Evidence Explorer

Oversight
24 decisions · 23 governed
3
AP
My view
All Health Plan
cardiac rehab program
Scoped to your reviews — utilization & clinical policy
Source System
Document Type
Date Range
Program: Cardiac Rehab
Trace ID
6 sources found
Program Claims Aggregate — 4,218 sessions YTD
Claims SystemExtracted: 8 Aug, 08:02
Utilization, extensions, cost
HEDIS 2026 Benchmark Tables — CR-1 to CR-4
Clinical Knowledge Base
Used in: 2 traces
National benchmarks
Peer Plan Datasets — 14 plans (anonymized)
Benchmark Exchange
Used in: 1 trace
Regional comparison
Valley Heart Associates Contract
Provider Contracts
Used in: 1 trace
$187/session rate schedule
ACC/AHA Cardiac Rehab Guidelines 2026
Clinical Knowledge Base
Used in: 2 traces
Comorbidity extension criteria
Member Comorbidity Profiles — 312 members
EHR System
Used in: 1 trace
Avg 2.8 comorbidities

Program Claims Aggregate — Cardiac Rehabilitation

Source: Claims System · Extracted: 8 Aug 2026, 08:02
Used by 2 Brain operations
Cardiac Rehab Program — YTD Aggregate
CR-PROG · 1 Jan – 8 Aug 2026
312 enrolled members · Valley Heart Associates & 6 network providers
Program Metrics
Total sessions (YTD)4,218
Enrolled members312
Avg sessions / member13.5
Extension rate14.2%EB-HP-02348, Step 2
Per-member program cost$6,730EB-HP-02348, Steps 2–3
Program completion rate71%
Extension rate exceeds the HEDIS CR-3 benchmark of 9.8%. Driver analysis attributes the variance to member comorbidity burden and the Valley Heart contract rate; both are traced in the utilization review.
How This Evidence Connects
benchmarked against HEDIS CR tables + 14 peer datasets
traced to Valley Heart contract rate $187/session
clinically justified per ACC/AHA criteria + comorbidity profiles