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Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)FHIR

Measure Information

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Table Options
Measure Information 2026 Performance Period
Title Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)FHIR
CMS eCQM ID CMS144FHIR
Measure Steward American Heart Association
Description

Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) <= 40% who were prescribed or already taking beta-blocker therapy during the measurement period

Stratification *See CMS144FHIR-v1.0.000-FHIR.html
Risk Adjustment *See CMS144FHIR-v1.0.000-FHIR.html
Rationale

Beta blockers improve survival and reduce hospitalization for patients with stable heart failure with reduced ejection fraction (HFrEF). Treatment should be initiated as soon as a patient is diagnosed with reduced LVEF and does not have prohibitively low systemic blood pressure, fluid overload, or recent treatment with an intravenous positive inotropic agent. Beta blockers have also been shown to lessen the symptoms of heart failure, improve the clinical status of patients, and reduce future clinical deterioration. Despite these benefits, use of beta blockers in eligible patients remains suboptimal.

Clinical Recommendation Statement

In patients with HFrEF, with current or previous symptoms, use of 1 of the 3 beta blockers proven to reduce mortality (e.g., bisoprolol, carvedilol, sustained-release metoprolol succinate) is recommended to reduce mortality and hospitalizations (Class I, Level of Evidence A) (Heidenreich, 2022).

Drugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only Beta-blocker therapy)

DrugInitial Daily Dose(s)Target Dose(s)Mean Doses Achieved in Clinical Trials
Beta Blockers


Bisoprolol1.25 mg once10 mg once8.6 mg/d
Carvedilol3.125 mg twice25-50 mg twice37 mg/d
Carvedilol CR10 mg once80 mg onceN/A
Metoprolol succinate extended release (metoprolol CR/XL)12.5 to 25 mg once200 mg once159 mg/d
Definition *See CMS144FHIR-v1.0.000-FHIR.html
Guidance

This eCQM is to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period.

A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.

In order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of "below 40%" or "ejection fraction between 35 and 40%" will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as "Moderate or Severe."

Beta-blocker therapy: For patients with prior LVEF <= 40%, beta-blocker therapy should include bisoprolol, carvedilol, or sustained release metoprolol succinate.

The requirement of two or more visits is to establish that the eligible clinician has an existing relationship with the patient.

This FHIR-based measure has been derived from the QDM-based measure CMS144v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).

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Specifications and Data Elements
Release Notes
Last Updated: Jun 30, 2026