Million Hearts Model cuts five-year heart attack, stroke risk in at-risk patients

The Million Hearts Model, which encouraged and paid for cardiovascular disease (CVD) risk assessment and reduction, cut first-time heart attacks and strokes over five years, according to a study published in the Oct. 17 issue of the Journal of the American Medical Association (JAMA).

Laura Blue, Ph.D., from Mathematica in Washington, D.C., and colleagues estimated the effects of the Million Hearts Model on first-time myocardial infarctions and strokes and Medicare spending over a period up to five years (2017 to 2021).

Analysis included data from 342 U.S.-based primary care and specialty practices, health centers, and hospital-based outpatient clinics with participating patients: 130,578 Medicare fee-for-service beneficiaries (aged 40 to 79 years) with medium or high CVD risk and 88,286 control beneficiaries.

The researchers found that the probability of a first-time CVD event within five years was lower for intervention beneficiaries than control beneficiaries (3.3% relative effect; adjusted hazard ratio, 0.97; 90% confidence interval, 0.93 to 1.00). For combined first-time CVD events and CVD deaths, the five-year probability was lower in the intervention group (4.2% relative effect; adjusted hazard ratio, 0.96; 90% confidence interval, 0.93 to 0.99).

For CVD events, Medicare spending was similar between the groups (effect estimate, −$1.83 per beneficiary per month), as was overall Medicare spending when including model payments (effect estimate, $2.11 per beneficiary per month).

"Results support guidelines to use risk scores for CVD primary prevention," the authors write.

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