Abstract
The decline in cardiovascular disease mortality is stalling, and Million Hearts, a nationwide cardiovascular risk factor control campaign, is only halfway to its goal. In this commentary we identify 3 barriers beyond public reporting of performance that are hard stops for many Medical Groups that are participating in the Million Hearts initiative: 1) the inability of many physicians to access and visualize their patient panel electronic medical record data for patient and quality management, 2) a lack of compensation for the cost of team-based primary care, and 3) external support for single-condition registries rather than a single registry that contains the information that is necessary to manage all conditions of interest. These barriers have been overcome by high-performing Medical Groups and, if their innovations are adopted as standard practice by the US health care community, we believe that the Million Hearts goal can be achieved.