Facility-Level Variation in Cardiac Rehabilitation Completion.

Abstract

Purpose To quantify facility-level variation in cardiac rehabilitation (CR) completion among Medicare beneficiaries after major cardiovascular procedures. Methods We analyzed Medicare fee-for-service claims for beneficiaries discharged alive after common cardiovascular procedures between July 2016 and December 2018. Beneficiaries were attributed to CR facilities via the national provider identifier on CR claims. Facilities with Results Among 183 888 beneficiaries who attended ≥1 CR session across 2194 facilities, the mean ± SD number of sessions attended was 25.6 ± 12.4, with 53 558 (29%) completing CR. Risk-adjusted facility-level completion rates ranged from 0% to 90.9% (median: 32.9%; IQR: 18.7%, 44.9%). After adjusting for patient factors, the median OR for CR adherence between facilities was 2.34 (95% CI, 2.26-2.43), indicating a facility-level difference in completion independent of patient mix. Completion did not differ significantly by urbanicity or facility volume but varied by region and level of community distress (P Conclusions Completion of CR varies widely across facilities and is highly facility-dependent, indicating opportunities for quality improvement.