The last decade has witnessed significant improvements in the care of acutely ill hospitalized patients. Elderly patients with an acute myocardial infarction (AMI) are now nearly twice as likely to receive evidence-based care and one-third less likely to die during their hospital stay compared with just 10 years ago.1,2 Similar trends exist for congestive heart failure (CHF) and pneumonia.2 National public reporting and pay-for-performance efforts, such as those implemented by the Centers for Medicare & Medicaid Services (CMS), have contributed to improvements in care for these conditions.1