In Reply Dr Feigin and colleagues raise 2 concerns regarding the CMS value-based payment model for primary prevention of myocardial infarction and stroke. First, they are concerned that the model continuously rewards only reduction in the highest decile of predicted 10-year cardiovascular event risk, although many events occur in patients at low to moderate risk. Second, they recommend that cardiac risks and management approaches be tailored based on patients’ individualized needs.
Sanghavi DM, Conway PH. Approaches to Prevention of Cardiovascular Disease—Reply. JAMA. 2015;314(21):2306-2307. doi:10.1001/jama.2015.13100