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Cardiac rehabilitation in the time of health-care reform.

Cardiac rehabilitation has evolved into a medically efficacious, cost-effective intervention for patients with ischemic heart disease. Most aspects of this therapy are well developed, and guidelines for programs exist. As the health-care delivery system undergoes scrutiny and evolution, it would be prudent for the practitioners of cardiac rehabilitation to evaluate the methods they use to deliver their services. Program administrators should reconsider traditional approaches that are largely based on reimbursement criteria. Goal-directed, patient-centered service delivery will allow individualization of care. A model for such an approach to cardiac rehabilitation is presented.