CDC’s 1305 and 1422 funding programs bring together four CDC programs – diabetes; heart disease and stroke prevention; nutrition, physical activity, and obesity; and school health - to support chronic disease prevention programs in states and large cities nationwide.

For a description of DP13-1305, visit: State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health (DP13-1305)

For a description of DP14-1422PPHF14, visit: State and Local Public Health Actions to Prevent Obesity, Diabetes, and Heart Disease and Stroke (DP14-1422PPHF14)

BASIC Domain 3 Health Systems Intervention includes Strategy 4 and Strategy 5
Strategy 4

Promote reporting of blood pressure and A1C measures; and as able, initiate activities that promote clinical innovations, team-based care, and self-monitoring of blood pressure.* Text in italics indicates optional strategies/activities for the basic component of FOA 1305

Performance Measure B.4.01

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0018

The purpose of this performance measure is to move states toward having the capacity to report state-level blood pressure control measures (as in the enhanced component of FOA 1305). The performance measure captures the number of health care systems in the state that report National Quality Forum (NQF) Measure 18 to promote quality improvement and population reporting of quality improvement data. (CDC DRAFT Operational 1305)

Optional Measures

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 59

Strategy 5

Promote awareness of high blood pressure among patients

Performance Measure B.5.01

Proportion of adults in the state aware that they have high blood pressure

The purpose of Strategy 5 is for States to increase the healthcare providers' awareness of the level of undiagnosed hypertension. The focus is specific to health systems and the care system design (protocols, clinical decision supports, and health IT) they have in place to assure that those with hypertension get properly diagnosed and treated. Note: This is not about increasing the public's awareness, or the patients' awareness.


BASIC PLUS Domain 3 Health Systems Intervention includes Strategy 1 and
Strategy 2

1305 Basic Plus funds basic states to implement selected enhanced strategies/interventions
Basic states are required to report on performance measures for these strategies/interventions

Strategy 1 Increase implementation of quality improvement processes in health systems

Interventions

Increase electronic health records (EHR) adoption and the use of health information technology (HIT) to improve performance

Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider and systems level

Promote the use of evidence-based practices and encourage health systems to implement standardized, guideline-based treatment protocols. Share tools to assist in chronic care management such as blood pressure and/or diabetes algorithms. Such as Million Hearts® Protocol for Controlling Hypertension in Adults

Note: All hypertension-related performance measures should be tracked for both interventions

Hypertension Performance Measures (Required)
Performance Measure 3.1.01

Proportion of health care systems with electronic health records (EHRs) appropriate for treating patients with high blood pressure

Performance Measure 3.1.03

Proportion of patients that are in health care systems that have electronic health records (EHRs) appropriate for treating patients with high blood pressure

Performance Measure 3.1.05

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0018

Performance Measure 3.1.07 (Domain 4 - 4.3.05)

Proportion of patients with high blood pressure in adherence to medication regimens

Performance Measure 3.1.09 (Domain 4 - 4.3.08)

Proportion of patients with high blood pressure that have a self-management plan (may include medication adherence, self-monitoring of blood pressure levels, increased consumption of nutritious food and beverages, increased physical activity, maintaining medical appointments)

Performance Measure 3.1.10 (Domain 4 - 4.3.10)

Proportion of adults with known high blood pressure who have achieved blood pressure control

Diabetes Performance Measures (Optional)
Performance Measure 3.1.02

Proportion of health care systems with electronic health records (EHRs) appropriate for treating patients with diabetes

Performance Measure 3.1.04

Proportion of patients that are in health care systems that have electronic health records (EHRs) appropriate for treating patients with diabetes

Performance Measure 3.1.06

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0059

Performance Measure 3.1.08 (Domain 4 - 4.3.06)

Proportion of patients with diabetes in adherence to medication regimens

Performance Measure 3.1.11

Decreased proportion of PWD with A1C >9

Performance Measure 3.1.12

Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes

Strategy 2 Increase use of team-based care in health systems

Interventions - States may choose one or both interventions

Increase engagement of non-physician team members (i.e., nurses, pharmacists, and patient navigators) in hypertension (HTN) and diabetes management in health care systems

Increase use of self-measured blood pressure monitoring tied with clinical support

Review items under the Team-based Care section of this site for resources on self-measured blood pressure monitoring to identify possible action steps. Your action steps may include; scanning your environment for existing efforts, identifying the prominent insurance carriers in your state and talking with the benefits managers to promote coverage of self-measured blood pressure monitoring equipment, working with health care providers to promote training of staff on how to teach patients about self-measured blood pressure monitoring, and educating the community about the importance of blood pressure control and home monitoring.

Hypertension Performance Measures (Required)
Performance Measure 3.2.01

Proportion of health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control

Performance Measure 3.2.03

Proportion of patients that are in health care systems that have policies or systems to encourage a multi-disciplinary team approach to blood pressure control

Performance Measure 3.2.05

Proportion of health care systems with policies or systems to encourage patient self-management of high blood pressure

Performance Measure 3.2.06

Proportion of patients that are in health care systems that have policies or systems to encourage patient self-management of high blood pressure

Performance Measure 3.2.07 (Domain 4 - 4.3.05)

Proportion of patients with high blood pressure in adherence to medication regimens

Performance Measure 3.2.09 (Domain 4 - 4.3.08)

Proportion of patients with high blood pressure that have a self-management plan (may include medication adherence, self-monitoring of blood pressure levels, increased consumption of nutritious food and beverages, increased physical activity, maintaining medical appointments)

Performance Measure 3.2.10 (Domain 4 - 4.3.10)

Proportion of adults with known high blood pressure who have achieved blood pressure control

Diabetes Performance Measures (Optional)
Performance Measure 3.2.02

Proportion of health care systems with electronic health records (EHRs) appropriate for treating patients with diabetes

Performance Measure 3.2.04

Proportion of patients that are in health care systems that have policies or systems to encourage a multi-disciplinary approach to A1C control

Performance Measure 3.2.08 (Domain 4 - 4.3.06)

Proportion of patients with diabetes in adherence to medication regimens

Performance Measure 3.2.11

Decreased proportion of PWD with A1C >9

Performance Measure 3.2.12

Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes

Enhanced Domain 3 Health Systems Intervention includes Strategy 1 and
Strategy 2

(Note on Supplemental Funding: Provided to enhanced states to expand/increase activities in selected strategies. No additional performance measures but targets should reflect expanded reach and outcomes.)

Strategy 1

Increase implementation of quality improvement process in health systems

Interventions
Increase electronic health records (EHR) adoption and the use of health information technology (HIT) to improve performance

Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider and systems level

Performance Measure 3.1.01

Proportion of health care systems with electronic health records (EHRs) appropriate for treating patients with high blood pressure

Performance Measure 3.1.02

Proportion of health care systems with electronic health records (EHRs) appropriate for treating patients with diabetes

Performance Measure 3.1.03

Proportion of patients that are in health care systems that have electronic health records (EHRs) appropriate for treating patients with high blood pressure

Performance Measure 3.1.04

Proportion of patients that are in health care systems that have electronic health records (EHRs) appropriate for treating patients with diabetes

Performance Measure 3.1.05

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 0018

Performance Measure 3.1.06

Proportion of health care systems reporting on National Quality Forum (NQF) Measure 59

Performance Measure 3.1.07 (Domain 4 - 4.3.05)

Proportion of patients with high blood pressure in adherence to medication regimens

Performance Measure 3.1.08 (Domain 4 - 4.3.06)

Proportion of patients with diabetes in adherence to medication regimens

Performance Measure 3.1.09 (Domain 4 - 4.3.08)

Proportion of patients with high blood pressure that have a self-management plan (may include medication adherence, self-monitoring of blood pressure levels, increased consumption of nutritious food and beverages, increased physical activity, maintaining medical appointments)

Performance Measure 3.1.10 (Domain 4 - 4.3.10)

Proportion of adults with known high blood pressure who have achieved blood pressure control

Performance Measure 3.1.11

Decreased proportion of PWD with A1C >9%

Performance Measure 3.1.12

Age-adjusted hospital discharge rate for diabetes as any-listed diagnosis per 1,000 persons with diabetes

Strategy 2

Increase use of team-based care in health systems

Interventions
Increase engagement of non-physician team members (i.e., nurses, pharmacists, and patient navigators) in hypertension (HTN) and diabetes management in health care systems

Increase use of self-measured blood pressure monitoring tied with clinical support

Performance Measure 3.2.01

Proportion of health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control

Performance Measure 3.2.02

Proportion of health care systems with policies or systems to encourage a multi-disciplinary team approach to A1C control

Performance Measure 3.2.03

Proportion of patients that are in health care systems that have policies or systems to encourage a multi-disciplinary team approach to blood pressure control

Performance Measure 3.2.04

Proportion of patients that are in health care systems that have policies or systems to encourage a multi-disciplinary approach to A1C control

Performance Measure 3.2.05

Proportion of health care systems with policies or systems to encourage patient self-management of high blood pressure

Performance Measure 3.2.06

Proportion of patients that are in health care systems that have policies or systems to encourage patient self-management of high blood pressure


What is 1422?

DP14-1422 State and Local Public Health Actions to Prevent Obesity, Diabetes and Heart Disease is a CDC initiative to support cross-cutting programs to prevent and control chronic diseases - the leading causes of death and disability in the United States. This program, building on efforts initiated in 2013, intensifies work in state and large city health departments to prevent obesity, diabetes, heart disease, and stroke and reduce health disparities through community and health system interventions. (CDC 2014)


1422 strategies and related performance measures are categorized under Community Strategies and Health System Interventions. You will see them referenced as:

  • Component 1: Strategies to build support for healthy lifestyles, particularly for those at high risk, to support diabetes and heart disease and stroke prevention efforts
  • Component 2: Health System Interventions to Improve the Quality of Health Care Delivery to Populations with the Highest Hypertension
  • Component 2: Community Clinical Linkage Strategies to Support Heart Disease and Stroke Prevention Efforts

The health system interventions and efforts to link community programs to clinical services aim to improve health care and preventive services to populations with the largest disparities in high blood pressure and pre-diabetes. Activities should complement but not duplicate those funded under the (DP13-1305) State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors and Promote School Health Initiative. (CDC 2014)



1422 Performance Measures that crossover with 1305 Domain 3 Health System
Interventions

The 1422 performance measures in Component 2: Health System Interventions to Improve the Quality of Health Care Delivery to Populations with the Highest Hypertension that crossover and compliment 1305 Domain 3 work are the following:

Performance Measure 13 Corresponding 1305 Measure 3.1.03

Percentage of patients within health care systems with electronic health records appropriate for treating patients with high blood pressure

Performance Measure 14 Corresponding 1305 Measure 3.1.03

Percentage of persons within health care systems with systems to report standardized clinical quality measures for the management and treatment of patients with high blood pressure

Performance Measure 15 Corresponding 1305 Measure 3.2.03

Percentage of patients within health care systems with policies or systems to encourage a multi-disciplinary team approach to blood pressure control

Performance Measure 16 Corresponding 1305 Measure 3.2.06

Percentage of patients within health care systems with policies or systems to encourage self-monitoring of high blood pressure

Performance Measure 17A

Percentage of patients within health care systems with policies or systems to facilitate identification of patients with undiagnosed hypertension

Performance Measure 17B

Percentage of patients within health care systems with policies or systems to facilitate identification of people with prediabetes

Performance Measure 24 Corresponding 1305 Measure 3.1.07, 3.2.07

Proportion of adults with high blood pressure in adherence to medication regimens

Performance Measure 30 (Optional Performance Measure) Corresponding 1305 Measure 3.2.10

Proportion of adults with known high blood pressure who have achieved blood pressure control

Websites worth Bookmarking
 
Performance Reporting Tips
  • Performance Measure Tracking Tips- shared by Janika Harris at the Florida Department of Health in Issue 2 of Off the Cuff (the Domain 3 Health Systems Update):

  > Set targets that are realistic and proportional, to show either an increase or decrease each year (e.g. by 3% or increase by 5 units), depending on the result statement of the measure. Although not on the work plan, don’t forget to track performance measure progress for Year 4.
  > In your tracking sheet or document make sure there are columns for “Target” and “Actual” for each year of the grant
  > Using MS Excel, states can see whether they’ve met targets or easily spot patterns by using the icon sets under 'conditional formatting'
  > Use the directional icon sets under the 'conditional formatting' tab in MS Excel to easily identify a directional pattern over the 5-year grant funding cycle.
  > Other techniques for determining percent increase or change using MS Excel are to calculate the percent change and the annual growth rate using Excel formulas.
  > If you want to test for significance in percent change from year to year you can use a statistical package such as SAS or IBM SPSS


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