Through financial incentives and an emphasis on proven health outcomes, the Affordable Care Act (ACA) provides opportunities to increase the availability of cardiac rehabilitation (CR) programs — including offering CR as part of worksite health programs (WHPs), according to an article in the August Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

"Fuller integration and widespread implementation of WHP with CR should be a priority for both employers and health care providers, given the burden of cardiovascular disease and the proven track record of CR," notes author Sherry O. Pinkstaff, PhD, PT, of University of North Florida, Jacksonville, and colleagues.

Preventable health risks

The authors highlight the health and economic impact of cardiovascular disease, with many affected patients being of working age. While employers pay 80 times more in diagnosis than in prevention of cardiovascular disease, 50 to 70 percent of this disease is associated with preventable health risks.

More companies are offering WHPs as a means of improving worker productivity by improving worker health. While such programs are generally cost-saving, they are still not available to most workers. Research has consistently shown that cardiac rehabilitation is effective in reducing the risk factors associated with cardiovascular disease.

Incentives for employers

Dr Pinkstaff and colleagues point out specific provisions of the ACA that provide incentives for employers to incorporate CR services into WHPs. Cardiac rehab is a natural fit with ACA incentives for delivering care that achieves measurable improvements in health — rather than incentives for providing more care.

Targeting the workplace as a site for CR has the potential to improve health and productivity for large numbers of patients, lowering costs for the health care system and employers alike. The authors acknowledge there will be challenges in finding innovative ways of delivering the full range of CR services in non-hospital settings. They write, "[I]ntegrating CR-type services into WHPs appears feasible, with a significant improvement in health profile and a favorable return on investment."

Citation — Pinkstaff SO, Arena R, Myers J, et al. The Affordable Care Act: new opportunities for cardiac rehabilitation in the workplace? J Occup Environ Med. 2014;56(8):809-13.