Aligning quality and payment for heart failure care: Defining the challenges

Edward P. Havranek, Harlan M. Krumholz, Adams Dudley, Kirkwood Adams, Douglas Gregory, Steven Lampert, Joann Lindenfeld, Barry M. Massie, Ileana Pina, Susan Restaino, Michael W. Rich, Marvin A. Konstam

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Hospitals may not support programs that improve the quality of care delivered to heart failure patients because these programs lower readmission rates and empty beds, and therefore further diminish already-declining revenues. A conflict between the highest quality of care and financial solvency does not serve the interests of patients, physicians, hospitals, or payers. In principle, resolution of this conflict-is simple: reimbursement systems should reward higher quality care. In practice, resolving the conflict is not simple. A recent roundtable discussion sponsored by the Heart Failure Society of America identified 4 major challenges to the design and implementation of reimbursement schemes that promote higher quality care for heart failure: defining quality, accounting for differences in disease severity, crafting novel payment mechanisms, and overcoming professional parochialism. This article describes each of these challenges in turn.

Original languageEnglish (US)
Pages (from-to)251-254
Number of pages4
JournalJournal of cardiac failure
Issue number4
StatePublished - Aug 2003
Externally publishedYes


  • Heart failure management
  • Quality of care
  • Reimbursement


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