On Jan. 1, 2027, CMS will roll out its new Ambulatory Specialty Model (ASM), with the stated goal of improving prevention and upstream management of chronic disease – including congestive heart failure – to help reduce avoidable hospitalizations and unnecessary procedures.
The mandatory five-year risk model targets cardiology specialists with at least 20 episodes of care, including services such as cardiopulmonary procedures/interventions, blood transfusions and associated labs, services related to bleeding, cardiac medications, diagnostic imaging, laboratory, outpatient visits, other hospitalizations, aftercare/rehab, durable medical equipment, patient transport and telehealth.
The program represents an increasing focus on reducing hospital readmissions and the overall cost of care. According to CMS, ASM builds on the Merit-based Incentive Payment System (MIPS) to measure clinician performance but especially emphasizes quality and cost performance, with participating clinicians evaluated by comparing their scores against other clinicians treating the same chronic condition.
The result of this model will be an adjustment to participating clinicians’ total Part B payments in a future performance year of up to +/-9% – a direct financial impact for physicians treating CHF. One of the key quality measures of ASM is tied to reducing unplanned cardiovascular-related admissions for patients with heart failure – a challenge well known within the healthcare industry, with more than half of patients hospitalized with heart failure being readmitted or dying within six months of initial discharge.1
The Role of Lung Fluid Measurement in Reducing Readmissions
Heart failure clinicians have long recognized pulmonary congestion as a key indicator of heart failure complications and hospital readmissions,1 but its usage has historically been limited by the tools available to assess pulmonary congestion in the hospital setting or guided by potentially misleading symptom presentation more than by objective, measurable data.
Patients can appear clinically stable in the face of residual pulmonary congestion; breathing may improve, symptoms may ease, and discharge may still seem appropriate to care teams tasked with determining discharge status. Residual congestion can leave patients vulnerable post-discharge, especially when treatment and related decisions are based on observations and patient feedback that don’t directly measure lung fluid levels. All of this, in turn, leads to the avoidable readmissions and treatment complications that CMS seeks to reduce through the Ambulatory Specialty Model. But there’s good news: There’s a simpler, more effective option proven to reduce hospital readmissions and improve patient outcomes.
From Subjective Assessments to Measurable Congestion Data
ReDS™ (Remote Dielectric Sensing) is a noninvasive, easy-to-use system for monitoring and management of pulmonary congestion in patients with heart failure and other chronic diseases. Unlike diagnostic tools such as CRx or natriuretic peptides measurement, which are limited to hospital settings, ReDS can be utilized across care settings – including outpatient clinics, skilled nursing facilities and at home.
ReDS uses radiofrequency (RF) technology to provide direct lung fluid measurement non-invasively, with low-power electromagnetic signals instantly assessing dielectric properties of lung tissue. Fluid-filled lung tissue and air-filled lung tissue respond differently to those signals, allowing ReDS to provide an absolute measure of lung fluid volume.
ReDS has been evaluated against high-resolution chest CT, the traditional standard of care method for diagnosing, evaluating, and monitoring pulmonary congestion. In a comparative study of patients hospitalized with acute heart failure, ReDS demonstrated that 32% of patients considered ready for discharge still had clinically significant residual lung congestion.2
A ReDS measurement takes approximately 45 seconds once the device is properly configured, giving clinicians objective lung fluid data they can apply to treatment decisions, discharge planning, and ongoing monitoring.
The technology is associated with significant reductions readmission rates, including an 87% reduction in heart failure hospitalization rates compared with the 90 days prior to ReDS monitoring, and a 79% reduction during the post-monitoring period.3
Transforming Pulmonary Congestion Assessments with ReDS
Heart failure care depends on timely, confident decisions about treatment, discharge, and follow-up. Symptoms and physical exams remain essential, but pulmonary congestion can persist even when patients appear to be improving.
ReDS helps move heart failure management from subjective assessment alone toward actionable pulmonary congestion data. Equipped with direct, noninvasive lung fluid level monitoring capabilities, care teams can better assess congestion status, support treatment adjustments, guide discharge planning, and prevent complications and readmissions.
Schedule a demo to see how ReDS can help your care team make more informed heart failure care decisions.
Sources
- Amir O, Ben-Gal T, Weinstein JM, et al. Evaluation of remote dielectric sensing technology-guided therapy for decreasing heart failure rehospitalizations. Int J Cardiol. 2017;240:279-284. doi:10.1016/j.ijcard.2017.02.120 https://pubmed.ncbi.nlm.nih.gov/28341372/
- Bensimhon D, Alali SA, Curran L, et al. The use of the ReDS noninvasive lung fluid monitoring system to assess readiness for discharge in patients hospitalized with acute heart failure: a pilot study. Heart Lung. 2021;50(1):59-64. doi:10.1016/j.hrtlng.2020.07.003 https://pubmed.ncbi.nlm.nih.gov/32703623/
- Alvarez-Garcia et al. ReDS Before and After Discharge in Patients with ADHF: The ReDS-SAFE HF Trial. JACC HF 2024; Early use of remote dielectric sensing after hospitalization to reduce heart failure readmissions. Lala et al. ESC Heart Failure 8:1047–1054.
