Abstract
Purpose: Provision of phase 2 cardiac rehabilitation (CR) has been directly impacted by coronavirus disease-19 (COVID-19). Economic analyses to date have not identified the financial implications of pandemic-related changes to CR. The aim of this study was to compare the costs and reimbursements of CR between two periods: (1) pre-COVID-19 and (2) during the COVID-19 pandemic.
Methods: Health care costs of providing CR were calculated using a microcosting approach. Unit costs of CR were based on staff time, consumables, and overhead costs. Reimbursement rates were derived from commercial and public health insurance. The mean cost and reimbursement/participant were calculated. Staff and participant COVID-19 infections were also examined.
Results: The mean number of CR participants enrolled/mo declined during the pandemic (10%; 33.8 +/- 2.0 vs 30.5 +/- 3.2, P = .39), the mean cost/participant increased marginally (+ 13%; $2897 +/- $131 vs $3265 +/- $149, P = .09), and the mean reimbursement/participant decreased slightly (-4%; $2959 +/- $224 vs $2844 +/- $181, P = .70). However, these differences did not reach statistical significance. The pre-COVID mean operating surplus/participant ($62 +/- $140) eroded into a deficit of -$421 +/- $170/participant during the pandemic. No known COVID-19 infections occurred among the 183 participants and 14 on-site staff members during the pandemic period.
Conclusions: COVID-19-related safety protocols required CR programs to modify service delivery. Results demonstrate that it was possible to safely maintain this critically important service; however, CR program costs exceeded revenues. The challenge going forward is to optimize CR service delivery to increase participation and achieve financial solvency.
