The Centers for Medicare and Medicaid Services (CMS) determined this week that intensive behavioral therapy for cardiovascular disease (CVD) is reasonable and necessary for the prevention or early detection of illness or disability. Under this coverage decision, CMS will cover one face-to-face visit annually to allow patients and their care providers to determine the best way to help prevent CVD. The visit must be furnished by primary care practitioners, such as a beneficiary’s family practice physician, internal medicine physician, or nurse practitioner, in settings such as physicians’ offices. During these visits, providers may screen for hypertension and promote healthy diet as part of an overall initiative to reduce the burden of cardiovascular disease in the United States.
This new coverage policy will add to the existing portfolio of free preventive services that are now available for people with Medicare, thanks to the Affordable Care Act. It contributes to the Million Hearts initiative led jointly by CMS and the Centers for Disease Control and Prevention in partnership with other HHS agencies, communities, health systems, nonprofit organizations, and private sector partners across the country to prevent one million heart attacks and strokes in the next five years.
Under this coverage decision, CMS will cover one face-to-face visit each year to allow patients and their care providers to determine the best way to help prevent cardiovascular disease. The visit must be furnished by primary care practitioners, such as a beneficiary’s family practice physician, internal medicine physician, or nurse practitioner, in settings such as physicians’ offices. During these visits, providers may screen for hypertension and promote healthy diet as part of an overall initiative to reduce the burden of cardiovascular disease in the United States.
Intensive behavioral therapy for CVD will consist of the following three components:
• encouraging aspirin use for the primary prevention of cardiovascular disease when the benefits outweigh the risks for men age 45-79 years and women 55-79 years;
• screening for high blood pressure in adults age 18 years and older; and
• intensive behavioral counseling to promote a healthy diet for adults with hyperlipidemia, hypertension, advancing age and other known risk factors for cardiovascular and diet-related chronic disease.
The behavioral counseling intervention for aspirin use and healthy diet should be consistent with the Five As approach that has been adopted by the USPSTF to describe such services:
•Assess: Ask about/assess behavioral health risk(s) and factors affecting choice of behavior change goals/methods.
•Advise: Give clear, specific, and personalized behavior change advice, including information about personal health harms and benefits.
•Agree: Collaboratively select appropriate treatment goals and methods based on the patient’s interest in and willingness to change the behavior.
•Assist: Using behavior change techniques (self-help and/or counseling), aid the patient in achieving agreed-upon goals by acquiring the skills, confidence, and social/environmental supports for behavior change, supplemented with adjunctive medical treatments when appropriate.
•Arrange: Schedule follow-up contacts (in person or by telephone) to provide ongoing assistance/support and to adjust the treatment plan as needed, including referral to more intensive or specialized treatment.
To read the new policy, visit the CMS website.
For more information on Million Hearts, visit our news release.
Filed under: Health News | Tagged: 5 A's, behavioral therapy, CDC, CMS, intensive behavioral therapy, medicare preventive services, Million Heart initiative, Million Hearts, primary care | Comments Off on News Release: Medicare Covers Intensive Behavior Therapy for Cardiovascular Disease, Focus on the 5 A’s
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