Top Things to Know: 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure
Published: November 02, 2020
- This document describes performance measures for heart failure that are appropriate for public reporting or pay-for-performance programs.
- The performance measures are from the 2017 American College of Cardiology/American Heart Association/Heart Failure Society of America heart failure guideline update and are selected from the strongest recommendations (Class 1 or 3).
- Quality measures are also provided that are not yet ready for public reporting or pay for performance but might be useful for clinicians and healthcare organizations for quality improvement.
- A new safety measure (laboratory monitoring for patients treated with mineralocorticoid receptor antagonists) is paired with a new treatment measure (mineralocorticoid receptor antagonists in patients with heart failure with reduced left ventricular ejection fraction).
- Other additions to the performance measures include the new medication, sacubitril/valsartan, and use of cardiac resynchronization therapy.
- To address frequent lack of titration of heart failure medications, two new performance measures are included based on dose, either reaching 50% of the recommended dose (e.g., beta blocker or angiotensin-converting enzyme inhibitor/angiotensin receptor antagonist/angiotensin receptor neprilysin inhibitor) or documenting that such a dose was not tolerated or otherwise inappropriate.
- For all measures, if the clinician determines the care is inappropriate for the patient, that patient is excluded from the measure.
- For all measures, patients who decline treatment or care are excluded.
- A patient-centered discussion of the benefits and risks of implantable cardioverter-defibrillator treatment remains a performance measure.
- To reflect the increasing importance of patient-reported outcome measures, two patient-reported outcomes quality measures were added that use heart failure patient-reported outcomes questionnaires currently accepted by the U.S. Food and Drug Administration.
Citation
Heidenreich PA, Fonarow GC, Breathett K, Jurgens CY, Pisani BA, Pozehl BJ, Spertus JA, Taylor KG, Thibodeau JT, Yancy CW, Ziaeian B. 2020 ACC/AHA clinical performance and quality measures for adults with heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circ Cardiovasc Qual Outcomes. 2020;12:e000099. doi:10.1161/HCQ.0000000000000099.