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Dr Justin Bachmann: Challenges of Implementing Behavioral Interventions in Cardiac Care

The biggest challenge of implementing behavioral interventions to improve care for patients with cardiovascular disease is reimbursement models, said Justin Bachmann, MD, MPH, FACC, Cardiologist and Clinical Investigator, Instructor of Medicine and Health Policy, Vanderbilt University Medical Center.


What are the challenges of implementing behavioral interventions to improve care for patients with cardiovascular disease?

The major challenge of this kind of care, and really of cardiac rehabilitation in general, is reimbursement models. Cardiac rehab has 1 reimbursement model, and it largely occurs within the institution outpatient setting, and the hospital outpatient setting. So, we really need some new reimbursement models. Things like home base rehabilitation and new ways to reimburse those types of models. Right now, we don’t really have many, so it’s just working within the reimbursement structures of Medicare and third-party insurers. Also, getting hospital systems and payers to acknowledge that efforts such as counseling techniques, motivational interviewing by staff and by nurses is important. Interventions such as cardiac rehabilitation are important to help keep patents out of the hospital, to keep them from being readmitted, which is certainly what the data shows. It’s important to bring payers around and also hospital systems and get them to recognize the fact that using these interventions to improve post-acute outcomes really can help keep them out of the hospital and improve their quality of life at home.

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