WHAT IS MILLION HEARTS? About the Campaign.
Sections for Million Hearts
WHAT IS MILLION HEARTS?
Million Hearts is a national initiative to prevent 1 million heart attacks and strokes over the next five years. The Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services are the co-leaders of Million Hearts within the U.S. Department of Health and Human Services, working alongside other federal agencies including the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Food and Drug Administration. Key private-sector partners include the American Heart Association, and YMCA, among others.
Heart disease and stroke are two of the leading causes of death in the United States. Million Hearts aims to improve heart disease and stroke prevention by:
- Improving access to effective care.
- Improving the quality of care.
- Focusing more clinical attention on heart attack and stroke prevention.
- Increasing public awareness of how to lead a heart-healthy lifestyle.
- Increasing the consistent use of high blood pressure and cholesterol medications.
Million Hearts brings together existing efforts and new programs to improve health across communities and help Americans live longer, healthier, more productive lives.
About the Campaign
The Building Blocks of Million Hearts:
An Overview of Public & Private Supports
Million Hearts will promote innovations to identify people now at cardiac risk, ensure that they receive appropriate treatment, reduce the need for blood pressure and cholesterol treatment, promote healthy diet and physical activity, and support smoke-free environments to reduce current and future cardiac risk.
Through communication, clinical measurement, and reporting to tens of thousands of health care providers and thousands of health care facilities for outpatient care, Million Hearts will provide a necessary focus showing that the ABCS (Aspirin for people at risk, Blood pressure control, Cholesterol management, Smoking cessation) are a top priority. Million Hearts will support health IT, connection and adherence to care, and other health system innovations that improve delivery of the ABCS to people who need them.
Partners from across the public and private health sectors, including federal agencies; doctors, nurses, pharmacists and other health care professionals; private insurers; businesses; health advocacy groups; and community organizations, will support Million Hearts through a wide range of activities.
The following are some of the current public and private sector supports. Going forward, Million Hearts will be successful through the long-term implementation, ongoing coordination of efforts, and ability to achieve sustained community and clinical innovations.
>>>>> Public Sector Supports <<<<
Data Harmonization. Several agencies within the Federal government will work toward ensuring that systems measuring the ABCS are consistent. This will both improve health system performance in delivering these essential services and reduce burden on provider and health care systems.
HHS is the government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
HHS works closely with state and local governments, and many HHS-funded services are provided at the local level by state or county agencies or through private sector grantees. The Department’s programs are administered by 11 operating divisions, including eight agencies in the U.S. Public Health Service and three human services agencies. The department includes more than 300 programs, covering a wide spectrum of activities. In addition to the services they deliver, HHS programs provide for equitable treatment of beneficiaries nationwide, and they enable the collection of national health and other data.
Communication and Surveillance. AHRQ will support Million Hearts through conferences and communications that will speed the identification and diffusion of innovative strategies to improve the delivery of the ABCS in communities and health care systems. AHRQ also has committed to supporting surveillance of cardiovascular events through its annual National Healthcare Quality and National Healthcare Disparities Reports, as well as promoting dissemination of evidence-based materials tailored to consumers and families through the Effective Health Care program.
Network to Support and Amplify the Reach of Community Transformation Grants. Concurrent with the Million Hearts release, CDC is awarding $4.2 million to seven national networks of community-based organizations to support community health promotion. Later this month, CDC will announce another $100 million in grants to empower communities to reduce smoking, improve nutrition and promote blood pressure control. By fostering healthy lifestyles and communities, especially among populations experiencing the greatest burden of chronic disease, Community Transformation Grants will help improve health, reduce health disparities and lower health care costs.
Coordinated Chronic Disease Prevention and Health Promotion. Also with the Million Hearts release, $40 million in resources will be granted to states to improve health by targeting nutrition, physical activity, and clinical preventive services, as well as promoting education and management for people diagnosed with or at high risk for chronic diseases.
Pharmacy Outreach Project. CDC and its partners will develop educational tools and resources for neighborhood pharmacists to use to enable public education for at-risk populations to stress the importance of staying on high blood pressure medications to prevent heart attacks and strokes.
Programs to Reduce Health Disparities. Reducing cardiovascular disease will significantly reduce health disparities. Programs such as the Mississippi Delta Health Intervention, which promotes heart health in both clinical and community settings across Mississippi’s 18-county Delta Region, and WISEWOMAN, which helps low-income, uninsured 40 to 64-year-old women reduce their risk for heart disease, stroke and other chronic diseases, are pivotal in linking community and clinical practices consistent with the recently released HHS Action Plan to Reduce Racial and Ethnic Health Disparities.
Medicare Advantage 5-Star Rating System. CMS uses the Medicare Advantage system not only to ensure that private Medicare Advantage plans meet Medicare’s quality standards but also to give consumers a tool to compare the quality of plans. Consistent with the Million Hearts goal, the rating system covers cardiovascular care, including cholesterol screening, weight and physical activity monitoring, and medication adherence.
Medicaid Incentives for Prevention of Chronic Disease. CMS is awarding more than $85 million in grants over 5 years to 10 States (Wisconsin, Minnesota, New York, Nevada, New Hampshire, Montana, Hawaii, Texas, California and Connecticut) to encourage Medicaid beneficiaries of all ages to participate in chronic disease prevention programs and take active steps to improve their health.
Physician Quality Reporting System. The Physician Quality Reporting System provides bonus payments to physicians and other health professionals for reporting quality information to Medicare. Among the measures that physicians and other health professionals may report for 2011 are Ischemic Vascular Disease: Use of Aspirin or another Antithrombotic; Controlling High Blood Pressure; Low Density Lipoprotein Control in Diabetes Mellitus; and Tobacco Use Assessment and Tobacco Cessation Intervention.
Quality Improvement Organizations (QIOs). A network of 53 Medicare-funded organizations nationwide that improve healthcare quality at the community level, QIOs will work with physician offices, clinics and other providers to create a Learning & Action Network focused on achieving the elements of ABCS, as well as other quality goals.
Medicaid Quality Measures Program. Five quality measures from this program correspond with the aim of Million Hearts, including: medical assistance with smoking and tobacco use cessation; congestive heart failure admission rate; controlling high blood pressure; adult BMI assessment; and comprehensive diabetes care: LDL-C screening.
Medicaid EHR Incentive Program. This program provides incentive payments to eligible professionals, eligible hospitals, and critical access hospitals as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Measures include both functional and clinical quality measures that address the Million Hearts priorities, including capturing smoking status and blood pressure (functional) and aspirin use and cholesterol screening (clinical quality).
Sodium Intake. Excess sodium intake is a contributor to high blood pressure, which is a major risk factor for heart disease and stroke. Most of the total sodium intake comes from processed and restaurant foods rather than what people add in cooking or at the table. As part of its ongoing efforts to help Americans control their sodium intake, FDA is seeking input on the opportunities for sodium reduction efforts, building on initiatives already undertaken by the food and restaurant industries.
ABCS measures. HRSA will require all community health centers starting in 2012 to annually report on the ABCS measures to track and improve performance, including new measures for 2012 for aspirin use and cholesterol screening. By 2017, HRSA is committing to increasing by 50% the number of health centers that meet or exceed Healthy People 2020 goals for the ABCS measures.
PCHM Recognition. By 2013, 25% of all health centers will have at least one site recognized as a patient-centered medical home (PCMH), a service delivery model designed to improve the quality of care through enhanced access, planning, management, and monitoring of patient care, especially important for patients at risk for heart attacks and strokes.
Implementation of EHRs. By 2017, all appropriate HRSA sponsored health care sites (Health Centers, Rural Health Clinics, Critical Access Hospitals and Ryan White Clinics) will receive targeted technical assistance on implementation of electronic health records and how to improve their use of clinical quality measures related to heart disease and stroke.
The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally-recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. This relationship, established in 1787, is based on Article I, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders. The IHS is the principal federal health care provider and health advocate for Indian people, and its goal is to raise their health status to the highest possible level. The IHS provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 564 federally recognized tribes in 35 states.
Heart Truth® and Million Hearts. NHLBI is aligning ongoing campaigns and activities like the Heart Truth campaign and continuing medical education materials with Million Hearts.
Clinical Practice Guidelines. NHLBI is supporting a new five-year $9.85 million contract for a National Program to Reduce Cardiovascular Risk focused on implementation of clinical practice guidelines to reduce CVD risk factors.
National Prevention Strategy
Million Hearts is aligned with the National Prevention Strategy and Strategy implementation by 17 National Prevention Council Federal Departments, and its public, private and nonprofit partners will advance the Million Hearts’ goals. Alignment is demonstrated in the Strategy’s Clinical and Community Preventive Services strategic direction and in three of its seven priorities – Tobacco-Free Living, Healthy Eating and Active Living.
National Quality Strategy
Addressing preventable causes of avoidable mortality, starting with cardiovascular disease, is a top for the National Quality Strategy. Alignment of metrics used to assess treatment of individuals at highest risk across HHS programs as well as promoting patient and family engagement with care are all core components of the Strategy.
Cardiovascular disease, diabetes, and obesity are associated with mental illness and treatment of the mental illness can reduce the effects of these disorders. Up to 83 percent of people with serious mental illness are overweight or obese and 44 percent of the US tobacco market is comprised of individuals with a mental or substance use disorder. All too often after overcoming an addiction or mental illness people with these disorders suffer from premature morbidity and mortality as a result of poor diet, lack of exercise and primary prevention services. SAMHSA has committed to aligning all available resources to support improved outreach and provision of comprehensive health care to people with mental and substance use disorders.
>>>>> Private Sector Supports <<<<<
Many national associations are committed to engaging their constituents in this important initiative, particularly those involved in the delivery of primary care whose involvement is so central to the reliable delivery of the ABCS.
American Heart Association (AHA) will help monitor progress of the initiative’s goals. AHA also is providing consumers with access to their heart health management tools, including Heart 360, My Life Check, and the Heart Attack Risk Calculator. In a critical effort to simplify and improve measurement and standardization of the ABCS, AHA will work with the federal government toward greater harmonization of clinical indicators with measurement standards. Additionally, AHA will educate physicians and disseminate best practices in the ABCS across health systems to improve patient care.
America’s Health Insurance Plans and its members will amplify their ongoing commitment to reduce cardiovascular disease, which includes community-based collaborations to reduce the burden of obesity and other risk factors for heart disease (UnitedHealthcare), beneficiary fitness programs (WellPoint), initiatives to reduce ethnic and racial disparities in cardiovascular health (Aetna) and programs to better manage chronic disease (Cigna).
AMA is committed to helping doctors help patients by creating a network for physicians to work together in resolving the most urgent professional and public health issues. Improving public health through positive lifestyle behaviors is a cornerstone of the AMA mission, and AMA chooses to lead by example. The AMA Healthier Life Steps, a component of one of the AMA’s five strategic issues for 2011, was designed to assist doctors with implementing healthier lifestyle behaviors in their own lives as well as their patients’ lives.
AMA Healthier Life Steps identifies health behaviors that are significantly related to heart disease, diabetes, cancer, and other illnesses. By offering suggestions on decreasing and eliminating poor diet, physical inactivity, tobacco use, and excessive or risky use of alcohol, AMA Healthier Life Steps supports doctors in their efforts to live healthier lives and helps them serve as role models for their patients.
For more than 100 years, the ANA has been the only full-service professional organization representing the interests of America’s 3.1 million registered nurses. The ANA works with policy development, lobbying, publications, and partnerships with other organizations to advocate for the rights of nurses and patients. The ANA contributes to the goals of Million Hearts through advocating and supporting the opportunity for all Americans to live healthy and tobacco-free lives.
The American Pharmacists Association (APhA) and The American Pharmacists Association Foundation will encourage its more than 62,000 members to engage in the Million Hearts Campaign by raising awareness with their patients and their communities through the many activities planned for American Pharmacists Month in October and beyond. In addition, APhA will continue to spread the healthy heart message during the APhA Annual Meeting & Exposition in March and via numerous publications and social media channels reaching tens of thousands of pharmacists and consumers nationwide.
Kaiser Permanente is committed to helping shape the future of health care. Kaiser Permanente is recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, the company’s mission is to provide high-quality, affordable health care services and to improve the health of members and the communities served. Kaiser Permanente is committed to improving the cardiovascular health of its members and communities across the U.S., so Kaiser Permanente’s goals are very much aligned with Million Hearts. Through Kaiser Permanente HealthConnect®, Kaiser Permanente’s electronic medical record system, and panel-based management tools, they are identifying members at-risk for cardiovascular care and then aggressively treating them and, when appropriate, providing chronic care management or surgical interventions. Kaiser Permanente’s ALL/PHASE program, which is based on research that a simple bundle of low-cost medications – Aspirin, Lisinopril and Lipid-lowering therapy – in combination with a beta blocker and lifestyle changes, dramatically reduces heart attacks and strokes by 60 percent for at-risk populations, like diabetics, underscores that ABCS are an effective strategy. Kaiser Permanente’s programs and similar innovations will compliment the aims of Million Hearts.
The National Alliance of State Pharmacy Associations (NASPA) and the Alliance for Patient Medication Safety (APMS)
The National Alliance of State Pharmacy Associations (NASPA) and the Alliance for Patient Medication Safety (APMS) will encourage state pharmacy associations and their members to engage in the Million Hearts Campaign throughout the year with many activities planned for American Pharmacists Month in October and beyond. NASPA will focus on heart health by promoting leadership, sharing, learning, and policy exchange among state pharmacy associations and pharmacy leaders nationwide, and support pharmacists, patients, States and communities working together to improve heart health.
The National Community Pharmacists Association (NCPA) enthusiastically supports the Million Hearts Initiative, and will encourage all 23,000 independent community pharmacies to become involved in the Initiative, feature the initiative at its Annual Convention in October, and continue to raise awareness through their publications and social media outlets. Community pharmacists will also offer programs supporting the Million Hearts goal, such as blood pressure and lipid monitoring and smoking cessation services, and the new Simplify My Meds program that improves adherence by reducing the potential for gaps between refills and identifying other possible barriers to adherence.
UnitedHealthcare strives to improve health care access for all Americans, create products and services that make health care more affordable, and find ways to make the health care system easier to understand. The company offers a wide spectrum of consumer-oriented health benefit plans and services to individuals and employers, covering approximately 25 million individual consumers.
In 2009, UnitedHealthcare joined forces with the American Health Association to promote physical activity by establishing walking paths throughout the country with the Walking Paths Program. The program aims to build 150 new paths within its first year and will also establish online walking resources to help people develop and maintain walking regimens.
Walgreens will engage its more than 26,000 health care providers to support the Million Hearts initiative’s prevention goal by providing blood pressure testing at no charge in consultation with a Walgreens pharmacist or Take Care Clinic Nurse Practitioner. In addition, Walgreens also plans to promote diabetes testing in November and heart health in February, and make Million Hearts resources available at their more than 7,760 drugstores nationwide.
TheE Y is increasing private sector partnerships to expand coverage for the Y’s Diabetes Prevention Program, as well as exploring opportunities to expand the successful National Diabetes Prevention Program and CDC’s Healthy Communities Program to better address risks for diabetes, heart attacks, and strokes. The Y also is actively encouraging Ys and other community partners to assess and improve community environments to promote healthy living.
FREQUENTLY ASKED QUESTIONS
What is the Million Hearts Initiative?
Million Hearts is a national initiative designed to prevent 1 million heart attacks and strokes in the United States over the next five years.
Why is Million Hearts being launched?
Heart disease and stroke are the first and fourth leading causes of death in the United States, making heart disease responsible for 1 of every 3 deaths in the country. Million Hearts will bring together a wide range of heart disease and stroke prevention programs, policies, and activities to raise awareness among health care providers, private-sector organizations, policymakers, and consumers about what can be done to prevent heart disease and stroke in our nation.
What is new about Million Hearts?
The Million Hearts Initiative will focus, coordinate, and enhance cardiovascular disease prevention activities across the public and private sectors in an unparalleled effort to prevent 1 million heart attacks and strokes over the next five years and demonstrate to the American people that improving the health system can save lives. Million Hearts will scale-up proven clinical and community strategies to prevent heart disease and stroke across the nation.
What are some examples of Million Hearts activities?
Some of Million Hearts’ wide-ranging activities may include:
- Educational campaigns to increase awareness about heart disease prevention and empower patients to take control of their heart health.
- Use of health information technology and quality improvement initiatives to standardize and improve the delivery of care for high blood pressure and high cholesterol.
- Community efforts to promote smoke-free air policies and reduce sodium in the food supply.
When does Million Hearts begin?
The Million Hearts Initiative launched in September 2011.
How long will Million Hearts last?
Million Hearts will last for five years, but the impact of the program is expected to continue far into the future.
Who will lead Million Hearts?
Forging strong partnerships is key to the success of Million Hearts. The Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services will co-lead Million Hearts efforts within the federal government, working alongside key private sector organizations such as the American Heart Association, and YMCA.
Who is involved in Million Hearts?
Million Hearts has a role for everyone, from consumers and health care providers to employers and communities. Multiple agencies with the U.S. Department of Health and Human Services (HHS) are involved in Million Hearts, including the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, the HHS Office of the Secretary, the Indian Health Service, the National Institutes of Health, the Office of the National Coordinator for Health IT, and the Substance Abuse and Mental Health Services Administration.
Private-sector organizations with significant participation in the Initiative include the American Heart Association, and YMCA.
How will Million Hearts achieve its goal?
Million Hearts will achieve its goal by emphasizing cardiovascular health across patients, providers, communities, and other stakeholders. Million Hearts will bring together a number of programs, policies, and campaigns designed to make a positive impact across the spectrum of prevention and care, promoting the “ABCS” of clinical prevention (appropriate aspirin therapy, blood pressure control, cholesterol control, and smoking cessation) as well as healthier lifestyles and communities.
- Learn more about the science of Million Hearts in CDC’s Morbidity and Mortality Weekly Report
- Check out Million Hearts in Circulation, [PDF-286K] a journal of the American Heart Association
- See the Million Hearts perspective in the New England Journal of Medicine
- See the Million Hearts press release issed on Tuesday, September 13, 2011 [PDF-132K]