TABLE 2.
ACC/AHA 2020 Heart Failure Clinical Performance, Quality and Structural Measures
| Measure No. | Measure Title | Care Setting | Attribution | Measure Domain | COR/LOE | |
|---|---|---|---|---|---|---|
| Performance Measures | ||||||
| PM-1 | LVEF assessment | Outpatient | Individual practitioner, Facility | Diagnostic | COR: 1, LOE: C; COR: 2a, LOE: C | |
| PM-2 | Symptom and activity assessment | Outpatient | Individual practitioner, Facility | Monitoring | COR: 1, LOE: C | |
| PM-3 | Symptom management | Outpatient | Individual practitioner, Facility | Treatment | See measure rationale in Appendix A for details | |
| PM-4 | Beta-blocker therapy for HFrEF | Outpatient, Inpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A; COR: 1, LOE: B | |
| PM-5 | ACE inhibitor or ARB or ARNI therapy for HFrEF | Outpatient, Inpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A; COR: 1, LOE: B-R | |
| PM-6 | ARNI therapy for HFrEF | Outpatient, Inpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: B-R | |
| PM-7 | Dose of beta-blocker therapy for HFrEF | Outpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A | |
| PM-8 | Dose of ACE inhibitor, ARB, or ARNI therapy for HFrEF | Outpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A; COR: 1, LOE: B-R | |
| PM-9 | MRA therapy for HFrEF | Outpatient, Inpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A; COR: 1, LOE: B | |
| PM-10 | Laboratory monitoring in new MRA therapy | Outpatient, Inpatient | Individual practitioner, Facility | Monitoring | COR: 1, LOE: A | |
| PM-11 | Hydralazine/isosorbide dinitrate therapy for HFrEF in those self-identified as Black or African American | Outpatient, Inpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A | |
| PM-12 | Counseling regarding ICD implantation for patients with HFrEF on guideline- directed medical therapy | Outpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A | |
| PM-13 | CRT implantation for patients with HFrEF on guideline-directed medical therapy | Outpatient | Individual practitioner, Facility | Treatment | COR: 1, LOE: A; COR: 1, LOE: B | |
| Quality Measures | ||||||
| QM-1 | Patient self-care education | Outpatient | Individual practitioner, Facility | Self-Care | COR: 1, LOE: B | |
| QM-2 | Measurement of patient-reported outcome-health status | Outpatient | Individual practitioner, Facility | Monitoring | See measure rationale in Appendix A for details | |
| QM-3 | Sustained or improved health status in heart failure | Outpatient | Individual practitioner, Facility | Outcome | See measure rationale in Appendix A for details | |
| QM-4 | Postdischarge appointment for patients with heart failure | Inpatient | Individual practitioner, Facility | Treatment | COR: 2a, LOE: B | |
| Structural Measure | ||||||
| SM-1 | Heart failure registry participation | Outpatient, Inpatient | Facility | Structure | COR: 2a, LOE: B | |
|
Rehabilitation Performance Measures Related to Heart Failure (From the 2018 ACC/AHA performance measures for cardiac rehabilitation (6)) | ||||||
| Rehab PM-2 | Exercise training referral for HF from inpatient setting | Inpatient | Facility | Process | COR: 1, LOE: A | |
| Rehab PM-4 | Exercise training referral for HF from outpatient setting | Outpatient | Individual practitioner, Facility | Process | COR: 1, LOE: A | |
ACC indicates American College of Cardiology; ACE, angiotensin–converting enzyme; AHA, American Heart Association; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor–neprilysin inhibitor; COR, class of recommendation; CRT, cardiac resynchronization therapy; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; ICD, implantable cardioverter-defibrillator; LOE, level of evidence; LVEF, left ventricular ejection fraction; MRA, mineralocorticoid receptor antagonists; PM, performance measure; QM, quality measure; and SM, structural measure.