Each site has the appropriate 6-person team on staff:

• Physician / Medical Director
• Registered Nurse / Case Manager
• Exercise Physiologist
• Group Support Specialist
• Stress Management Specialist
• Registered Dietician

The site also has a:

• Program Director  (This role is provided by one of the 6-person team members)
• Administrative Assistant
• Chef / Food Services
• Marketing Recruiter

Each site sends their 6-person team to a 4-day didactic & experiential training retreat.

The Dr. Dean Ornish Program for Reversing Heart Disease is offered to participants in 4-hour sessions.

Each session includes:

• 1 hour of yoga and meditation taught by a certified teacher
• 1 hour of supervised exercise, taught by an exercise physiologist
• 1 hour of a support group, led by a clinical psychologist or equivalent
• 1 hour of a group meal and a lecture, with a lecture by a dietitian or nurse

In this model, the physician acts as “quarterback” of a team that also includes a:

• Registered nurse
• Yoga and meditation teacher
• Exercise physiologist
• Registered dietitian
• Clinical psychologist or equivalent

Participants meet for 18 four-hour sessions over a 9, 12, or 18 week period (depending on the format offered at a particular site).

After the 72 hours of training, participants move into a ‘self-directed community’ in which they continue to meet on a regular basis to support the lifestyle changes.

Data Collection

Site provides:

• Baseline Data
• 72-hour Data
• Annual 1-year Data

On the site’s certification anniversary, each site is required to meet or exceed 80% of the annual benchmarks located in the table below (i.e. a minimum of 11 of the 14 benchmarks)

For Intensive Cardiac Rehabilitation (ICR), the Centers for Medicare and Medicaid Services (CMS) require statistically significant reduction in 5 or more of the following measures:

• Low density lipoprotein
• Triglycerides
• Body mass index
• Systolic blood pressure
• Diastolic blood pressure
• The need for cholesterol, blood pressure, and diabetes medications

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.