Public reporting on cardiac electrophysiology procedures and outcomes: where are we now and where are we headed?

Over the years, public reporting of patient outcomes has been promoted as a means to improve healthcare quality. More recently, in response to dramatic rises in healthcare costs, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 was implemented in an effort to link quality with reimbursement. As part of a value-based model, public reporting of procedural outcomes has been incorporated into this initiative. Outcomes measures that have been introduced in cardiology include heart failure readmission and post-myocardial infarction medication prescription. Public reporting of these data has led not only to positive changes but also to unintended negative consequences. The limited number of existing registries and lack of clear consensus on quality metrics have posed challenges for quality and value assessment in cardiac electrophysiology. After learning from the lessons of existing models of public reporting, physicians, professional societies, stakeholders, and patients will need to collaborate to develop a health care model that can improve outcomes and reduce waste.