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 HeartsĀ® 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 tools within the Resource & Links button for Self-Measured Blood Pressure Monitoring to identify possible action steps. Your action steps may include; scanning your environment for existing efforts, identify the prominent insurance carriers in your state and talk with the benefits managers to promote coverage of self-measured blood pressure monitoring equipment, work with health care providers to promote training of staff in how to teach patients about self-measured blood pressure monitoring, and educate 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

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