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  2. CQM-4894

Add guidance to clarify which blood pressure readings should be used to evaluate the numerator

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Details

    • EP/EC eCQMs
    • Status: Open
    • Moderate
    • Resolution: Unresolved
    • None

    Description

      Brief Description of Measure:

      ​CMS165: Controlling High Blood Pressure:
      Percentage of patients 18-85 years of age who had a diagnosis of hypertension overlapping the measurement period or the year prior to the measurement period, and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period

      Description of Issue:

      This measure is derived from the HEDIS Controlling Blood Pressure measure and is designed to evaluate the most recent BP readings.
      NCQA has received feedback from implementers stating confusion over the current guidance statement regarding multiple blood pressure readings taken on the same day and the rationale for us not allowing "averages" of blood pressures over a length of time.
      NCQA does not plan to revise this specific measurement at this time as a measure that calculates BP averages would be a different measurement. Records of numeric average BP readings can be used, but an average calculation will not be performed by the measure. ** 

      Proposed Solution:

      ​We plan to revise the header guidance to reduce confusion for implementers. Please see the proposed change below:
      Before
      //Header: Guidance
      If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. 
      After
      //Header: Guidance
      If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance. ** 

      Rationale for Change:

      The revised guidance provides additional clarification on what is required to meet the numerator.  

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            khancock Mathematica EC eCQM Team
            sgearhart Mathematica EH eCQM Team
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            Dates

              Created:
              Updated: