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Implementing the new HEDIS hypertension performance measure.

C Sennett

    Managed Care (Langhorne, Pa.)
    |December 4, 2001
    PubMed
    Summary
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    Poor blood pressure control affects many Americans. Managed care organizations can improve hypertension control through new Healthcare Effectiveness Data and Information Set (HEDIS) measures, driving better patient outcomes and demonstrating value.

    Area of Science:

    • Public Health
    • Health Services Research
    • Quality Improvement

    Background:

    • Suboptimal blood pressure control poses significant public health risks in the United States.
    • Managed care organizations (MCOs) have a critical role and opportunity in addressing hypertension control.

    Purpose of the Study:

    • To introduce and discuss the implications of the new Healthcare Effectiveness Data and Information Set (HEDIS) hypertension control measure.
    • To outline the necessary steps for MCOs to effectively respond to the HEDIS hypertension measure and improve care.

    Main Methods:

    • Introduction of a new HEDIS measure focused on hypertension control.
    • Emphasis on the need for analysis of care delivery barriers and measurement of key processes.
    • Highlighting the roles of various MCO managers (medical directors, pharmacy directors, QA directors) in driving change.

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    Main Results:

    • The HEDIS measure creates pressure and opportunity for health plans to improve hypertension control.
    • Effective response requires analysis, measurement, and targeted interventions to change provider and enrollee behaviors.
    • Successful implementation will challenge MCO managers to influence behavior and leverage resources.

    Conclusions:

    • The HEDIS hypertension measure provides a framework for MCOs to demonstrate leadership in improving cardiovascular health.
    • MCOs can transform public perception by prioritizing high-value care and health maintenance.
    • Addressing the HEDIS measure is crucial for MCOs to showcase their commitment to quality care for millions at risk of heart disease and stroke.