The Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services have implemented Million Hearts (MH), an initiative to coordinate efforts across the United States to promote cardiovascular health. This report examines the partnerships developed in MH, defines the practices and approaches to cardiovascular disease prevention that occurred as a result of the program, and provides suggestions for future MH activities.

A Social Network Analysis and Qualitative Assessment of Partnerships for Million Hearts®

Malcolm V. Williams, Danielle M. Varda, Ryan Andrew Brown, Courtney Armstrong, Praise O. Iyiewuare, Rachel Ross, Kayleigh Newman, Sara Sprong

ResearchPublished Jun 20, 2018

The Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services have implemented Million Hearts (MH), an unprecedented initiative to coordinate efforts across the United States to promote cardiovascular health. In work conducted by RAND Corporation and the University of Colorado at Denver, researchers sought to develop information and a data-informed evidence base regarding the successes and challenges of MH. To accomplish these aims, researchers used a mixed-methods approach that involved an environmental scan, key informant interviews, and a social network analysis to assess the current state of MH and to understand how this initiative might grow and strengthen the goal of decreasing cardiovascular disease (CVD). Based on their analysis, researchers conclude that the MH network has been successful in engaging a diverse set of public and private partners to collaborate together to address CVD issues and become an effective information-sharing network. Further, MH partners placed high levels of trust and value in one another. They also indicated that participation in the network was beneficial to their organizations. It appears that keeping the network intact, as is, can have some tangible benefits without a lot of additional resources or change. However, this research did identify barriers that participants in MH experienced in implementing MH activities or building effective relationships, including a lack of direct funding, difficulties with bringing partners to the table, a lack of experience among partners, and different perspectives on CVD prevention among partners.

Key Findings

The Bulk of the Million Hearts Partnerships and Activities Identified Occurred at the Local Level and Often Do Not Have a Direct Association with Organizations Involved in the Core National Million Hearts Partnership.

  • The national partnership is developing resources (information, tools, branding, etc.) that may be used to support the work of these local initiatives.
  • This indicates that the goal of bringing a group of diverse stakeholders together to address issues of cardiovascular disease has been achieved at the national level.

A Large Majority of Partners Believe That Million Hearts Played at Least a Fairly Substantial Role in Their Organizations' Cardiovascular Disease Prevention Work.

  • About half of the social network analysis participants said that their partnerships with other organizations were strengthened by it, which further helped them achieve their goals.
  • Participants also identified raising awareness of the ABCS (aspirin when appropriate, blood pressure control, cholesterol management, and smoking cessation), sharing resources among stakeholders, developing new programs, and communicating between sectors and agencies as their most important outcomes.

The Million Hearts Network Effectively Enables a Diverse, Cross-Sector Group of Federal and Private-Sector Partners to Share Information About Issues Related to Cardiovascular Health.

  • Participation in the network requires only minimal resources for partners; however, the return on trust and value among members is high.
  • These results demonstrate that the network is meeting its current goals and intentions to create an information-sharing platform.

Suggestions for Consideration

  • Consider maintaining current programming and leveraging existing activity and resources. Leadership may also want to explore what activities are occurring among partners and use them as examples of ways that other members might interact. Specifically, leadership may want to develop a list of best practices for working collaboratively to achieve Million Hearts goals.
  • Alternatively, current activity could be maintained, but Million Hearts could focus on strengthening current levels of commitment and engagement among members, such as by constructing forums to share success stories and tips for better prevention efforts.
  • Another strategy would be to reevaluate current activities, focusing on some activities suggested by partners. For example, several respondents said they would like to see Million Hearts pay closer attention to measuring its impact and the impact of its partner organizations. Leadership may also want to consider how to leverage underutilized resources, skills, and expertise to contribute to network activities.
  • Consider reviewing Million Hearts' purpose and clarifying goals, revising member expectations, or changing governance.
  • Consider developing diversified funding strategies to support Million Hearts work. The organization could provide small, one-time funding opportunities or support the development of tools or information that partners can use in their work.
  • Million Hearts could also adopt other strategies for sustainability suggested by partners, such as providing additional support from leadership to partners, developing easier platforms for national reporting, creating efforts toward better alignment of payment mechanisms, providing more focus on population and clinical interventions, and building partnerships with organizations dedicated to specific populations.

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RAND Style Manual
Williams, Malcolm V., Danielle M. Varda, Ryan Andrew Brown, Courtney Armstrong, Praise O. Iyiewuare, Rachel Ross, Kayleigh Newman, and Sara Sprong, A Social Network Analysis and Qualitative Assessment of Partnerships for Million Hearts®, RAND Corporation, RR-1875-ASPE, 2018. As of October 6, 2024: https://www.rand.org/pubs/research_reports/RR1875.html
Chicago Manual of Style
Williams, Malcolm V., Danielle M. Varda, Ryan Andrew Brown, Courtney Armstrong, Praise O. Iyiewuare, Rachel Ross, Kayleigh Newman, and Sara Sprong, A Social Network Analysis and Qualitative Assessment of Partnerships for Million Hearts®. Santa Monica, CA: RAND Corporation, 2018. https://www.rand.org/pubs/research_reports/RR1875.html.
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