Development, structure, and implementation of cardiometabolic clinics in the United States, with a focus on comprehensive patient care

Metabolic syndrome and associated cardiometabolic risk factors affect over one‑third of US adults, increasing the risk for atherosclerotic cardiovascular disease, type 2 diabetes, and chronic kidney disease. Recently termed cardiovascular-kidney-metabolic syndrome, the syndrome contributes to substantial clinical and economic burden. Despite guideline recommendations, affected patients who have multimorbidity often receive suboptimal, fragmented care. Cardiometabolic clinics (CMCs) comprise a multidisciplinary team that deliver comprehensive, preventive care to patients with cardiometabolic risk factors and diseases. This review outlines key considerations for the development, structure, and implementation of CMCs in the US. Initial steps include developing a financial model to demonstrate potential return on investment, defining the target patient population, establishing care delivery and operational plans, such as cost coverage evaluations, and leveraging digital solutions to improve access and engagement. The proposed CMC structure comprises a core team of a navigator and specialist in cardiometabolic diseases, based on two US-based models: the comprehensive care model and Cardiometabolic Center Alliance – Cardiometabolic Center of Excellence model. Training the team across cardiometabolic conditions is essential. Once established, demonstrating a positive return on investment can support expanding the team to additional specialties. Scalability remains crucial due to the rising prevalence of cardiovascular-kidney-metabolic syndrome. Studies show CMCs increase uptake of guideline-directed medical therapies and improve cardiometabolic outcomes, although larger, long-term studies are needed. Benefits also extend to healthcare providers, including improved communication, greater convenience, and reduced redundant tests and visits, supporting cost savings. CMCs can potentially reduce the clinical and economic burden of cardiovascular-kidney-metabolic syndrome in the US.