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WASHINGTON — Doctors lowered the incidence of heart disease and strokes among their patients when Medicare rewarded them for focusing on sicker patients, according to research of a pilot program released Tuesday in the Journal of the American Medical Association. The pilot program didn’t increase overall costs at all.

The five-year pilot program is one of many that Medicare has run since the Affordable Care Act created an office to test whether Medicare payment policies can influence doctors in ways that keep patients healthier. That Obama-era initiative has not worked out as well as was hoped, but the Million Hearts Cardiovascular Disease Risk Reduction Model is one of the initiative’s bright spots.

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Medicare paid doctors in the pilot program to assess the risk of heart problems, then Medicare paid them to focus on sicker patients. The pilot paid doctors more when they improved such measurements as blood pressure and cholesterol levels for sicker patients.

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