The American journal of managed care
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Heart failure (HF) substantially impacts the health and financial security of an increasing proportion of the US population. It worsens debility and quality of life and may lead to hospitalization and death. HF is a clinical syndrome with diverse symptomatic presentations. ⋯ Clinicians should focus on diagnosing, treating, and preventing the etiologies that are known to cause HFpEF. Results from a small proportion of randomized controlled trials have shown therapeutic benefit for small molecules, although limited, if any, demonstrated mortality benefit has been noted. More research and investment are needed to decrease the burden of HFpEF and to discover lifesaving treatments for this growing population.
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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. ⋯ 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.