Though cardiac rehab can be a vital
resource on the road to recovery, just 12
percent of eligible Medicare beneficiaries ever
participate. One reason participation rates have
historically been low is a Medicare rule that
requires a physician to directly supervise these
programs, which can limit access and add on
The American Heart Association supports
H.R. 3355 and S. 488 that would allow
physician assistants, nurse practitioners and
clinical nurse specialists to supervise cardiac
rehabilitation services on a day-to-day basis
under Medicare. The legislation will not
alter the requirement for medical direction
of these programs, but rather would allow
non-physician practitioners to meet the direct
Urge your congressional representative today
to co-sponsor bipartisan legislation that would
allow non-physician providers to supervise
cardiac rehab programs and make cardiac
rehab accessible to more Medicare patients.
Even when they receive a prescription for cardiac rehab,
some heart survivors run into barriers that keep them from
participating. Here are five common stumbling blocks and
suggestions for getting past them.
1. “I’m scared to work out. What if I have
another cardiac event.”
First, according to Pat Dunn, the chances of this happening
are small — one cardiac event for every 49,000 hours of
rehab. Second, if you’re working out in a gym supervised
by a cardiologist and staffed by trained professionals —
what could be safer? A third thing to consider is that even
if you had another heart attack, because your rehab is
strengthening your heart, and a stronger heart can better
compensate for the damage, you are more likely to survive.
2. “I can’t take time off of work for rehab.”
Even if your job won’t accommodate your need for
recovery, most programs are flexible and offer multiple
times throughout the day so you can fit it in to your
schedule. And if not, plans can be tailored to your needs.
3. “I can’t afford it.”
Medicare covers Phase 2 cardiac rehab for many
conditions, and most insurers follow Medicare but may
require a co-payment. From the Medicare website: “You
pay 20 percent of the Medicare-approved amount if you
get the services in a doctor’s office. In a hospital outpatient
setting, you pay the hospital a co-payment. The Part B
deductible applies.” The American Heart Association has
resources developed for patients to support them along
with their formal cardiac rehab program.
4. “I know what I need to do.”
Knowing what to do and doing it are worlds apart.
And even if you know what’s needed, do you have the
equipment? Do you have the supervising cardiologist,
certified exercise physiologist and nurses standing by? Do
you have other patients supporting you in accomplishing
your workout and lifestyle changes?
5. “I feel fine! I don’t need rehab.”
Congratulations on feeling good, but maintaining that
requires effort. Cardiac rehab is designed and implemented
for that purpose, including the counseling and lifestyle
education. Besides that, there is immense value in the
emotional support you get from other participants.