PQA Is Launching a Heart Failure Technical Expert Panel
Self-Nominations are Due by Friday, March 27
PQA is convening a measure development technical expert panel (TEP) to support the development of a new health plan measure concept: Evidence of Guideline-Directed Medical Therapy in Persons with Heart Failure. This measure will assess the percentage of individuals with prescription claims for guideline-directed medical therapies for the treatment of heart failure.
The TEP will include approximately 15 individuals from PQA member organizations with clinical, methodological or other expertise related to heart failure quality measurement. Up to three additional individuals representing patients, caregivers and patient advocates will be selected to participate. Nominations are due by Friday, March 27. The first TEP meeting is April 22.
PQA members should visit the Member Resources Library to access the nomination form. A separate nomination form is available for patients, caregivers and patient advocates. A TEP Self-Nomination Information document provides additional details on the panel and what is required for nominations.
The inclusion of patients, caregivers and patient advocates as members of the TEP is part of PQA’s commitment to engaging individuals and communities as partners in its work to improve safe, effective and appropriate medication use. Given the focused nature of this TEP, preference will be given to individuals with lived experience with heart failure.
PQA’s Focus on Heart Failure
PQA identified heart failure as a priority area for measure development in 2025. A PQA Health Plan Measure Concept Advisory Group agreed to move the heart failure concept forward for public comment. Comments received further supported the recommendation to advance the heart failure measure concept for development.
PQA has drafted initial specifications, and the goal of the TEP will be to support full specification of the measure concept and advancement to the PQA Quality Metrics Expert Panel for review prior to testing and subsequent steps in PQA’s standard measure development process.
Heart Failure’s Impact and Guideline-Directed Medical Therapy
Heart failure is a complex clinical syndrome characterized by the heart’s inability to pump blood effectively due to structural or functional impairments.1 Approximately 6.7 millions Americans over the age of 20 have heart failure and prevalence is projected to increase to 8.7 million by 2030.2
Multi-society, U.S.-based clinical practice guidelines recommend the use of guideline-directed medical therapy (GDMT) for all individuals with heart failure, regardless of age or heart failure type, although the strength of evidence and level of recommendation vary.3 GDMT includes four medication classes:
- angiotensin receptor–neprilysin inhibitors (ARNi), angiotensin-converting enzyme inhibitors (ACEi), or angiotensin receptor blockers (ARB);
- beta-blockers;
- mineralocorticoid receptor antagonists (MRAs); and
- sodium–glucose cotransporter-2 (SGLT2) inhibitors.
There is strong evidence for GDMT, with positive impacts on patients including improved survival, fewer hospitalizations and better quality of life.4, 5 Real-world evidence demonstrates underutilization of GDMT, with substantial gaps in care; one study found that only 70 percent of patients received any GDMT within six months of diagnosis.4, 6, 7
References
1. Pirbhat S A, Malik A, Chhabra L,. Heart Failure (Congestive Heart Failure). Stat Pearls Publishing. Accessed January 30, 2026. https://www.ncbi.nlm.nih.gov/books/NBK430873/
2. Bozkurt B, Ahmad T, Alexander K, et al. HF STATS 2024: Heart Failure Epidemiology and Outcomes Statistics An Updated 2024 Report from the Heart Failure Society of America. J Card Fail. Jan 2025;31(1):66-116. doi:10.1016/j.cardfail.2024.07.001
3. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022:e895-e1032. doi:10.1016/j.jacc.2021.12.011
4. McCullough PA, Mehta HS, Barker CM, et al. Mortality and guideline-directed medical therapy in real-world heart failure patients with reduced ejection fraction. Clin Cardiol. Sep 2021;44(9):1192-1198. doi:10.1002/clc.23664
5. Polsinelli VB, Sun JL, Greene SJ, et al. Hospital Heart Failure Medical Therapy Score and Associated Clinical Outcomes and Costs. JAMA Cardiol. Nov 1 2024;9(11):1029-1038. doi:10.1001/jamacardio.2024.2969
6. Greene SJ, Ayodele I, Pierce JB, et al. Eligibility and Projected Benefits of Rapid Initiation of Quadruple Therapy for Newly Diagnosed Heart Failure. JACC Heart Fail. Aug 2024;12(8):1365-1377. doi:10.1016/j.jchf.2024.03.001
7. Shin JI, Xu Y, Chang AR, et al. Prescription Patterns for Sodium-Glucose Cotransporter 2 Inhibitors in U.S. Health Systems. J Am Coll Cardiol. Aug 20 2024;84(8):683-693. doi:10.1016/j.jacc.2024.05.057