The Department of Health and Human Services (HHS), along with several association and industry partners, has launched Million Hearts, an initiative that aims to prevent one million heart attacks and strokes in the U.S. over the next five years. Currently, cardiovascular disease (CVD) costs $444 billion every year in medical costs and lost productivity for people living in the U.S.

The Million Hearts initiative is focused on two goals:

• Empowering Americans to make healthy choices, such as preventing tobacco use and reducing sodium and transfat consumption.
• Improving care for people who do need treatment by encouraging a targeted focus on ABCS care, which stands for: Aspirin for people at risk, Blood pressure control, Cholesterol management and Smoking cessation.

“Heart disease causes one of every three American deaths and constitutes 17 percent of overall national health spending,” said HHS Secretary Kathleen Sebelius. “By enlisting partners from across the health sector, Million Hearts will create a national focus on combating heart disease.”

Specific goals are:

Indicator	Baseline	2017 goal
Aspirin use for people at high risk	47%	65%
Blood pressure control	46%	65%
Effective treatment of high cholesterol (LDL-C)	33%	65%
Smoking prevalence	19%	17%
Sodium intake (average)	3.5g/day	20% reduction
Artificial transfat consumption (average)	1% of calories/day	50% reduction

“If we succeed in achieving our Million Hearts goals, 10 million more Americans with high blood pressure will have it under control, 20 million more Americans with high cholesterol will have it under control and four million fewer Americans will smoke by 2017,” said Centers for Disease Control and Prevention Director Thomas R. Frieden, MD, MPH.

“The treatment of heart disease and stroke account for about $1 of every $6 spent on U.S. healthcare,” said Donald Berwick, MD, administrator of the Centers for Medicare & Medicaid Services (CMS).

The private sector initiatives include:

• The American Heart Association will help monitor progress of the initiative’s goals and provide consumers with access to their heart health management tools, including Heart 360, My Life Check and the Heart Attack Risk Calculator.
• Walgreens will engage its more than 26,000 healthcare providers to support the Million Hearts initiative’s prevention goal by providing blood pressure testing at no charge in consultation with a Walgreens' pharmacist or Take Care Clinic Nurse Practitioner.
• The Y will aim to expand coverage of the Y’s Diabetes Prevention Program as well as the National Diabetes Prevention Program and CDC’s Healthy Communities Program to better address risks for diabetes, heart attacks and stroke.
• America’s Health Insurance Plans and its members will amplify their ongoing commitment to reduce CVD, which includes community-based collaborations to reduce the burden of obesity and other risk factors for heart disease (UnitedHealthcare), beneficiary fitness programs (WellPoint), initiatives to reduce ethnic and racial disparities in cardiovascular health (Aetna) and programs to better manage chronic disease (Cigna).
• The American Pharmacists’ Association and the American Pharmacists’ Association Foundation will encourage their more than 62,000 members to engage in the Million Hearts Campaign by raising awareness with their patients and their communities.
• The National Alliance of State Pharmacy Associations and the Alliance for Patient Medication Safety will encourage state pharmacy associations and their members to engage in the Million Hearts campaign throughout the year with activities planned for American Pharmacists Month in October and beyond.
• The National Community Pharmacists Association will encourage its 23,000 independent community pharmacies to become involved in the initiative and to raise awareness through their publications and social media outlets.

Also, associations like the American Medical Association and American Nurses Association have already committed their constituencies to this work, according to HHS.

In addition, HHS will target more than $200 million in new and refocused investments to achieve the goals of Million Hearts:

• Today, CDC is announcing $40 million for chronic disease prevention programs to health departments across the U.S.
• The FDA and the Food Safety and Inspection Service are launching efforts to identify opportunities to reduce sodium in food to put more control into consumers’ hands.
• CDC is announcing a $2 million Pharmacy Outreach Project to team up with pharmacists to provide additional advice and support to patients diagnosed with high blood pressure.
• CMS is announcing $85 million in Medicaid Incentives for Prevention of Chronic Diseases grants awarded to 10 states. These awards support prevention programs for Medicaid beneficiaries of all ages.
• CDC is announcing $4.2 million in funds to seven national networks of community-based organizations to support, disseminate and amplify the reach of the Community Transformation Grant program. Later this month, CDC will announce another $100 million in grants to communities across the U.S., focused on reducing smoking, improving nutrition and promoting blood pressure control.
• The Substance Abuse and Mental Health Services Administration will align all available resources to support improved outreach and provision of comprehensive healthcare to people with mental and substance use disorders.

HHS also will seek to achieve the goals of Million Hearts by:

• Enhancing focus on cardiovascular disease prevention
  • Federal agencies and private sector partners will focus and align measurement strategies which will both improve ABCS care and simplify reporting for providers. For example, CMS plans to enhance its focus on the ABCS in the Physician Quality Reporting System, which provides bonus payments, and in the future, payment reductions, based on the reporting of quality information by eligible professionals.
  • Beginning in 2012, HRSA will require all community health centers to report annually on the ABCS measures to track and improve performance, including new measures for 2012 for aspirin use and cholesterol screening. These efforts will help to improve ABCS care for more than 20 million patients.
• Focusing health IT efforts to prevent heart attacks and strokes
  • Ongoing HIT improvements will increase focus on CVD prevention and give providers improved tools for their delivery of ABCS care. Regional extension centers will seek to reach nearly 100,000 primary care doctors, and Beacon Communities will seek to reach more than 100 million patients within the next few years.
• Improving the delivery of ABCS care through clinical steps, including:
  • Quality Improvement Organizations (QIOs): A network of 53 Medicare-funded organizations to improve healthcare quality at the community level, QIOs will work with physician offices, clinics and other providers to create Learning & Action Networks focused on achieving the elements of ABCS as part of each QIO’s tasks and goals.
  • Learning from Local Innovators (Healthcare Innovations Exchange). The HHS Agency for Healthcare Research and Quality’s Healthcare Innovations Exchange support efforts to identify and disseminate healthcare improvement projects led by local communities and leaders.

For further information on the public and private support of the Million Hearts initiative, visit: http://millionhearts.hhs.gov/about-mh.shtml.