Medicare has decided to pay for supervised exercise therapy for older Americans hobbled by a serious condition linked to smoking and diabetes that puts people in danger of heart attacks, strokes and amputations.
It costs Medicare nearly $4 billion a year on surgeries and procedures to treat peripheral artery disease (PAD).
Research shows that treadmill workouts overseen by a medical professional improve the distances PAD patients can walk and their quality of life. This low-tech approach may reduce hospitalizations and help people live longer too. But virtually none of them now gets exercise therapy outside of studies.
Drugs don't work well, so doctors have used surgery or catheter procedures with balloons or stents to bypass or unblock blood vessels in the legs. The expensive procedures — costing thousands of dollars — do work, but experiments show treadmill walking works just as well for a fraction of the cost.
About 2,600 hospital-based rehab centers are gearing up for an influx of patients after Medicare's decision. Other insurers usually follow Medicare's lead, so coverage for younger patients may be ahead. Peripheral artery disease affects about 8 million Americans; about 2 million of them have disabling leg pain.
"It's often described as a cramping feeling as if someone has their leg in a vise," said Diane Treat-Jacobson of the University of Minnesota. Her research shows that walking through the pain in short sessions with rest breaks eventually improves the distances people can walk pain-free.