Toward Precision Policy — The Case of Cardiovascular Care

The U.S. health care system is in the midst of a transition toward delivery of high-value rather than volume-based health care. As part of this shift, policies that offer incentives to physicians and hospitals to deliver better-quality care at lower cost are being implemented nationwide. Cardiovascular conditions and procedures, which are both common and expensive, have frequently been targeted by these efforts. Given that such initiatives were rolled out with little evidence to support their efficacy, it is not surprising that many have failed to improve the quality of care or patient outcomes. Unfortunately, some such efforts have also had unintended consequences.