November 5, 2021
Delivering Quality Care: Blood Pressure Control
To support quality care, we are providing information to providers to encourage discussions with members on health topics. Watch for more on health care quality in News and Updates.
High blood pressure, or hypertension, is known as a "silent killer" 
because it usually has no warning signs. Nearly half of adults in the U.S. have hypertension, according to the Centers for Disease Control and Prevention (CDC) , and only about 1 in 4 of them have the condition under control. Encourage our members to talk with you about their blood pressure and heart health .
Why Is Blood Pressure Control Important?
Controlling high blood pressure can prevent heart disease and stroke, which are among the leading causes of death in the U.S. According to the American Heart Association , blood pressure control can also reduce the risk of kidney disease, vision loss, peripheral artery disease and sexual dysfunction.
Closing Care Gaps
Controlling high blood pressure is a Health Effectiveness Data Information Set (HEDIS®) measure developed by the National Committee for Quality Assurance (NCQA) . The NCQA recommends controlling both the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults as follows:
- SBP < 140 mmHg
- DBP < 90 mmHg
View our clinical practice guidelines on hypertension here.
Tips to Consider
Consider talking with members about:
- Taking medications as prescribed
- Smoking cessation
- Increased physical activity
- Maintaining a healthy weight
- Limiting alcohol intake
- Eating a low-sodium diet
- Returning for follow-up visits. Reach out to members who cancel or miss appointments and assist them with rescheduling as soon as possible.
Best practices include using the proper codes when filing claims. Proper coding can help identify gaps in care, provide accurate data and streamline your administrative processes.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA.
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