Preventing Heart Attacks and Strokes Everyday (PHASE)

PHASE is a population health management program designed to reduce the risk of heart attacks and strokes in patients at high risk. PHASE follows Kaiser Permanente’s evidence-based protocol that has been shown to prevent one heart attack or stroke for every ten patients successfully enrolled in the program for five years. PHASE targets patients with diabetes mellitus, hypertension, and known vascular disease for a handful of interventions designed to control blood sugar, blood pressure, and weight, to prescribe cardio-protective medications, to assist in cessation of smoking, and to identify and manage patients at risk for depression.

To learn more about PHASE, check out this brief video from Kaiser Permanente!


By March 31, 2021, we will: (1) manage chronic conditions of high-risk populations to decrease their risk of cardiovascular disease (CVD) and/or cardiovascular events; (2) improve ability to screen for key CVD risk factors as well as the ability to follow-up with patients who have those risk factors; and (3) advance health equity by achieving high performance for all populations on measures impacting cardiovascular health.


  • AACI
  • Gardner Health Services
  • Indian Health Center of Santa Clara Valley
  • North East Medical Services
  • Planned Parenthood Mar Monte
  • Ravenswood Family Health Center
  • School Health Clinics of Santa Clara County

Population served

Adults 18 and over with a current or previous diagnosis of diabetes mellitus, hypertension, coronary artery disease (Heart Disease), TIA (transient ischemic attack) or Cerebrovascular Accident (Stroke).


January 1, 2020 – March 31, 2021


Kaiser Permanente Northern California Community Benefit Programs