Controlling High Blood Pressure

Last updated: May 17, 2016

CMS Measure ID: CMS165v4
Version: 4
NQF Number: 0018
Measure Description:

Percentage of patients 18-85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90mmHg) during the measurement period.

Initial Patient Population:

Patients 18-85 years of age who had a diagnosis of essential hypertension within the first six months of the measurement period or any time prior to the measurement period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period. Also exclude patients with a diagnosis of pregnancy during the measurement period.

Numerator Statement:

Patients whose blood pressure at the most recent visit is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period.

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Effective Clinical Care
Next Version: Controlling High Blood Pressure
Previous Version: Controlling High Blood Pressure
Measure Score: Proportion
Improvement Notation:

Higher score indicates better quality

Guidance:

In reference to the numerator element, only blood pressure readings performed by a clinician in the provider office are acceptable for numerator compliance with this measure. Blood pressure readings from the patient's home (including readings directly from monitoring devices) are not acceptable.

If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed not controlled.

Specifications

Release Notes

Header

  • Copyright updated.
  • Disclaimer updated.
  • eMeasure version number incremented.

Logic

  • Changed data type of 'result' or 'finding' to 'performed'.
  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Introduced the new timing operator 'overlaps' to replace two lines of logic (AND/AND NOT) or to enforce when an event or set of events occur to meet the measure intent.
  • Removed extraneous AND from Numerator and Denominator Exclusions.
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • Replaced 'starts before or during' (SBOD) with 'starts before end of' (SBE).
  • The top level logical operator for the Numerator Exclusions, Denominator Exclusions, Denominator Exceptions, and Measure Population Exclusions defaults to 'OR'.
  • Used the 'satisfies all' and 'overlaps' operators to indicate the most recent visit with a blood pressure should be used to evaluated the blood pressure reading.

Value Sets

  • Value set Other Services Related to Dialysis (OID 2.16.840.1.113883.3.464.1003.109.12.1015): Added 2 SNOMED Codes (251000124108, 311000124103).

External Resources