Elevating global heart failure care with new certification (Levels vs. Recognition Tiers in Heart Failure Centers of Excellence)
Elevating global heart failure care with new certification
(Levels vs. Recognition Tiers in Heart Failure Centers of Excellence)
Source: Medical News – September 2026
Based on: American Heart Association (AHA) / American College of Cardiology (ACC) programs for Heart Failure Centers of Excellence
Keynotes
1. Levels of Care (Structural Levels)
• Level 1 – Foundation/Basic: core requirements only (HF clinic, simple MDT, discharge bundle, basic registry).
• Level 2 – Advanced: adds rapid GDMT titration clinics, device referral (ICD/CRT), telemonitoring, palliative care integration.
• Level 3 – Comprehensive/Hub: high-volume referral center with advanced MCS (Mechanical Circulatory Support, e.g., LVAD, BiVAD) and transplant capability, plus training and research programs.
MCS (LVAD/BiVAD) indicates capability — either performed onsite or through a formal, rapid referral pathway — but not necessarily available in every Level 3 center.
These levels describe the structure and clinical services available in the center.
2. Recognition Levels (Tiers) in AHA GWTG-HF
• Bronze: continuous data reporting for ≥90 days.
• Silver: continuous data reporting for ≥12 months.
• Gold: sustained reporting for ≥24 months with stricter quality thresholds.
These tiers measure performance and quality reporting, not structural capacity.
3. Key Difference
• Levels (1–3): focus on what services a center provides (structural and functional capabilities).
• Tiers (Bronze–Gold): focus on how well the center delivers and documents quality care over time.
4. Practical Implication
• A small community hospital may qualify as Level 1 (Foundation) structurally, but still achieve Gold recognition tier if it maintains excellent data reporting and outcomes.
• Conversely, a large Level 3 (Comprehensive) hub could be downgraded in recognition tier if it fails to report outcomes consistently.
Conclusion & Practical Implications
In Heart Failure Centers of Excellence, Levels (1–3) define the center’s capabilities, while Recognition Levels (Bronze–Gold) define its quality performance over time. Both dimensions are essential: one shows capacity, the other shows accountability.