Heart failure has been on a steady rise in the United States, accounting for 45% of cardiovascular deaths in 2022. An estimated 6.7 million Americans aged 20 and up have heart failure, projected to reach 11.4 million by 2050. The economic burden is expected to grow concurrently, with costs already projected to exceed $70 billion by 2030.¹
The CMS Ambulatory Specialty Model (ASM) seeks to address the growing clinical and financial burden of heart failure by improving outpatient chronic disease management in outpatient settings, increasing accountability for quality and cost while improving care coordination. Targeting specialists who treat Original Medicare patients for lower back pain or heart failure, ASM seeks to improve patient outcomes through better risk assessment, stronger coordination, fewer unnecessary procedures, and avoidable hospitalizations.²
ASM holds specialists more directly accountable for chronic disease management, avoidable care utilization, and costs of care. For heart failure specialists, success under ASM will depend on how effectively care teams manage patients across treatment, discharge, follow-up, and ongoing monitoring. To best understand what this means in practice, it helps to look at how providers will be evaluated under the ASM scorecard.
The ASM Scorecard and Its Impact on Heart Failure Specialists
Building on the CMS Merit-based Incentive Payment System (MIPS), ASM evaluates specialists across four performance categories: Quality, Cost, Improvement Activities, and Promoting Interoperability.
With ASM implementation beginning on January 1, 2027 and running through December 31, 2031, providers need to understand how they’ll be evaluated and how to prepare for success under ASM. Under its two-sided risk arrangement, providers may receive financial incentives or penalties based on their performance relative to program peers.²
Quality
Over half of hospitalized heart failure patients face re-hospitalization or death within six months of discharge.³ Under ASM, providers are evaluated on clinical quality measures, including the reduction of heart failure readmission rates and improved patient outcomes. Specialists have an opportunity to identify risk earlier, intervene proactively, and help reduce avoidable readmissions before patients’ conditions worsen.
Cost
The associated cost of heart failure care per patient is an estimated $30,000 per patient, with nearly half due to in-patient hospitalizations.⁴ With ASM guidelines highlighting avoidable and unnecessary care, providers can help reduce costs with proactive measures earlier in the care cycle, and address concerns before they reach the hospitalization stage. Identifying pulmonary congestion and intervening before symptoms worsen may help reduce avoidable hospitalizations, improving outcomes while lowering the overall cost of care.
Improvement Activities
Clinical care processes and patient engagement are key components under ASM. Improvement activities emphasize coordinated care, patient engagement, and effective clinical workflows. Strengthening communication across specialists, primary care providers, and other members of the care team can help support improved outcomes throughout the patient journey, from rapid follow up through ongoing treatment measures.
Promoting Interoperability
Building on the importance of coordinated care, ASM gives heart failure providers further incentive to harness technology and electronic health record (EHR) integration to improve communication and data sharing efforts. Data should be simple to share across teams to promote better care coordination.
While meeting these performance measures may seem especially challenging when the countdown to ASM implementation is already underway, the ReDS™ Pro System from Sensible Medical helps support heart failure management by providing objective lung fluid measurements that inform treatment decisions and strengthen coordinated patient care without introducing complex workflows for staff or invasive procedures to patients.
Meeting ASM Metrics with ReDS
Pulmonary congestion is the most common cause of worsening HF leading to hospitalization. Accurate remote monitoring of lung fluid volume may guide optimal treatment and help reduce the risk of re-hospitalization. ReDS elevates heart failure management by simplifying lung fluid assessments non-invasively at the point of care, and has been associated with reductions in readmission rates of up to 87% in a single-center study.⁵
Using radiofrequency, ReDS assesses dielectric properties of lung tissue, delivering accurate, objective data in as little as 45 seconds.
Objective lung fluid assessments can help support quality efforts by helping caregivers (including clinicians and skilled nurses) assess congestion status, guide treatment/medication adjustments, support discharge planning/decisions, and monitor patients after discharge.
Cost performance depends on the ability to manage risk upstream, and not simply respond to complications as they occur. ReDS can help caregivers intervene before costly hospitalizations occur. With an 84.6% accuracy rate in the detection of pulmonary edema, helping clinicians identify at-risk patients earlier.
Accurate, objective lung fluid data can become part of a more coordinated post-discharge heart failure care workflow, enabling heart failure care providers to better determine who needs closer follow up, who may need treatment adjustment, who might benefit from more outreach, and how care teams align around the same measurable data.
Pulmonary fluid monitoring with ReDS can help improve communication and care coordination across the care team, informing treatment decisions, care planning, and post-discharge management while supporting value-based care initiatives such as ASM. Identifying residual or worsening fluid status earlier with ReDS was associated with a 30-day readmission rate of 2.6% (vs. 11.8% without ReDS) and medication adjustments in 65% of patients.³
Supporting Confident, Value-Based Heart Failure Care
As providers prepare for the rollout of ASM, heart failure specialists are under increased accountability for patient outcomes, care coordination efforts, and the overall costs of care.
Success under ASM will depend on the ability to identify risks earlier, coordinate follow-up efforts, reduce avoidable utilizations, and improve patient outcomes across the continuum of care.
The ReDS Pro System helps support these efforts by providing measurable lung fluid data to better inform treatment decisions, discharge planning, and ongoing patient monitoring.
Schedule a demo to learn how ReDS can help your organization strengthen heart failure management and get ready for ASM.
Sources
- Heart Failure Society of America Annual Report. 2025 Report Summary. https://hfstats.org/stat-category/2025-report-summary-top-10-key-points/
- https://www.cms.gov/priorities/innovation/innovation-models/asm
- Lala A, Barghash MH, Giustino G, et al. Early use of remote dielectric sensing after hospitalization to reduce heart failure readmissions. ESC Heart Fail. 2021;8(2):1047-1054. doi:10.1002/ehf2.13026
- Wei C, Heidenrich P, et al. The Economics of Heart Failure Care. Progress in Cardiovascular Diseases. 2024;82:90-101. doi: 10.1016/j.pcad.2024.01.010
- 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
- Rafique Z, McArthur R, Sekhon N, et al. Remote dielectric sensing for detecting pulmonary edema in the emergency department. Am J Emerg Med. 2022;55:11-15. doi:10.1016/j.ajem.2022.02.030
