Project Overview
Mathematica and its partner RAND are helping CMS determine whether a quality improvement model with performance-based payments reduced first-time heart attacks and strokes among Medicare beneficiaries.
Our role is to help CMS determine if the model was successful, which means assessing (1) whether and how the model reduced first-time heart attacks and strokes and (2) whether the model reduced Medicare spending on hospitalizations and post-acute care for cardiovascular events enough to fully offset model payments.
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services
Mathematica helps Medicare assess whether a quality improvement model with performance-based payments reduced heart attacks and strokes for Medicare beneficiaries.
Cardiovascular disease is a leading cause of death and disability in the United States. In 2017, CMS launched the Million Hearts Cardiovascular Disease Risk Reduction Model to reduce the incidence of first-time heart attacks and strokes among Medicare beneficiaries ages 40 to 79. The model paid providers for assessing each of their Medicare patients’ risk of having a heart attack and stroke over 10 years, and then made additional payments to organizations that successfully reduced risk for their high-risk patients (those with a 30 percent or higher risk of a heart attack or stroke over 10 years). CMS tested the model in a rigorous randomized trial that included primary care practices, cardiology practices, health centers, and hospitals throughout the country. Our evaluation uses mixed methods to assess whether and how the model improved preventive cardiovascular care and reduced first-time heart attacks and strokes.
Evidence & Insights From This Project

Effects of the Million Hearts Model on Myocardial Infarctions, Strokes, and Medicare Spending
The Million Hearts Model paid health care organizations to assess and reduce cardiovascular disease (CVD) risk. Model effects on long-term outcomes are unknown.
Learn MoreRelated Staff
Efficiency Meets Impact.
That's Progress Together.
Mathematica delivers evidence-based solutions to optimize programs and policies for efficiency, cost savings, and measurable impact. Learn more about becoming a client or partner.
Work With Us