Our proven lifestyle program is now available to Medicare recipients.

Better adherence and clinical outcomes than have ever been reported.

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Ornish Programs Reimbursed by Medicare

Summary

Dr. Ornish’s Program for Reversing Heart Disease was the first program scientifically proven to reverse heart disease without drugs or surgery.  After 17 years of internal and external review of the scientific literature published by Dr. Ornish and his colleagues at the non-profit Preventive Medicine Research Institute (PMRI), Medicare began covering “Dr. Dean Ornish’s Program for Reversing Heart Disease” as a branded program under a new benefit category, “intensive cardiac rehabilitation” (ICR).  This is the first time that Medicare has covered an integrative medicine program.

Medicare coverage creates a sustainable new paradigm of medical care that is more caring and compassionate, as well as more cost effective and competent, at a time when the limitations of conventional medicine are becoming increasingly apparent.  Because of this, many private insurance companies are also covering this program.

People are empowered with a proven program that can quickly reverse their heart disease and other chronic conditions, allowing them to sustainably transform their lives for the better. Overall adherence to Dr. Ornish’s Program after one year in hospitals and clinics that have offered it has been 85‑90%.

The Ornish Spectrum is a program that helps you make healthy, sustainable lifestyle changes in:

Site Approval

There are two steps to becoming a certified provider of Dr. Ornish’s Program for Reversing Heart Disease with Medicare:

• Certification by Dr. Ornish
  If you are a health care professional or a site wishing to become a certified provider of Dr. Ornish’s Program for Reversing Heart Disease, please submit a request, below.  We will get back to you soon with details of the training and certification, including training dates for 2012.
• Enrollment with Medicare
  Once individuals and/or sites have been trained and are certified by Dr. Ornish, they may enroll with their local Medicare Administrative Contractor (MAC) as an Intensive Cardiac Rehabilitation (ICR) provider.

Patient Eligibility Criteria

Effective January 1, 2010, Medicare Part B will cover ICR program services for beneficiaries who have experienced one or more of the following:

Within the preceding 12 months:

• An acute myocardial infarction within the preceding 12 months;

At any time:

• A coronary artery bypass surgery;
• Current stable angina pectoris;
• Heart valve repair or replacement;
• Percutaneous transluminal coronary angioplasty or coronary stenting;
• A heart or heart-lung transplant; or,
• Other cardiac conditions as specified through a national coverage determination (NCD) (CR only).

Patients have better adherence and clinical outcomes than have ever been reported from a program of comprehensive lifestyle changes.

Here are the latest findings from all of the 3,780 patients who went through our program at Highmark Blue Cross Blue Shield in Pennsylvania, Nebraska, and West Virginia as of October 2011:

• Overall attendance after 1 year was 87.9%;
• 45.2% of these patients had heart disease– 34.0% had type 2 diabetes, and the others had only risk factors (high blood pressure, cholesterol, or weight), yet adherence was comparable in all categories of patients (85-90% after 1 year);
• The average patient lost 13.3 pounds in the first 12 weeks and 15.9 pounds after 1 year;
• Significant reductions in systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, and LDL-cholesterol after 12 weeks were still significant after 1 year;
• Exercise capacity increased from 8.7 to 10.6 METS after 12 weeks (18% increase) and to 10.8 METS after one year (24% increase);
• Significant reductions in depression and hostility (the emotions most strongly linked with heart disease) after 12 weeks that were still significant after 1 year;
• Hemoglobin A1C in diabetics decreased from 7.4% at baseline to 6.5% after 12 weeks and 6.8% after one year (complications of diabetes such as blindness, kidney failure, heart disease, and amputations can be prevented when hemoglobin A1C is less than 7.0%);
• 96.5% of patients reported improvement in severity of angina (chest pain) after 1 year.

Ornish Certified Sites with Medicare Reimbursement

“We are just beginning to train and certify programs, so the site network will be growing significantly in the next few months.”

If you are interested in learning more about certified sites that have medicare reimbursement, please submit the below form.

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