Hospital participation in the Get With The Guidelines-Heart Failure program was associated with a 0.15-point increase in guideline-directed medical therapy scores and 3-5% lower all-cause mortality across 30 days to one year in over 1.2 million Medicare beneficiaries with heart failure. Participating hospitals achieved better medication prescribing rates for beta blockers, ACE inhibitors, and mineralocorticoid receptor antagonists compared to non-participating facilities. These findings illuminate how structured quality improvement programs can translate evidence-based heart failure treatments into real-world practice. The mortality benefit, while modest, represents thousands of lives saved given heart failure affects over 6 million Americans annually. However, the observational design cannot definitively establish causation—participating hospitals may have been more motivated to improve care regardless of the program. The study's strength lies in its massive Medicare dataset spanning eight years, though results may not generalize to younger patients or those with private insurance. As a preprint awaiting peer review, these promising results require validation before widespread implementation decisions. The research suggests systematic quality initiatives may offer incremental but meaningful improvements in cardiovascular outcomes.