For years, success in cardiovascular care has largely been measured by what happens during the patient visit. Under ASM, success will increasingly depend on what happens after the patient leaves the clinic.

The ability to consistently execute care between visits, optimizing therapy, coordinating multidisciplinary care, engaging patients, and preventing avoidable deterioration, will become central to both clinical outcomes and financial performance.

ISHI was built for exactly this challenge.

A New Era of Accountability

Heart failure remains one of the most complex and resource-intensive conditions managed in cardiology. Clinicians know what evidence-based care looks like. National guidelines clearly define appropriate therapies, monitoring strategies, and medication optimization.

Yet real-world execution remains difficult. Medication titration is delayed. Patients become disengaged. Symptoms progress between visits. Care teams struggle to keep pace with growing patient populations while balancing increasingly limited resources.

The challenge is consistently executing that plan between visits.

Beginning in 2027, CMS will directly measure and financially reward or penalize how effectively participating cardiologists perform against those expectations.

Most Practices Already Have the Pieces

Many cardiology organizations have already invested in technologies intended to improve longitudinal care. Remote Patient Monitoring generates valuable physiologic data. Care Management programs support ongoing patient engagement. Virtual care expands access beyond the clinic. Electronic health records improve documentation and communication.

Each capability plays an important role. The challenge is that they often operate independently.

Disconnected programs create disconnected execution.

Data exists. Programs exist. Patients are enrolled. But execution between visits often remains fragmented. Collecting information alone does not improve outcomes. Consistent clinical action does.

ISHI Was Built Around Execution

ISHI was never designed around a billing code. It wasn't built around a single monitoring device. It wasn't created to replace physicians or existing care programs. ISHI was designed to solve a much more practical question:

How can cardiology practices consistently execute heart failure care between visits?

The ISHI model combines:

  • Cardiologist-led clinical oversight

  • Experienced heart failure clinicians

  • Structured care pathways

  • AI-enabled prioritization

  • Remote monitoring

  • Continuous patient engagement

Rather than adding another disconnected technology, ISHI connects the people, workflows, and information required to execute care consistently at scale.

Helping Practices Succeed Under ASM

The CMS Ambulatory Specialty Model evaluates participating cardiologists across several core performance domains. ISHI was intentionally designed to strengthen the operational capabilities needed to perform successfully within that framework.

  • More consistent execution of guideline-directed medical therapy

  • Earlier identification of patient deterioration

  • Improved patient engagement and adherence

  • Better coordination across care teams

  • Reduced avoidable utilization

  • Greater operational efficiency without adding headcount

ISHI is not simply another care management program. It is the operational layer that helps practices consistently execute care between visits.

Why This Matters Now

The Ambulatory Specialty Model represents more than a new payment methodology. It signals a broader shift in specialty care. Healthcare is moving beyond episodic encounters toward continuous accountability for patient outcomes.

The organizations that succeed will not necessarily be those with the most technology. They will be the ones with the strongest operational infrastructure for delivering care consistently between visits.

Long before the Ambulatory Specialty Model was announced, ISHI recognized that the greatest opportunity to improve heart failure outcomes wasn't simply identifying risk. It was ensuring patients received consistent, proactive care after they left the clinic.

Because in the future of cardiovascular care, what happens between visits may matter just as much as what happens during them.