www.MercyCareAZ.org

May 5, 2023

New HEDIS Guidelines for Blood Pressure Documentation



Applicable to: Mercy Care Advantage

                           

There has been an increase in telehealth and other virtual medical visits during the COVID-19 pandemic in 2020. In order to account for this increase, the National Committee for Quality Assurance (NCQA) expanded the options for accepting telehealth and member reported information to meet compliance for many HEDIS measures including Controlling Blood Pressure (CBP). 


Teaching members to take and record their blood pressure at home is a useful tool in the management of hypertension. 


In the past, these blood pressure readings were not accepted for the CBP measure, however, now, member reported BP readings meet compliance if they are:

  • Taken by a member with a digital device*
  • Reported to their healthcare provider during a telehealth visit
  • Documented in the member’s medical record as a distinct numeric result that was taken and reported by the member, examples:
  • Member reports BP has been running 144-151/83-88, acceptable
  • Member reports BP today 110/70, acceptable
  • Member reports average BP 139/70, acceptable
  • Member reports home BP 140-150/80-90, this would not be acceptable as the range is generic and not distinct values.

 

Either synchronous telehealth visits or telephone visits which include interactive audio are acceptable visit types.

 

*May be covered under additional benefits, Over the Counter Benefit (OTC), you can refer the member to the following website for more information:

https://www.mercycareaz.org/members/advantage-formembers/additional-benefits

 

Source:

Technical Specifications for Health Plans

HEDIS ® Measurement year 2021 & Measurement year 2022 Volume 2

 

In the meantime, don't hesitate to contact your Mercy Care Network Management Representative with any questions or comments. You can find this Notice and all other provider notices on our Mercy Care Advantage website.


Thanks for all you do!



                           
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