Improving Hypertension _ Diabetes Control and Prevention
An e-NEWSLETTER from Quality Insights                                                                                      August 18, 2017

In This Issue

HIPS module moduleAccording to the Centers for Disease Control and Prevention (CDC), approximately 11 million Americans who have hypertension don't know it and are not receiving treatment to control it, even though most of these individuals have health insurance and visit a health care provider each year. 
That means potentially millions of people with uncontrolled hypertension are seen by clinicians but remain undiagnosed. While following best practices and providing the highest levels of care, providers can still have patients "hiding in plain sight" who are at risk for or have undiagnosed hypertension.
Finding these patients and spreading the word about how other healthcare professionals can find them may help save lives.
Hypertension Hiding in Plain Sights Module
To help Pennsylvania providers uncover those patients with undiagnosed hypertension, Quality Insights has developed a module, Undiagnosed Hypertension: Hiding in Plain Sight. This module provides background about the prevalence of undiagnosed hypertension, clinician and patient resources, training videos, and more. Download the full module here.

The module and its resources will be featured over the next few weeks in these e-newsletters. Quality Insights encourages you to review and implement these tools and strategies, as appropriate, to uncover undiagnosed hypertension in your patient population.
Video Highlights Four Steps to Finding Undiagnosed Hypertensive Patients 

video videoWatch this Million Hearts® video, Finding Undiagnosed Hypertensive Patients, to learn more about the four steps to finding patients "hiding in plain sight" with undiagnosed hypertension. Start with the steps that make the most sense for your practice or system. The most important action to take is beginning the search for these patients. Treating uncontrolled hypertension dramatically reduces patients' risk for heart attack and stroke. Bringing individuals "hiding in plain sight" into clear view will help protect millions from unnecessary and preventable events.

The four steps include:
  1. Establish clinical criteria for potentially undiagnosed hypertension. (Example criteria: Systolic BP >140 or Diastolic BP >90 for more than one visit in the past year including the present day visit AND no diagnosis of hypertension)
  2. Search electronic health record data for patients who meet the established clinical criteria. (Example report: Run a registry report to identify patients with an encounter in the past year that had a systolic BP that was >140 or diastolic BP that was >90, including present day visit, and hypertension was not diagnosed.)
  3. Implement a plan to diagnose these patients and to treat those with hypertension. (Example: If BP elevated, repeat measurement. If 2nd reading elevated, schedule follow-up appointment for re-check. Consider addition of hypertension diagnosis to the problem list.)
  4. Calculate your health practice's or system's hypertension prevalence and compare your data against local, state, or national data.

shot vaccineAugust is National Immunization Awareness Month (NIAM) and focuses on highlighting the importance of vaccination for people of all ages, not just kids. It is important for adults to get vaccinations to protect their health. Even healthy adults can become seriously ill and pass diseases on to others. 

Everyone should have their vaccination needs assessed on a regular basis. Certain vaccines are recommended based on a person's age, occupation, or health conditions (such as asthma, chronic obstructive pulmonary disease, diabetes or heart disease).

Key Messages for Providers
Below are a few key messages for providers about the importance of patients with diabetes staying current on vaccines

Diabetes and the Flu:
  • For patients with diabetes, some illnesses like influenza can make glucose control more difficult. Ensure your patients are vaccinated and their vaccinations are up to date.
  • Less than half of adults under age 65 with diabetes are getting the vaccines they need to protect against influenza, pneumococcal, and hepatitis B. Take every opportunity to make sure your patients are up to date on recommended vaccines
  • Diabetes, even if it is well-managed, puts patients at higher risk of serious problems from flu. These problems can lead to hospitalization and sometimes even death. 
  • Some of these problems from flu include pneumonia, bronchitis, sinus infection, and ear infections. The flu can also make some chronic health problems worse.
  • Diabetes can make the immune system less able to fight infections. Infections can make it harder to control blood sugar levels.

toolThe Million Hearts® Hypertension Prevalence Estimator Tool   provides the user with a health system's expected hypertension prevalence, which is the estimated percentage of patients receiving care within the health system who have hypertension. 

Health systems can compare their expected hypertension prevalence calculated using the Estimator Tool with their measured prevalence to assess if they potentially have a large percentage of their patient population who have undiagnosed hypertension.
Visit the EHR Incentive Programs Website for Information about 2017 Program Requirements

abstract-mouse.jpg visitThe Centers for Medicare & Medicaid Services (CMS) would like to remind eligible professionals (EPs) and eligible hospitals that the Medicaid EHR Incentive Program, which is administered voluntarily by states and territories, will continue through 2021.

To participate in the program in 2017, EPs and eligible hospitals must attest to:
To learn more, visit the 2017 program requirements page on the EHR Incentive Programs website. For state-specific information and resources, review the Medicaid State Information page.

Incentive Payment Information
  • There are no payment adjustments in the Medicaid EHR Incentive Program.
  • EPs and eligible hospitals who meet program requirements can continue to attest to their state Medicaid agencies to receive yearly incentive payments.
  • The incentive payment is a fixed amount for each year of participation.  
  • EPs and eligible hospitals can receive incentive payments for six years nonconsecutively. EPs and eligible hospitals who began the program in 2016 must participate consecutively to receive the full payment amount over six years.
  • Eligible hospitals that are eligible to participate in the Medicare and Medicaid EHR Incentive Programs may attest under Medicare to avoid a payment adjustment.
Please note: 2016 was the last year EPs and eligible hospitals could begin participation in the Medicaid EHR Incentive Program.
Quality Insights Offers free Quality Payment Program Support to Pennsylvania Practices 

360 degree support qualityNeed help jump starting or maximizing your participation in the Medicare Quality Payment Program (QPP)? Good news! Quality Insights can help. As part of initiatives from the Centers for Medicare & Medicaid Services (CMS), Quality Insights is offering comprehensive QPP assistance to  Pennsylvania practices at NO COST. Eligible clinicians include physicians (MD/DO and DMD/DDS), podiatrists, optometrists, chiropractors, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists.

Quality Insights' 360-degree approach to assistance includes:
  • Resources - Simple, curated, online tools and quality improvement plans for every level of QPP readiness
  • Training - Expert-led webinars and live chats archived for your viewing convenience
  • Technical Assistance - Quality Insights team of Practice Transformation Specialists are available online and via telephone to personally guide you through the QPP process.
  • Networking - Opportunities to connect with local "mentors" or share experiences, questions and solutions with other small practices working their way through the QPP process
The entire program is specifically designed to help participating small practices maximize quality and improve MIPS scores. 

Want more information?
If your practice has 15 or fewer MIPS eligible clinicians
If your practice has 16 or more MIPS eligible clinicians :
contact information

For more details about the Improving Hypertension and Diabetes Care & Prevention project, please contact Rhonda Dodson.
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Funding provided by the Pennsylvania Department of Health through the State Public Health Actions to Prevent and Control 
Diabetes,  Heart Disease, Obesity and Associated Risk Factors and Promote School Health federal grant from the Centers for 
Disease Control  and Prevention. Publication number: PADOH-HD-081817