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The push for high quality care in all fields of medicine highlights the importance of establishing and adhering to quality indicators. In response, several gastrointestinal societies have established quality indicators specific to Barrett’s esophagus, which serve to create thresholds for performance while standardizing practice and guiding value-based care. Recent studies, however, have consistently demonstrated the lack of adherence to these quality indicators, particularly in surveillance (appropriate utilization of endoscopy and obtaining biopsies using the Seattle protocol) and endoscopic eradication therapy practices. These findings suggest that innovative interventions are needed to address these shortcomings in order to deliver high quality care to patients with Barrett’s esophagus.