May 2, 2022
HEDIS 2022 – Controlling High Blood Pressure
The Controlling High Blood Pressure quality measure continues to be a focus for improvement within MPP and remains on your 2022 CI Scorecard. Health plans for commercial and Medicare populations have now weighted this metric 3 times the other metrics. MPP performs at less than a 4-star rating and therefore may not receive incentive dollars for this measure. Every patient aged 18-85 with a diagnosis of hypertension during the measurement year should have a controlled blood pressure reading documented.
Controlling high blood pressure is an important step in preventing heart attacks, stroke and kidney disease, and in reducing the risk of developing other serious conditions. Control is being defined by NCQA HEDIS as: Systolic <140 and Diastolic <90.
Documentation:
- The most recent BP reading during the measurement year on or after the date when the second claim for hypertension was submitted.
- BP can be taken from remote monitor devices that are digitally stored and transmitted directly to provider.
- If the BP reading is high at the beginning of the visit, retake it at the end of the visit and record both systolic and diastolic readings while reporting the lower of the two.
- Visit type need not be the same for the two visits. Only one of the two visits may be in the form of a telephone visit, an online assessment, or a telehealth visit.
Exclusions:
- Diagnosis of pregnancy in the measurement year.
- Non-acute admission in the measurement year. (i.e.: skilled nursing facility, rehab)
- Evidence of ESRD, dialysis, nephrectomy, or kidney transplant.
Top reasons a BP measurement may be inaccurate:
- Use incorrect cuff size (too small of a cuff adds 2-10 mm hg).
- Putting the cuff over clothing, rather than a bare arm, (can add 10-40 mm Hg to a measurement).
- Having a full bladder (can add 10-15 mm Hg).
- Talking or having a conversation (can add 10-15 mm Hg).
- Failing to support the arm at heart level (can add 10 mm Hg).
- An unsupported back (can increase a measurement by 5-10 mm Hg). That same range applies to feet left dangling from an exam table or high chair.
- Crossing legs (can add an extra 2-8 mm Hg).
MPP has partnered with the Michigan Peer Review Organization (MPRO) in a Cardiac Learning and Action Network to improve this metric across our populations. One way to help improve this measure is accurate blood pressure reading. Errors in technique lead to inaccurate measurement. MPP is providing a Blood Pressure Measurement Competency Training video and reference materials at no cost. We ask all of our practices to participate in this training.
McLaren Employed Practices
An education module on this metric, Strategies and Techniques for Blood Pressure Management – Blood Pressure Competency Training, will be part of McLaren University for the Medical Assistants and other clinical staff working in the employed and residency practices. The training will include a pre- and post-test and reference materials. The module will be assigned with new-hire and annual clinical competency training.
Independent Practices
Access to the training module, Strategies and Techniques for Blood Pressure Management – Blood Pressure Competency Training, and related materials including a pre- and post-test and reference materials, have been sent to office managers for independent practices, but if you have not received this information, please reach out to:
Dawn Smith
p (248) 484-4942, f (248) 484-4999
dawn.smith@mclaren.org