Wilawan Thirapatarapong1, Randal J Thomas, Quinn Pack, Saurabh Sharma, Ray W Squires. 1. Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (Dr Thirapatarapong); Cardiovascular Health and Rehabilitation Program, Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota (Drs Thomas, Pack, and Squires and Mr Sharma); and Division of Cardiovascular Disease, Baystate Medical Center, Springfield, Massachusetts (Dr Pack).
Abstract
BACKGROUND: Although cardiac rehabilitation (CR) improves outcomes in patients with heart failure (HF), studies suggest variable uptake by patients with HF, as well as variable coverage by insurance carriers. The purpose of this study was to determine the percentage of large commercial health insurance companies that provide coverage for outpatient (CR) for patients with HF. METHODS: We identified a sample of the largest US commercial health care providers and analyzed their CR coverage policies for patients with HF. We surveyed 44 large private health care insurance companies, reviewed company Web sites, and, when unclear, contacted companies by e-mail or telephone. We excluded insurance clearinghouses because they did not directly provide health care insurance. RESULTS: Of 44 eligible insurance companies, 29 (66%) reported that they provide coverage for outpatient CR in patients with HF. The majority of companies (83%) covered CR for patients with any type of HF. A minority (10%) did not cover CR for patients with HF if it was considered a preexisting condition. CONCLUSIONS: A significant percentage of commercial health care insurance companies in the United States report that they currently cover outpatient CR for patients with HF. Because health insurance coverage is associated with patient participation in CR, it is anticipated that patients with HF will increasingly participate in CR in coming years.
BACKGROUND: Although cardiac rehabilitation (CR) improves outcomes in patients with heart failure (HF), studies suggest variable uptake by patients with HF, as well as variable coverage by insurance carriers. The purpose of this study was to determine the percentage of large commercial health insurance companies that provide coverage for outpatient (CR) for patients with HF. METHODS: We identified a sample of the largest US commercial health care providers and analyzed their CR coverage policies for patients with HF. We surveyed 44 large private health care insurance companies, reviewed company Web sites, and, when unclear, contacted companies by e-mail or telephone. We excluded insurance clearinghouses because they did not directly provide health care insurance. RESULTS: Of 44 eligible insurance companies, 29 (66%) reported that they provide coverage for outpatient CR in patients with HF. The majority of companies (83%) covered CR for patients with any type of HF. A minority (10%) did not cover CR for patients with HF if it was considered a preexisting condition. CONCLUSIONS: A significant percentage of commercial health care insurance companies in the United States report that they currently cover outpatient CR for patients with HF. Because health insurance coverage is associated with patient participation in CR, it is anticipated that patients with HF will increasingly participate in CR in coming years.
Authors: Quinn R Pack; Aruna Priya; Tara Lagu; Penelope S Pekow; Robert Berry; Auras R Atreya; Philip A Ades; Peter K Lindenauer Journal: J Cardiopulm Rehabil Prev Date: 2019-01 Impact factor: 2.081
Authors: Abraham Samuel Babu; Francisco Lopez-Jimenez; Randal J Thomas; Wanrudee Isaranuwatchai; Artur Haddad Herdy; Jeffrey S Hoch; Sherry L Grace Journal: BMC Health Serv Res Date: 2016-09-06 Impact factor: 2.655