The reviewers found that all three types of programs had some long-term benefits, including reductions in mortality and hospitalization, and improved quality of life, Dr. Clark said. “The foundation for change is happening at 12 months.”
Information on program costs was sketchier, he noted. Only 6 out of 41 studies mentioned costs, and three of those “reported or implied” cost savings without giving any relevant data. Most of the studies were heavy on male participants, with seven studies having no women at all.
In the end, panel members generally agreed that the Ornish program and similar interventions improved patients' long-term survival rates and quality of life, but they were less certain that other providers would be able to successfully implement the program and that it could be easily translated to Medicare patients, many of whom have multiple chronic illnesses.
A CMS spokesman said there is no timetable for when a national coverage determination will be made.
Dr. Dean Ornish said Medicare should cover lifestyle interventions the same way as other heart disease treatments. Vivian E. Lee