Paul L. Hess, MD, MHS, and Vincenzo B. Polsinelli, MD, delve into heart failure treatment protocols and their real-world implications. They discuss the importance of the Guideline-Directed Medical Therapy (GDMT) score, emphasizing its role in enhancing patient outcomes. The variability in treatment effectiveness across hospitals is scrutinized, revealing stark differences in mortality and rehospitalization rates. The duo advocates for stronger adherence to hospital-level guidelines as a means to improve care quality and reduce healthcare costs.