care or analgesic prescriptions.
Cancer Med
September 2025
Department of Urology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Introduction: In the past decade, the management of advanced prostate cancer has shifted to novel hormonal therapies. As a result, urologists have increased their involvement in the management of advanced prostate cancer. These therapies require close monitoring due to the possibility of adverse cardiometabolic events.
View Article and Find Full Text PDFJTCVS Open
August 2025
Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Mich.
Background: Regular imaging surveillance is guideline-recommended for the management of thoracic aortic aneurysm (TAA) but has not been well described in clinical practice. Here we evaluated the frequency of imaging procedures and associated outcomes, procedures, and healthcare costs in patients with TAA.
Methods: A retrospective cohort study of inpatient and professional claims for 28,459 Medicare beneficiaries age ≥65 years with a diagnosis of TAA between 2017 and 2019 was performed.
Ear Nose Throat J
September 2025
Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute, Athens, OH, USA.
Background: Hearing loss is a significant public health issue in the United States, affecting an estimated 72.9 million people, or 22% of the population. Despite its prevalence and clinical impact, insurance coverage for hearing-related interventions remains inconsistent.
View Article and Find Full Text PDFJAMA Intern Med
September 2025
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
Importance: Hospitals have reported growing difficulty in discharging patients in a timely manner, often citing bottlenecks in postacute care. Medicare Advantage plans, now the dominant form of Medicare coverage, may contribute to these delays due to administrative and network constraints, yet national evidence is lacking.
Objective: To quantify changes in hospital length of stay for Medicare Advantage vs traditional Medicare beneficiaries.