Defining a path toward improved heart failure care

Defining a path toward improved heart failure (HF) care is essential, as there is a clear need to improve HF treatment quality, outcomes, and value. This article reviews potential strategies to help improve the quality of HF clinical care and decrease costs. To start, HF phenotyping may be useful in guiding patient treatment, as some phenotypes are associated with higher hospitalization costs and longer length of stay. Identifying and addressing social determinants of health that may be barriers to optimal health may improve management of HF and help to prevent disease progression. In addition, patient-reported outcomes can be useful for evaluating the effectiveness of treatment regimens and assessing which treatments lead to a genuine improvement in quality of life (QOL). Recent innovations in payment reform have seen the implementation of value-based payment (VBP) models over the traditional fee-for-service (FFS) models. FFS models can lead to low-quality care focused on treating illness instead of supporting wellness initiatives. By contrast, VBP models aim to decrease excessive health care costs, thereby increasing incentives to hospitals that deliver high-quality patient care. Further, novel care delivery approaches, such as hospital-at-home and other digital tools, can provide patients with lower-cost care and are associated with improved QOL, including reductions in hospital readmission.