Building the Future Heart Failure Workforce – Together

Dear HFSA Members,

As we look toward the future of heart failure care, one truth has become clear: our patients’ needs are growing faster than our ability to meet them. Across the country, the number of clinicians specializing in advanced heart failure and transplantation remains far below the demand. This gap threatens not only access to specialized care, but also the quality and continuity of care that our patients deserve.

That is why the Heart Failure Society of America is leading with a bold, strategic response — the HFSA Heart Failure Workforce Initiative. This initiative is designed to strengthen the heart failure clinician pipeline, elevate the value of our specialty, and ensure that patients today and tomorrow receive the expert care they need.

Following recent discussions with the HFSA Board of Directors, the Initiative now moves forward with two core priorities: Improving Compensation for Advanced Heart Failure Cardiologists and Marketing Heart Failure as a Career Path to Early Trainees.

Improving Compensation and Recognition

Our first priority addresses one of the most pressing concerns in the field: compensation for advanced heart failure and transplant cardiologists (AHFTCs). Despite the extraordinary complexity of care we provide, the current Relative Value Unit (RVU) system does not adequately reflect the time, expertise, and coordination required in heart failure management. Much of our work involves high-level decision-making and longitudinal patient care that does not fit neatly into procedural codes.
 
To address this, HFSA will engage expert consultants with CMS to explore mechanisms for enhanced RVU credit for E/M-based heart failure work. This effort will be grounded in data and advocacy – assessing existing precedents and identifying pathways for regulatory recognition of AHFTC expertise.
 
We also plan to advocate for the requirement of a heart failure specialist on all structural heart teams, including those performing MitraClip and tricuspid interventions. Whether through AHFTC certification or new Level 2/distinction criteria, this step would ensure that every patient undergoing complex structural procedures will benefit from the involvement of a clinician with deep heart failure expertise. Beyond improving care quality, this requirement would meaningfully increase the demand for certified heart failure specialists nationwide.
 
Finally, HFSA will lead efforts to gather and publish data demonstrating the downstream financial and clinical impact of AHFTC care. By quantifying revenue generation and reductions in readmissions, we can provide members with powerful tools for advocacy in their institutions. These data-driven arguments will be essential for salary negotiations, institutional resource allocation and recognition of the indispensable role our members play in comprehensive cardiovascular care.

Building the Next Generation of Heart Failure Specialists

The second pillar of the HFSA Workforce Initiative focuses on the future: inspiring early-career trainees to choose heart failure as their path.

Our field thrives on intellectual challenge, human connection and the opportunity to transform lives – yet many medical students and residents are unaware of the depth and diversity of a career in heart failure. To change that, HFSA will launch a national marketing campaign aimed at medical students and internal medicine residents, particularly those in their formative decision-making years.

This multi-platform campaign – spanning social media, email outreach, and presence at major cardiology meetings – will showcase the stories, innovations and rewards that define our specialty. It will highlight the impact heart failure specialists have on outcomes, research and patient lives.

HFSA will also be hosting a dedicated “Heart Failure as a Career” Conference, offering trainees an immersive, day-long introduction to the field, complete with networking opportunities with HFSA leaders and peers.

These efforts will reinforce a central message: heart failure is not a subspecialty of constraint but one of possibility – a dynamic, evolving discipline at the heart of cardiovascular innovation and patient-centered care.

A Collective Commitment

HFSA’s success in this endeavor depends on the engagement and leadership of our members. As we advocate for fair compensation, institutional recognition and workforce development, we will rely on the insights of clinicians across practice settings – from academic centers to community hospitals. Your stories, data and experience will guide our advocacy and give strength to our message.

In the months ahead, we will be reaching out for volunteers to assist with data collection, outreach and mentorship activities tied to the Workforce Initiative. We invite every member to play a role in shaping the future of our field. Together, we can ensure that the next generation of heart failure clinicians is larger, stronger and better supported than ever before. Our patients are counting on us – and as always, HFSA will be there to lead the way.
 

Kenneth B. Margulies, MD, FHFSA
HFSA President 2025-2026