# Low participation in cardiac rehabilitation among eligible patients Bottleneck · id `cardio:bottleneck-low-cardiac-rehab-participation` · Cardiovascular Atlas · release `73130c34862e2d06` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, organ or system: Heart Browse, condition area: Acute care and long-term living ## In plain language Only about 1 in 4 people who were eligible for cardiac rehabilitation under Medicare in 2016 attended any sessions. In a study of Medicare fee-for-service beneficiaries, 24.4% took part, fewer took part among women, Hispanic and non-Hispanic Black beneficiaries and in some regions, and about a quarter of those who took part completed the program. The Million Hearts road map set a goal of at least 70% participation by 2022. A joint scientific statement from rehabilitation and cardiology societies also describes the use of cardiac rehabilitation in the United States as significantly underused. ## Technical summary The burden claim rests on one observational claims study of Medicare fee-for-service beneficiaries eligible in 2016 and followed through 2017 (Circulation: Cardiovascular Quality and Outcomes, 2020). It covers one insurance group and one period; this record has not looked for later data, and the 2022 goal date has passed. The Million Hearts cardiac rehabilitation toolkit (second edition, 2023) is aimed at hospital teams that want to raise use; its content is cite-only here. The same joint statement is the source for the home-based programs idea. ## Claims, with the population each applies to ## Context: Medicare fee-for-service beneficiaries eligible for cardiac rehabilitation in 2016 Recipient: Adult; Population: Medicare fee-for-service beneficiaries who were eligible for cardiac rehabilitation in 2016 (366,103 people), identified through a qualifying event: acute myocardial infarction hospitalization, coronary artery bypass surgery, heart valve repair or replacement, percutaneous coronary intervention, or heart or heart-lung transplant.; Care setting: Medicare fee-for-service claims in the United States.; Geography: United States; results are also given by Census Division and hospital referral region.; Life stage: Adults; participation decreased with increasing age (abstract). The abstract gives no age range.; Follow-up: Participation, timely initiation and completion were assessed through 2017. ### In an observational study of Medicare fee-for-service beneficiaries who were eligible for cardiac rehabilitation in 2016, 89,327 of 366,103 (24.4%) participated (attended at least 1 session), assessed through 2017. Of those who participated, 24.3% started within 21 days of the qualifying event and 26.9% completed rehabilitation (36 or more sessions attended). Participation was lower among women (18.9%) than men (28.6%), and lower among Hispanic (13.2%) and non-Hispanic Black (13.6%) beneficiaries than non-Hispanic white beneficiaries (25.8%). It varied by region, from 18.6% (East South Central Census Division) to 39.1% (West North Central), and by qualifying event, from 7.1% (acute myocardial infarction without procedure) to 55.3% (coronary artery bypass surgery only). The Million Hearts Cardiac Rehabilitation Collaborative set a road map goal of raising participation rates to 70% or more by 2022. - Category: Burden - Evidence stage: Observational - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Medicare fee-for-service beneficiaries who were eligible for cardiac rehabilitation in 2016 (366,103 people), identified through a qualifying event: acute myocardial infarction hospitalization, coronary artery bypass surgery, heart valve repair or replacement, percutaneous coronary intervention, or heart or heart-lung transplant.; Care setting: Medicare fee-for-service claims in the United States.; Geography: United States; results are also given by Census Division and hospital referral region.; Life stage: Adults; participation decreased with increasing age (abstract). The abstract gives no age range.; Follow-up: Participation, timely initiation and completion were assessed through 2017. - Limitations: Medicare fee-for-service beneficiaries only, so the figures do not describe people with other coverage. Participation means attending at least one session. The study is observational and uses claims, and the abstract gives no reasons for non-participation. It covers a 2016 eligible group followed through 2017; this record has not looked for later data, and the 2022 goal date has passed. The AACVPR, AHA and ACC scientific statement separately describes the use of cardiac rehabilitation in the United States as significantly underused. - Last checked: 2026-10-15 - Sources: 1. Supports: Tracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS AND RESULTS, sentences 1 to 3. Retrieved 2026-10-15T13:48:13Z. Source state: Current. Snapshot hash: 6db5ce7d181853fffb9f652f9ef651232e1df7ddaccaa02faa9ded4505b0516f. How it applies: Eligible group, participation, timely initiation and completion. 2. Supports: Tracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS AND RESULTS, sentence 5. Retrieved 2026-10-15T13:48:13Z. Source state: Current. Snapshot hash: 6db5ce7d181853fffb9f652f9ef651232e1df7ddaccaa02faa9ded4505b0516f. How it applies: Differences by sex, ethnicity, region and qualifying event. 3. Background: Tracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, BACKGROUND, sentence 2. Retrieved 2026-10-15T13:48:13Z. Source state: Current. Snapshot hash: 6db5ce7d181853fffb9f652f9ef651232e1df7ddaccaa02faa9ded4505b0516f. How it applies: The 70% participation goal. 4. Background: Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, paragraph 1, sentence 2. Retrieved 2026-10-15T13:48:14Z. Source state: Current. Snapshot hash: 826982c6fe78c5bd8a7b612fbd6af9232ad966689235ccf3f9d64e3e36ccc15b. How it applies: Statement that cardiac rehabilitation is significantly underused in the United States. ## Connected pages - The service whose use falls short: Cardiac rehabilitation (`cardio:cardiac-rehabilitation`) - Filed under this front: Rehabilitation and living well (`cardio:front-rehabilitation-and-living-well`) - Addressed by: Home-based cardiac rehabilitation (`cardio:idea-home-based-cardiac-rehab`) - Addressed by: Million Hearts Cardiac Rehabilitation Change Package (`cardio:million-hearts-cardiac-rehab-change-package`) ## Provenance Content hash: 76296b011bbc5c8fe251db095f7a2de5d28ec1722edeb5338ce5b9b1b8fdab82 Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-15