American Heart Association hospital-based quality improvement programs named as option to ease burden of Medicare reimbursement for hospitals

DALLAS, October 15, 2020 —The quality improvement registries from the American Heart Association have been named as an alternative submission option by the Centers for Medicare and Medicaid Services (CMS) for Medicare* reimbursement in the Bundled Payments for Care Improvement Advanced (BPCI Advanced) Model from the CMS. 

The addition of this “Alternative Quality Measures Set” provides a choice on how quality of care is measured in the model, by offering BPCI Advanced participants the option of using each  Get With The Guidelines® (GWTG) module (GWTG-Stroke, GWTG-Heart Failure, GWTG-Coronary Artery Disease and GWTG-Arterial Fibrillation) from the American Heart Association, the leading global volunteer organization dedicated to fighting heart disease and stroke. 

The GWTG program modules focus on hospital-based quality improvement efforts to increase adherence to evidence-based care guidelines and promote using real-time data to drive actionable performance improvement measures that better patient outcomes in stroke, heart failure, resuscitation, AFib and coronary artery disease. 

“The Bundled Payments for Care Improvement Advanced Model is an important option for clinicians and heart centers who are interested in investing in practice innovation, care redesign and improving care coordination in order to reduce healthcare expenditures while improving quality of care at the same time. Organizations that invest in BPCI are helping prepare for the future rather than relying on the past,” said Jonathan P. Piccini, MD, MHS, FACC, FAHA, FHRS; volunteer expert for the American Heart Association and associate professor of medicine and director of cardiac electrophysiology for Duke University Medical Center

As per CMS, the model rewards providers for delivering services more efficiently and recognizes high quality care. BPCI Advanced aims to help hospitals and clinicians work more collaboratively to achieve these goals, which have the potential to improve the beneficiary/patient experience and align to the CMS Quality Strategy goals of promoting effective communication and care coordination, highlighting best practices, and making care safer and more affordable. 

An overarching goal of the model is to promote seamless, patient-centered care throughout each clinical episode, regardless of which health care provider(s) is/are responsible for a specific element of that care.  

“Including national hospital registry data as an option for submission under the BPCI Advanced Alternate Quality Measures dataset validates the work and effectiveness of the Get With The Guidelines quality improvement programs and rewards providers for innovation that lays the groundwork for improved care coordination and patient outcomes,” said John J. Warner, M.D., FAHA, chair of the quality oversight committee and past president of the American Heart Association and executive vice president of health system affairs for UT Southwestern Medical Center.

CMS is pleased to have this opportunity to promote quality measures that are more clinically relevant, provide greater choice and flexibility for participants, and help reduce administrative burden by leveraging data that are already being reported through clinical data registries.  

The American Heart Association will offer a webinar on October 22, 2020 at 12pm ET to discuss the importance of the Alternative Quality Measures Set and how the GWTG registries can support BPCI participants with their data submission and quality improvement efforts.

* Note: Revised on October 19, 2020 to correct an error stating Medicaid over Medicare.

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About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.orgFacebookTwitter or by calling 1-800-AHA-USA1.

Media Contact Info:

For Media Inquiries and AHA/ASA Expert Perspective: 214-706-1173

Karen Springs; C: 972.259.0350; karen.springs@heart.org

For Public Inquiries: 1-800-AHA-USA1 (242-8721); heart.org and stroke.org

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