CMS Quality Conference Q&A with Dr. Tom Frieden

Help Spread the Word!: 


Dr. Tom Frieden, CDC
Dr. Tom Frieden, CDC

Tom Frieden, MD, MPH, became director of CDC in June 2009. Dr. Frieden has worked to control health threats from infectious diseases, respond to emergencies and battle the leading causes of suffering and death in our nation and around the world. A physician with training in internal medicine, infectious diseases, public health and epidemiology, Dr. Frieden is especially known for his expertise in tuberculosis control. He began his career at CDC as an Epidemic Intelligence Service (EIS) Officer at the New York City Health Department. Dr. Frieden speaks Spanish and graduated from Oberlin College. He received both his medical degree and master’s of public health degree from Columbia University and completed infectious disease training at Yale University. He has received many awards and honors and has published more than 200 scientific articles.

Dr. Frieden was a keynote speaker at the 2016 CMS Quality Conference.

QIO News: Tell us your thoughts about the recent CMS Quality Conference. What were your chief takeaways?

Dr. Tom Frieden: The conference highlighted the meaningful relationship between the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS), and the promise for continued collaboration between clinical medicine and public health as the U.S. health system migrates toward a value-based payment system. The event highlighted that heart disease and stroke remain the nation’s leading causes of death and of health disparities, and provided a platform to discuss the challenges and opportunities preventing and treating cardiovascular disease in the U.S. Now, more than ever, we need to double down on our efforts to improve the nation’s cardiovascular health.

The conference provided a powerful reminder that all of us — CDC, CMS, Quality Improvement Organizations (QIOs) and other partners — must continue to work together across the health care system to prevent heart attacks and strokes, because most of these events are preventable.

QIO News: What do you hope listeners took away from your plenary presentation on progress measures?

Dr. Frieden: Despite our successes, our current performance to reduce cardiovascular disease is not where it should be — and it’s not improving fast enough to protect the millions of people at risk.

We have an aging population and an increasing number of Americans who are obese or who have diabetes, both major risk factors for heart disease and stroke. Unfortunately, the rate of decline in cardiovascular disease mortality decelerated substantially beginning in 2009. We must implement policies and strategies to prevent cardiovascular disease. These include providing consistent, team-based care, removing barriers to patient adherence, and using real-time data to improve performance.

QIO News: In your presentation, you talked a lot about the intersection of public health and health care. Why is this so important? And how is the CDC partnering with CMS and the QIO Program to advance this intersectionality?

Dr. Frieden: Million Hearts is an important example of public health and health care combining complementary assets to drive progress on a common goal — preventing heart attacks and strokes.

CDC has looked at the data rigorously to establish the focus areas for Million Hearts and has funded 50 state and many local health departments to improve cardiovascular health outcomes and link community actions with those in clinical settings.

CMS has provided data on the ABCS (aspirin use when appropriate, blood pressure control, cholesterol management, smoking cessation), developed programs that embed the ABCS and drive performance in those measures, and formed learning networks to spread best and promising practices. 

QIO News: The Million Hearts initiative has had a lot of success over the past five years. What are your goals for the initiative moving forward?

Dr. Frieden: Although we will not have final numbers until 2019, current data suggest that about half a million heart disease and stroke events will have been prevented over the five-year initiative. Moreover, we have laid the groundwork for accelerating progress and improving outcomes in the next five years. Change doesn’t happen overnight. It will take time to see the impact of policy levers that will build a healthier environment and new programs that transform health care delivery.

As we near the five-year mark, we’re excited by what the future may hold for the Million Hearts initiative. We have forged a powerful mix of partnerships — including our relationship with CMS — that will remain critically important as we move forward.

Looking ahead, we will continue to focus on optimizing care through the ABCS and cardiac rehabilitation. We will also continue to emphasize the use of health IT tools and clinical innovations that improve prevention and treatment.

The ABCS will remain a priority. Our future efforts will also promote increased physical activity. We intend to redouble our efforts to improve outcomes for priority populations. For example, we will focus efforts to improve blood pressure control among African Americans. Given trends in cardiovascular disease mortality, we will work to improve physical activity and blood pressure control among all people ages 45-64.

Overall, we have the right mix of experience, priorities and partners needed to continue to prevent heart disease and stroke.

QIO News: Shifting gears, beyond receiving an annual influenza vaccination, what recommendations do you have for Medicare beneficiaries to stay healthy at this time of year?

Dr. Frieden: There are many steps people can take to stay heart healthy, both immediate and long-term. If you have high blood pressure or high cholesterol, keep it under control. Follow your doctor’s instructions, take medication as prescribed, and, as appropriate, learn how to monitor your blood pressure at home or in your community. Follow a healthy diet rich in fruits and vegetables, and try to reduce the sodium you eat each day. Be physically active on a regular basis, such as walking, swimming, cycling, dancing or gardening. Quit smoking and avoid secondhand smoke, and if you don’t smoke — don’t start.

Finally, if you have a cardiac event or procedure, ask your doctor about enrolling in a cardiac rehabilitation program. Cardiac rehab participation reduces your risk of another event or hospitalization, and enhances health, longevity and quality of life.