Project Overview
Mathematica and its partner RAND are helping CMS determine whether a quality improvement model with performance-based payments reduced first-time heart attacks and strokes among Medicare beneficiaries.
Our role is to help CMS determine if the model was successful, which means assessing (1) whether and how the model reduced first-time heart attacks and strokes and (2) whether the model reduced Medicare spending on hospitalizations and post-acute care for cardiovascular events enough to fully offset model payments.
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services
Mathematica helps Medicare assess whether a quality improvement model with performance-based payments reduced heart attacks and strokes for Medicare beneficiaries.
Cardiovascular disease is a leading cause of death and disability in the United States. In 2017, CMS launched the Million Hearts Cardiovascular Disease Risk Reduction Model to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries ages 40 to 79. The model paid providers for assessing each of their Medicare patients’ risk of having a heart attack and stroke over 10 years, and then made additional payments to organizations that successfully reduced risk for their high-risk patients (those with a 30 percent or higher risk of a heart attack or stroke over 10 years). CMS tested the model in a rigorous randomized trial that included primary care practices, cardiology practices, health centers, and hospitals throughout the country. Our evaluation uses mixed methods to assess whether and how the model improved preventive cardiovascular care and reduced first-time heart attacks and strokes.
Evidence & Insights From This Project

Evaluation of the Million Hearts Cardiovascular Disease Risk Reduction Model: Fourth Annual Report
Over four years (2017 to 2020), the Million Hearts CVD Risk Reduction Model enrolled more than 250,000 Medicare beneficiaries throughout the United States who were at elevated risk of having a heart attack or stroke over 10 years.
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