As you know, February is American Heart Month, an important time to shine a spotlight on heart disease, the number one killer of Americans. This year marks the 60th anniversary of American Heart Month, and it’s so important to reinforce the importance of heart health and specifically, efforts to ensure that millions of people live longer and healthier lives.

Blue Cross & Blue Shield of Rhode Island (BCBSRI) recognizes the importance of heart health, as well as the prevalence of heart disease and heart failure as a common (but preventable, by adopting a healthy lifestyle) condition. Some of the numbers are eye-opening:

• About 6.5 million adults in the U.S. have heart failure, a number expected to grow to roughly eight million by 2030.
• This includes about two percent of those aged 40-59, and five percent of those aged 60-69.
• In general, about half of all people diagnosed with CHF will survive for five years. About 30 percent will survive for 10 years.
• The heart failure hospitalization rate per 1,000 Medicare beneficiaries in Rhode Island, across all races/ethnicities, was 18.5, compared to a national rate of 16.3.

To help address this, we recently (in late 2023) began a comprehensive program aimed at educating our members to improve their heart failure. Our Congestive Heart Failure (CHF) Care Management Program uses specific interventions and resources to help give members the ability to self-manage their heart disease.

The reason we created this program was simple: members who are diagnosed with heart failure, as well as other chronic conditions, are at an extremely high risk for poor health outcomes which lead to significantly increased healthcare costs. Some of the most common risk factors for CHF are coronary artery disease (CAD), flu, diabetes, high blood pressure, obesity, and heart disease-related conditions such as angina, arrhythmia, pulmonary hypertension, and congenital heart defects.

The CHF program is available to our Medicare Advantage members and will eventually be made available to members of our commercial plans also to help us maximize its effectiveness. The program includes several core elements, such as guideline-directed medical therapy; nutrition (e.g., cardiac diet, salt, and water restrictions), including referrals to a registered dietitian if necessary; symptom monitoring; exercise tolerance; smoking cessation; and behavioral health resources as needed.

But perhaps the most important part of the program is providing the ability for members to remotely self-monitor their symptoms, as well as provide them with associated education, resources, and tools to help self-manage their CHF. We’re providing this capability through a partnership with AMC Health, a proven leader in virtual care and remote patient monitoring (RPM) solutions that deliver high-quality, low-cost patient-centered clinical interventions through advanced analytics and a simple user interface. Program participants’ PCPs and care teams coordinate care to help them manage their medications, provide education to help modify their lifestyles, if necessary, and provide referrals for behavioral health and other services as needed.

So far, we’ve seen very positive results and health outcomes for members in the program, including:

• 28 percent reduction in hospitalizations
• 44 percent reduction in 30-day member readmissions
• 72 percent continuous hypertension control at 18 months
• 81 percent continuous glycemic control improvement
• 65 percent reduced risk of microvascular complications
• 29 percent reduced risk of heart attack
• 25 percent reduced risk of stroke
• 70 percent increase in patient satisfaction

We’re thrilled to see results like this, and we hope you join us in continuing to highlight heart-healthy lifestyles to your patients during American Heart Month and all year long. As always, thank you for your partnership and all you do to help our members stay safe and healthy.