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An Update on the Pritikin and Ornish Ultra Low-Fat Diet Medicare Boondoggle

In 2016 a huge boondoggle was foisted on Americans who were undergoing cardiac rehabilitation after myocardial infarction or coronary artery bypass surgery. I became incensed about so-called “intensive cardiac rehabilitation” when patients in my previous practice were suddenly being counseled intensively on very low-fat diets and not on the Mediterranean diet I recommended.

My post in response entitled “The Pritikin Diet: Discredited By Medicine But Now Endorsed By Your Federal Government” described in detail the lack of scientific support for the Pritikin diet and the shenanigans that led to it being adopted.

The Cardiac Rehabilitation Incentive Payment Model, was finalized in a rule issued by the CMS. It was part of a package of experimental payment models aimed at reducing healthcare spending while improving outcomes, including the expansion of CMS’ mandatory bundled-payment program to include all care associated with bypass surgery and heart attacks.

This experiment would bring significantly more money into the coffers of the hospital systems that managed to induce patients to sign up.

Under the cardiac rehab payment model, the CMS plans to pay participating hospitals $25 per session of cardiac rehabilitation or intensive cardiac rehabilitation for the first 11 sessions. It would pay $175 per session thereafter, for a maximum of 36 total sessions. Those payments would apply only to Medicare beneficiaries with heart attacks and coronary artery bypass surgery

When I formally objected to this experiment being foisted on my patients I was told that cardiac rehab was losing money and by signing up for this program it would now become profitable.

Indeed, ICR using either the CMS-approved Pritikin or Ornish programs is a big money-maker. Hospitals also like to use it for marketing.

Here’s a typical puff piece from a medical system near me:

UC San Diego Health is the only program in San Diego to offer Ornish Lifestyle Medicine  to intensive cardiac rehabilitation patients. The program includes stress management, support groups and nutrition, focusing on a low-fat, whole foods, plant-based eating plan

We, the American taxpayers are still paying for these unsuspecting patients to be brainwashed into believing (as the Ornish and Pritikin programs believe) that they can prevent and reverse their coronary atherosclerosis only by pursuing these near-vegan, very low-fat diets.

Skeptically Yours,


N.B. I’ve gone back and edited my original article on this. Over the years, several readers have commented that they felt that my description of Pritikin’s death was inconsiderate.

I think they were right. I emphasized the fact that Pritikin “slashed his wrists” as his manner of committing suicide and that phrase is gone. In my defense, I have spent a lot of writing time outlining how the death of Robert Atkins has been distorted by vegans. I wasn’t distorting Pritikin’s death but the precise manner of his suicide wasn’t relevant to any points I was making.

Also, (intended humorously) I said that participants in the Pritikin experiments I described were at risk for slashing their wrists and I’ve taken that out.

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