According to the American Heart Association, nearly half of American adults have high blood pressure, or hypertension (HTN) – and many are not even aware they have it. Controlling blood pressure is key in preventing heart attacks, stroke, and kidney disease and reducing the risk of developing other serious conditions. Providers can help patients manage their high blood pressure by prescribing medications and encouraging healthy lifestyle changes.

Measure Compliance

Percent of members ages 18-85 with a blood pressure reading of <140/90 mm Hg (both SBP and DBP) to be considered adequately controlled during the
measurement year.

Measure Tips

• The last obtained BP reading of the year is what is evaluated in order to meet measure requirement.
• Member reported BP is acceptable to meet measure requirement during a telehealth visit.
• Schedule your snowbirds earlier in the year prior to 4th quarter of measurement year.
• Include Codes with visit Claim submission
• Schedule a follow-up visit for BP recheck as needed.

Measure Exclusions

• Members in hospice or palliative care at any time during the measurement year.

Best Practices

• Remind patients with hypertension about the importance of taking their medication, and its effect on blood pressure readings. Document those patients not taking medication as prescribed.
  Note: If blood pressure reading is high when the patient arrives, re-check later in the visit before patient leaves the office.
• Outreach to patients to schedule yearly and follow-up on appointments.
• Review diet (e.g. avoid alcohol consumption), medications, exercise regimen, and treatment adherence with the patient at each visit. Consider prescribing a blood pressure monitoring device for members with uncontrolled HTN.
• Help patients set self-management goals, which may include decreasing dietary salt, home blood pressure monitoring, stress reduction, exercise, meditation, and losing weight.
• Partner with patients to help identify any barriers to effective health management and connect them with care coordinators or other practice staff for available resources.
• Submit a claim/encounter with appropriate CPT II codes (preferable) to reduce the need for medical record reviews.

Encourage your patients to:

• Check blood pressure regularly – at home, doctor’s office or pharmacy. Patients should avoid food, caffeine, tobacco and alcohol for 30 minutes prior to taking a reading and take it at approximately the same time each day, using the same arm. If the patient does not own a blood pressure cuff, many pharmacies can take their blood pressure.
• Quit smoking – or don’t start. Call (800) QUIT-NOW or visit smokefree.gov.
• Avoid alcohol consumption.
• Eat a healthy diet – more fruits, vegetables, potassium, and whole grains; less sodium, saturated fat, trans fat and cholesterol.
• Read nutrition labels – most of the sodium we eat comes from processed & restaurant foods; about 90% of Americans eat too much sodium.
• Stay active – maintain a healthy weight and aim for 21/2 hours of moderate physical activity each week.
• Use mail-order pharmacy service to save on the cost of medications.

HealthCare Partners (HCP) is here to help!

HCP Pharmacy Staff
Call: (516) 515–8861
Monday through Friday, 8:30am – 5:30pm EST

HCP Case Managers
Call: (888) 258–0203
Monday through Friday, 8:30am – 5:30pm EST
Our Case Managers can:

• Teach patients about their condition.
• Guide them in making a treatment plan.
• Help them get medications and care.
• Coordinate transportation based on member’s assigned benefit.
• Set up referrals and doctor visits.
• Provide a Nurse on call, 24/7 at (516) 238-6124.

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