Twelve weeks in cardiac rehabilitation can make all the difference in preventing the progression of heart disease. And that serves a dual purpose: improving patient care and reducing the likelihood of readmission.

"Many patients who start cardiac rehab come to us in wheelchairs or use walkers. They're scared and often depressed," says Brenda Doughty, R.N., cardiac rehab manager at Texas Health Arlington Memorial Hospital. Participants have ranged in age from 25 to 95. "It is remarkable. People of all ages and fitness levels support and encourage each other as they work together to improve their heart health. They make phenomenal progress, and we have a little graduation ceremony at the end, where many tears are shed in celebration of their achievements."

In 2007, the hospital remodeled and expanded its cardiac rehabilitation department, almost doubling the exercise area to more than 2,500 square feet. Since the Centers for Medicare & Medicaid Services in 2006 expanded coverage for these services, many hospitals have been upgrading their facilities.

Since the Affordable Care Act lays out significant penalties for hospitals with high readmission rates, concepts like cardiac rehab likely will gain even more traction in the coming years.

"Many more hospitals considering cardiac rehab have the opportunity to improve quality and control costs," says Neal Gold, M.D., an internist and director at Sg2, a health care analytics company in Skokie, Ill. "It improves the overall cardiovascular health of patients, and theoretically, that could lead to fewer readmissions."

Many programs are focsing on more than just physical therapy. Provena Saint Joseph Hospital in Elgin, Ill., conducts weekly lectures about cardiac-risk factors. Participants meet individually with a dietitian to discuss their eating habits. "That's also part of their educational regime," says Barbara Kuhn, R.N., manager of outpatient cardiopulmonary rehab.