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The Million Hearts Cardiovascular Disease (CVD) Risk Reduction Model tests whether providing targeted incentives to health care providers to reduce CVD risk lowers the incidence of first-time heart attacks and strokes among Medicare beneficiaries (ages 40-79 who have not had a previous heart attack or stroke). This report presents findings through evaluation year two of the five-year randomized trial. Findings include positive impacts on rates of providers calculating risk scores and of beneficiaries starting or intensifying statin or anti-hypertensive medications. Findings further include a 7 percent reduction in all-cause mortality.