Blood Pressure Control for Patients With Diabetes (BPD)

HEDIS Measure

Blood Pressure Control for Patients With Diabetes (BPD)

Line of business: Commercial Medicaid Medicare

Data Collection Method:

Administrative (Claims)
Hybrid (HEDIS Chart Chase)
Supplemental Data Submission

• Standard – Electronic Clinical Data System (ECDS) Layout
• Non-Standard - Medical Record

Measure Description

The percentage of members 18–75 years of age with diabetes (types 1 and 2) whose blood pressure (BP) was adequately controlled (<140/90 mm Hg) during the measurement year taken during an outpatient, telehealth visit, e-visit or virtual check-in encounter or remote monitoring event.

Numerator Compliance

The most recent BP reading taken during the measurement year.

The member is numerator compliant if the BP is <140/90 mm Hg.

The member is not compliant if the BP is ≥140/90 mm Hg, if there is no BP reading during the measurement year or if the reading is incomplete (e.g., the systolic or diastolic level is missing).

If there are multiple BPs on the same date of service, use the lowest systolic and lowest diastolic BP on that date as the representative BP. Member reported digital blood pressure readings are acceptable.

Best Practices

• Document BP readings at every visit
• BP readings that are 140/90 or greater should be re-taken
• Schedule follow-up visits for blood pressure control after diagnosis or medication adjustment
• Consider referral to cardiologist for those whose BP goal cannot be attained, or for complicated patients
• Make sure the proper cuff size is used
• Ensure patients do not cross their legs and have their feet flat on the floor during the reading
• Make sure the elbow is at the same level as the heart
• Take it twice: if the patient has a high blood pressure reading at the beginning of the visit, retake and record it at the end of the visit and consider switching arms for subsequent readings
• Educate patients about the risks of uncontrolled blood pressure
• Reinforce the importance of medication adherence and encourage patients to report side effect

Quality Value Set Directory Coding Tips

Systolic Blood Pressure

Systolic Less Than 140

Systolic Greater Than or Equal To 140

Diastolic Blood Pressure

Diastolic Less Than 80

Diastolic 80-89

Diastolic Greater Than or Equal To 90