Hypertension: Improvement in Blood Pressure

Last updated: May 4, 2017

CMS Measure ID: CMS65v5
Version: 5
NQF Number: None
Measure Description:

Percentage of patients aged 18-85 years of age with a diagnosis of hypertension whose blood pressure improved during the measurement period.

Initial Patient Population:

All patients aged 18-85 years of age, who had at least one outpatient visit in the first six months of the measurement year, who have a diagnosis of essential hypertension documented during that outpatient visit, and who have uncontrolled baseline blood pressure at the time of that visit

Denominator Statement:

Equals Initial Population

Denominator Exclusions:
  • Exclude from the denominator all patients with evidence of end-stage renal disease (ESRD) on or prior to December 31 of the measurement year. Documentation of dialysis or kidney transplant also meets the criteria for evidence of ESRD.
  • Exclude from the denominator all patients with a diagnosis of pregnancy during the measurement year.
Numerator Statement:

Patients whose follow-up blood pressure is at least 10 mmHg less than their baseline blood pressure or is adequately controlled.

If a follow-up blood pressure reading is not recorded during the measurement year, the patient's blood pressure is assumed “not improved.”

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: Centers for Medicare & Medicaid Services
Domain: Effective Clinical Care
Next Version: Hypertension: Improvement in Blood Pressure
Previous Version: Hypertension: Improvement in Blood Pressure
Measure Score: Proportion
Improvement Notation:

A higher score indicates better quality

Guidance:

Blood pressure readings must be taken while the patient is sitting. If multiple measurements occur on the same date, the last systolic and diastolic readings should be used.

Occurrence A of Physical Exam, Performed: Systolic Blood Pressure (result) represents the baseline blood pressure, which must occur prior to Occurrence B of Physical Exam, Performed: Systolic Blood Pressure (result), which represents the follow-up blood pressure.

To calculate the Physical Exam, Performed: Delta systolic blood pressure (result) data element, subtract the value of Occurrence B of Physical Exam, Performed: Systolic Blood Pressure (result) from the value of Occurrence A of Physical Exam, Performed: Systolic Blood Pressure (result).

The data element Physical Exam, Performed: Delta systolic blood pressure (result) is intended to represent the result of the mathematic comparison between systolic blood pressures taken during two separate visits. This is a calculation artifact, and there's no requirement to document the delta data element in the medical record.

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.
  • Moved the FIRST operator and added a satisfies all operator to the initial population to capture the first visit that has an out of control blood pressure and a diagnosis of hypertension.
  • 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'.

Value Sets

No changes

External Resources