Ornish Programs Reimbursed by Medicare

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Summary

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.

Dr. Ornish’s Program for Reversing Heart Disease is the only program scientifically proven to reverse heart disease currently offered in hospitals, clinics, and physician offices that Medicare and other private insurance companies are covering. 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%.

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).

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.

West Virginia University Hospitals, Inc.
Medical Center Drive
Morgantown, WV
26506-8120
Program Director: David Harshbarger
Phone: 304/598-4000 x73079
Direct: 304/293-2520
Fax: 304/293-3725
E-mail: harshbargerd@rcbhsc.wvu.edu
Web:
www.hsc.wvu.edu/Wellness/Dr-Dean-Ornish-Program/

Silverton Hospital
WellspringHeart
1475 Mt. Hood Avenue
Woodburn, OR
97071
Program Director: Stacey L. Wolf
Phone 971-983-5261
Fax 971-983-5215
E-mail: swolf@silvhosp.org
Web: www.wsheart.com

Stamford Hospital
Cardiac Rehabilitation Dept.
Tully Health Center
32 Strawberry Hill Court
Stamford, CT 06902
Murray Low, EdD, FAACVPR, FACSM/Program Director
E-mail: mlow@stamhealth.org
Phone: (203) 276-2183
Web: http://www.stamfordhospitalheart.com/

Ornish Spectrum - Prevention Program

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Participants learn about the clinically proven and scientifically validated, Dean Ornish Program for Reversing Heart Disease, through its trained and compassionate staff.

Components include:

  • practicing stress management techniques to relax
  • improve overall well being
  • learning a moderate exercise program
  • group support, to improve communication

Participants will also learn about the whole foods, low fat nutrition plan that is tailored by the program’s registered dietitician.

This plan features:

  • recipes
  • cooking demonstrations to enjoy
  • eating out tips
  • nutrition label reading

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 the Spectrum Prevention Program

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

Pennsylvania Hospital Site List

West Virginia Hospital Site List

 

Hamot Heart Institute
Sterling Square, Suite 211
3330 Peach Street
Erie, PA 16508
Walter Horner
Program Director
E-mail: walter.horner@hamot.org
Phone 814-877-5480
Inquiries 814-877-5481
Fax: 814-860-7842

Jameson Health System
1211 Wilmington Avenue
Room 430
New Castle, PA 16105
Lori Brothers
Program Director
E-mail: lbrothers@jamesonhealth.org
Phone: 724-656-4660
Fax: 724-656-4160

Jefferson Regional Medical Center
PO Box 18119, 565
Coal Valley Road
Pittsburgh, PA 15236-0119
Lexi Robinson
Team Leader
E-mail:
Lexi.robinson@jeffersonregional.com

Info: 888-ORNISH-4-U
Fax: 412-653-1394

Monongahela Valley Hospital
1163 Country Club Road
Monongahela, PA 15063
Randall Komacko
Program Director
E-mail: ornishstaff@monvalleyhospital.com
Phone: 724-379-1960
Fax: 724-379-1961

Westmoreland Regional Hospital
532 West Pittsburgh Street
Greensburg, PA 15601
Barb Liptak and Nancy Urick/
Program Directors
E-mail: bliptak@westmoreland.org
and nurick@westmoreland.org
Phone: Barb – 724-850-3157
Nancy – 724-832-5068

Evangelical Community Hospital
7095 West Branch Highway
Lewisburg, PA 17837
Megan Bollinger/Program Director
E-mail: mbollinger@evanhospital.com
Phone: 570-768-3205
Fax: 570-522-2095

Windber Medical Center
600 Somerset Avenue
Windber, PA 15963
Amy Burke/Program Director
E-mail: aburke@windbercare.org
Phone: 814-467-3634
Fax: 814-467-3629

Indiana Regional Medical Center
835 Hospital Rd
Indiana PA 15701
Nancy Smith- Program Director
E-mail: nsmith@indianarmc.org
Phone: 724-357-8088
Fax: 724-357-6958

Butler Memorial Hospital
Diabetes Center
113 Woody St
Butler PA 16001
Joyce Rudolph- Program Director
724-284-4374
Email: jlr.cde@butlerhealthsystem.org

Butler Whole Health
2001 Ehrman Rd
Cranberry Twp PA 16066
Rochelle Rashid-Nebel- Program Coordinator
724-631-0053
Email:
rochelle.rashid@butlerhealthsystem.com

Excela Health Hospitals

Excela Health Frick
508 South Church Street
Mt. Pleasant, PA 15666

Excela Health Westmoreland
532 West Pittsburgh Street
Greensburg, PA 15601

Excela Health Latrobe
121 West Second Ave
Latrobe, PA 15650

Excela Health Jeannette
600 Jefferson Ave
Jeanette PA 15644
Contacts for all Excela Health Hospitals
Barb Liptak and Nancy Urick
Program DirectorsE-mail:
bliptak@westmoreland.org
nurick@westmoreland.org
Phone: 1-877-771-1234
Fax: 724-547-1458

 

Charleston Area Medical Center, Inc.
3200 MacCorkle Avenue, SE
Charleston, WV 25304
Program Director
Ed Haver
Phone: 304-388-9520, direct
304-388-9411, inquiries
Fax: 304-388-9422
E-mail: ed.haver@camc.org

St. Mary’s Medical Center
2900 1st Avenue
Huntington, WV 25702
Program Director
Mona Wilson
Phone: 304/526-1253
Fax: 304/526-8807
E-mail: mona.wilson@st-marys.org

West Virginia University Hospitals, Inc.
Medical Center Drive
Morgantown, WV 26506-8120
Program Director
David Harshbarger
Phone: 304/598-4000 x73079, direct
304/293-2520, inquiries
Fax: 304/293-3725
E-mail: harshbargerd@rcbhsc.wvu.edu
Web:
www.hsc.wvu.edu/wellness/ornish

The Wellness Center at City Hospital
2000 Foundation Way
Suite 1200
Martinsburg, WV 25401
Phone: 304/264-1000 ext. 1814
Fax: 304/264-1331
E-mail: ddjarnett@cityhospital.org


Ornish Spectrum – Reversing Heart Disease Program

Preventive Medicine Research Institute Preventive Medicine Research Institute Preventive Medicine Research Institute Preventive Medicine Research Institute Preventive Medicine Research Institute

Dr. Dean Ornish’s Program for Reversing Heart Disease is an outpatient experiential program. It is a non-invasive treatment option that combines four components to slow, stop and even reverse the progression of coronary artery disease.

This treatment option combines:

  • Low-fat, whole food nutrition
  • Stress management
  • Monitored fitness
  • Group support

Clinical outcomes consistently demonstrate that the Ornish participants show improvements in:

  • Blood pressure
  • Weight
  • BMI
  • Cholesterol
  • Angina
  • Depression
  • Hostility
  • VItality

Each Ornish certified site has a dedicated team of caring professionals to provide support every step of the way:

  • Physician / Medical Director
  • Nurse Case Manager
  • Exercise Physiologist
  • Clinical Psychologist
  • Registered Stress Management Instructor
  • Registered Dietician

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 the Reversing Heart Disease Program

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

Pennsylvania Hospital Site List

West Virginia Hospital Site List

 

Hamot Heart Institute
Sterling Square, Suite 211
3330 Peach Street
Erie, PA 16508
Walter Horner
Program Director
E-mail: walter.horner@hamot.org
Phone 814-877-5480
Inquiries 814-877-5481
Fax: 814-860-7842

Jameson Health System
1211 Wilmington Avenue
Room 430
New Castle, PA 16105
Lori Brothers
Program Director
E-mail: lbrothers@jamesonhealth.org
Phone: 724-656-4660
Fax: 724-656-4160

Jefferson Regional Medical Center
PO Box 18119, 565
Coal Valley Road
Pittsburgh, PA 15236-0119
Lexi Robinson
Team Leader
E-mail:
Lexi.robinson@jeffersonregional.com

Info: 888-ORNISH-4-U
Fax: 412-653-1394

Monongahela Valley Hospital
1163 Country Club Road
Monongahela, PA 15063
Randall Komacko
Program Director
E-mail: ornishstaff@monvalleyhospital.com
Phone: 724-379-1960
Fax: 724-379-1961

 

Charleston Area Medical Center, Inc.
3200 MacCorkle Avenue, SE
Charleston, WV 25304
Program Director
Ed Haver
Phone: 304-388-9520, direct
304-388-9411, inquiries
Fax: 304-388-9422
E-mail: ed.haver@camc.org

West Virginia University Hospitals, Inc.
Medical Center Drive
Morgantown, WV 26506-8120
Program Director
David Harshbarger
Phone: 304/598-4000 x73079, direct
304/293-2520, inquiries
Fax: 304/293-3725
E-mail: harshbargerd@rcbhsc.wvu.edu
Web: http://www.hsc.wvu.edu/Wellness/Dr-Dean-Ornish-Program/

Connecticut Hospital Site List

Oregon Hospital Site List

 

Stamford Hospital
Cardiac Rehabilitation Dept.
Tully Health Center
32 Strawberry Hill Court
Stamford, CT 06902
Murray Low, EdD, FAACVPR, FACSM/Program Director
E-mail: mlow@stamhealth.org
Phone: (203) 276-2183
Web: http://www.stamfordhospitalheart.com/

 

Silverton Hospital
WellspringHeart
1475 Mt. Hood Avenue
Woodburn, OR 97071
Sarah Fronza/Program Director
E-mail: sfronza@silvhosp.org
Phone 971-983-5307(direct)
Inquiries 971-983-5212
Fax 971-983-5215
Web http://www.wsheart.com