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Heart disease is cited as the leading cause of death for men and women. It is stated that one person dies every forty seconds from heart disease. The healthcare community has placed great importance on focusing resources to improve heart health outcomes and to reduce the financial burden incurred in treating this epidemic.

Heart failure (HF) is one of the most common causes of hospitalization and readmission. More than 25 percent of patients hospitalized for heart failure are readmitted to the hospital within 30 days of discharge. Although not all re-hospitalizations for CHF can be prevented, the risk of re-hospitalization increases with lack of compliance to discharge instructions. Compliance to medication, diet and activity regimens, and weight management are key factors in improving outcomes. Patients should be well educated on identifying signs and symptoms when CHF is not under good control. Post-discharge care should be coordinated with patients’ primary care physicians who can help with medication reconciliation to help prevent re-hospitalization. Care coordination intervention plays a very key role in improving patient outcomes for this patient population.
 
A multidisciplinary integrated care approach is seen as a best practice management of heart disease. Care coordination facilitates the communication and collaboration needed among stakeholders. The key goals of care coordination are; the management of the transitions of care, medication reconciliation, reducing preventable emergency department visits and hospital readmissions.
 
Given the substantial burden that heart failure represents, payers and professional organizations have developed performance measures surrounding patients and their treatment. These required measures serve to encourage healthcare providers to provide better care by following evidence-based practice guidelines. Healthcare analytics can be quite useful in revealing opportunities to improve performance, quality and efficiency.
 
In 2013 Medicare introduced voluntary payment model pilot programs to financially incentivize improved quality and coordination of care at a lower cost for HF episode of care. Medicare’s cost and utilization metrics has shown that there are great savings opportunities to be realized by payers, providers and other stakeholders. The bundled-payment model for cardiac care was the second mandatory demonstration project created by the agency. The mandatory component has drawn criticism from providers, and the new administration. Medicare has deemed it necessary to generate statistically reliable estimates of the impact of the program in different settings. There is still more to come on final rulings.
 
Healthcare Navigation Systems provides consultation and support for care coordination and outcomes improvement initiatives.