15 Jul Reimbursing Patients For Home Blood Pressure Monitoring May Make Business Sense
MedicalResearch.com Interview with:
Alejandro Arrieta, PhD
Department of Health Policy and Management
Florida International University
Medical Research: What are the main findings of the study?
Dr. Arrieta: We found that it makes business sense for insurance companies to reimburse patients for the cost of blood pressure monitors that they can use at home. In just the first year, we estimate that insurance companies can produce returns that range from $0.85 to $3.75 per dollar invested in blood pressure monitors provided to their members.
Medical Research: What should clinicians and patients take away from your report?
Dr. Arrieta: Our study builds on previous evidence that blood pressure measurements obtained in a clinic setting are often inaccurate. Around 12-30% of patients are over-diagnosed due to the white coat effect, the tendency to produce falsely high blood pressures in a clinic setting. On the other hand, around 10-23% of patients are under-diagnosed due to masked hypertension, the failure to detect hypertension in the doctor’s office. As a consequence, many patients are currently receiving hypertensive medications that are not required, and many others are not taking needed medications because their hypertension was not detected.
Home blood pressure monitoring empowers patients to become better informed about their own blood pressure levels. By improving the accuracy of their blood pressure assessment and by monitoring their blood pressures outside the clinic setting, patients help themselves, help their physicians, and save money for insurance companies.
Providers can benefit when patients use blood pressure monitors at home because they can improve the accuracy of hypertension diagnosis and the monitoring of blood pressure levels. However, there are also costs to the providers when they incorporate home blood pressure monitoring in their clinical practice. Those costs have to be considered for a fair reimbursement.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Arrieta: Further research is needed to understand whether home blood pressure monitoring is also cost-beneficial from the provider perspective and whether widespread adoption of home monitoring would necessitate a revision of the relative value unit (RVU) for reimbursement purposes. Surveys indicate that about 2 in 3 primary care providers do not routinely recommend home monitoring to their hypertensive patients. To be the standard of care for diagnosis and treatment of hypertension, Home blood pressure monitoring has to make business sense not only to payers but also to providers.
Cost-Benefit Analysis of Home Blood Pressure Monitoring in Hypertension Diagnosis and Treatment: An Insurer Perspective
Alejandro Arrieta, John R. Woods, Nan Qiao, and Stephen J. Jay
Hypertension. 2014;HYPERTENSIONAHA.114.03780published online before print July 14 2014, doi:10.1161/HYPERTENSIONAHA.114.03780