Three new performance measures and six new quality measures are included as part of updated "Clinical Performance and Quality Measures for Adults With Heart Failure" released by the ACC and the American Heart Association (AHA) in collaboration with the Heart Failure Society of America (HFSA) on Aug. 8. The new document is a focused update of previous performance and quality measures released in 2020 and reflect the strongest recommendations from the "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure."

Developed by the ACC/AHA Task Force on Performance Measures and led by Chair Michelle M. Kittleson, MD, PHD, FACC, and Vice Chair Khadijah Breathett, MD, MS, FACC, the document describes performance measures for heart failure that are appropriate for public reporting or pay-for-performance programs.

Of note, the three new performance measures address optimal blood pressure control in patients with heart failure with preserved ejection fraction; the use of SGLT2 inhibitors for patients with heart failure with reduced ejection fraction; and the use of guideline-directed medical therapy in hospitalized patients.

The six new quality measures focus on:

• Use of SGLT2 inhibitors in patients with heart failure with mildly reduced and preserved ejection fraction
• Optimization of guideline-directed medical therapy prior to intervention for chronic secondary severe mitral regurgitation
• Continuation of guideline-directed medical therapy for patients with heart failure with improved ejection fraction
• Assessment of social determinants of health and known cardiovascular risk
• Counseling regarding contraception and pregnancy risks for individuals with cardiomyopathy
• Monoclonal protein screening when interpreting a bone scintigraphy scan assessing for suspected transthyretin cardiac amyloidosis

According to the Writing Committee, the quality measures "are not yet ready for public reporting or pay-for-performance but might be useful to clinicians and health care organizations for quality improvement." In addition, they add: "For all measures, if the clinician determines the care is not appropriate for the patient based on objective evidence to support decision-making, or if the patient declines treatment, that patient is excluded from the measure."

Aside from the additional new measures, no measures were retired from the original 2020 ACC/AHA Heart Failure Measure Set, nor were any revised following careful review by the committee.

Read the full document.