Using Population Health Strategies to Reduce Readmissions and Morbidity in HF

EP: 1.Classification of Heart Failure

EP: 2.Pillars of HF Therapy and Evidence-Based Recommendations Based on Ejection Fraction Status

EP: 3.Aligning Value Statements and Cost-Effective Coverage In Accordance With ACC Guidelines

EP: 4.Economic Burden Associated with HF-Related Comorbid Disease

EP: 5.Transformative Opportunities in Population Health for Patients With HF

EP: 6.Notable Updates to ACC Guidelines

EP: 7.Recognizing Risk Factors to Mitigate Pre-Heart Failure

EP: 8.Real-World Approaches to Treatment Sequencing for HF with Reduced and Preserved Ejection Fraction

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EP: 9.Using Population Health Strategies to Reduce Readmissions and Morbidity in HF

EP: 10.Cost of Care Driven by Early ACC Guideline-Directed Therapy in HF

EP: 11.Pivotal Clinical Trials Shaping HF Treatment Landscape

EP: 12.Switching to Appropriate Guideline-Directed Therapy to Improve HF Patient Outcomes

EP: 13.Balancing Payer Utilization Strategies With Clinical Effectiveness in HF

EP: 14.SGLT2 Inhibitor Impact on Hospitalization Reduction and HF Disease Progression

EP: 15.Cost-Saving Strategies Through PCP-Prescribed Therapies in HF

EP: 16.Improving HF Population Health Management and Collaborative Care

EP: 17.Navigating Multidisciplinary HF Treatment With Multiple Comorbidities

EP: 18.Patient and Provider Perceptions Surrounding Affordability for HF Treatments

EP: 19.Identifying Unmet Needs Surrounding Patients With Heart Failure

EP: 20.A Population Health Approach to Managing Heart Failure

Ryan Haumschild, PharmD, MS, MBA: Do you start patients on different therapies based on whether they have reduced ejection fraction or preserved ejection fraction? What are some of the key differences in which you might focus one population health strategy on one patient population and another population health strategy on another?

Rohit Uppal, MD, MBA, SFH: Dr [John E.] Anderson entertained this question well. The differences from a population health perspective aren’t significant. When we look at these 2 groups, our goals for them are quite similar. We know that negative morbidity outcomes are similar for both groups, so what can we do to reduce symptoms and improve quality of life? As hospitalists, can we reduce the risk of readmission? The biggest difference is that for the patients with preserved ejection fraction, there’s no clear evidence that our interventions reduce mortality. But certainly, the goal of reducing morbidity is significant. With reduced ejection fraction, the strategy is clearer. How can we get our patients on evidence-based goal-directed therapy? I don’t have anything to add in terms of sequencing.

We’re seeing patients with preserved ejection fraction with many comorbidities, so we’re managing the symptoms of their heart failure to make those incremental improvements in their quality of life, and focusing more on the common conditions that we see alongside their CHF [congestive heart failure]: hypertension, AFib [atrial fibrillation], coronary artery disease, and diabetes. We manage those comorbidities just like we would in a non-CHF population, unless there are opportunities where maybe the second or third line of therapy overlaps with a heart failure therapy. Dr Anderson mentioned SGLT2 [inhibitors] for diabetics, or the mineralocorticoid receptor antagonist for hypertension, which are great examples of that.

Ryan Haumschild, PharmD, MS, MBA: I appreciate that overview. Dr Anderson did a great job giving his input on initial treatment, and that’s what helps guide a lot of the decisions. To your point, you might treat these patients the same. As long as we’re getting those outcomes and managing those comorbidities, that’s going to give them their best chance at reducing progression of heart failure.

Transcript edited for clarity.