Controlling High Blood Pressure: Ages 18-85

About This Measure

This measure reports the percentage of adults ages 18 to 85 diagnosed with hypertension and whose blood pressure was adequately controlled during the measurement year. Higher rates are better.

The data presented below are taken from the Adult Core Set for Federal Fiscal Year (FFY) 2016. Reporting is currently voluntary and reporting methods can vary by state.  For example, some states have access to different data on populations covered under fee-for-service as compared to populations covered under managed care. This variation in data availability can impact measure performance. Readers should review the detailed measure notes located after the graph to better understand states’ reported rates.

Adequate control is defined as a blood pressure:

  • Less than 140/90 for adults ages 18 to 59
  • Less than 140/90 for adults ages 60 to 85 with a diagnosis of diabetes
  • Less than 150/90 for adults ages 60 to 85 without a diagnosis of diabetes

High blood pressure, or hypertension, increases the risk of heart disease and stroke, which are the leading causes of death in the United States. Controlling high blood pressure is an important step in preventing heart attacks, strokes, and kidney disease. It also reduces the risk of developing other serious conditions.

CMS publicly reported states’ performance on this measure for the first time for FFY 2016.

The red dashed line represents the median, or middle of all values reported.

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Stem plot with a median of 55% and the states and values:

State Percent
California 61%
Colorado 59%
Connecticut 48%
Delaware 40%
Dist. Of Col. 48%
Georgia 32%
Hawaii 51%
Kentucky 52%
Louisiana 26%
Maryland 62%
Massachusetts 68%
Mississippi 37%
New Hampshire 63%
New Jersey 54%
New Mexico 54%
New York 64%
Oregon 65%
Pennsylvania 61%
Rhode Island 72%
Tennessee 55%
Texas 44%
Utah 67%
Vermont 57%
Virginia 57%
Washington 54%
West Virginia 55%

Source: Mathematica analysis of MACPro reports for the Adult Core Set FFY 2016 reporting cycle; see 2016 Child and Adult Health Care Quality Measures

Notes:

The following states did not report data to CMS for this measure: AK, AL, AR, AZ, FL, IA, ID, IL, IN, KS, ME, MI, MN, MO, MT, NC, ND, NE, NV, OH, OK, SC, SD, WI, and WY.

Measure Specific Tables (MSTs) available on Medicaid.gov provide important context for understanding state performance on each measure. MSTs include information about variation in included populations, methods, and data sources used to calculate the measure, as well as deviations from Core Set measure specifications.

Unless otherwise specified:

  • States used Adult Core Set specifications, based on HEDIS 2016 specifications. 
  • The measurement period for this measure was January 1, 2015 to June 1, 2015. KY and MS reported data for CY 2015. 
  • Rates displayed reflect state reporting for Medicaid beneficiaries ages 18 to 85 or ages 18 to 64.

The Adult Core Set specifications include guidance for calculating this measure using the hybrid method. The hybrid method uses a combination of administrative and medical records data to identify services included in the numerator or to determine exclusions from the denominator based on diagnoses or other criteria. Unless otherwise specified, administrative data sources are the state’s Medicaid Management Information System and/or data submitted by managed care plans, including behavioral health plans; medical record data sources are paper and/or electronic health records.

Unless otherwise specified in state-specific comments, denominators for the hybrid method are assumed to be the sample size for the medical chart review. Some states reported exclusions from the denominator, as noted in the state-specific comments below.

State-Specific Comments:

CA: Rate includes managed care population who were in the same MCO for the continuous enrollment period (26 MCOs), representing 69 percent of the population. Rate excludes FFS population (representing 10 percent of the population), individuals who were not in the same MCO for the entire continuous enrollment period (representing 21 percent of the population), and Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 407,911. Rate is provisional due to changes in the Medicaid program and data systems during this period.

CO: Rate includes FFS, PCCM, and managed care populations (1 MCO), representing 98 percent of the population. Rate excludes population in 1 MCO, representing 2 percent of the population. Denominator is the sample size; measure-eligible population is 43,002. Rate was calculated by the state's EQRO.

CT: Rate includes FFS population. Rate excludes Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 38,223.

DE: Rate includes managed care population (2 MCOs), representing 85 percent of the population. Rate excludes FFS population, representing 15 percent of the population. Denominator is the sum of the samples for the MCOs; measure-eligible population is not available.

DC: Rate includes managed care population (4 MCOs), representing 77 percent of the population. Rate excludes FFS population, representing 23 percent of the population. Denominator is the sample size; measure-eligible population is 11,367.

GA: Rate includes FFS and managed care populations (4 MCOs). Rate excludes Medicare-Medicaid Dual Eligibles and Planning for Healthy Babies (P4HB) demonstration members per CMS Special Terms and Conditions. Denominator is the sample size; measure-eligible population is not available.

HI: Rate includes managed care population (5 MCOs). Denominator is the sum of samples for the MCOs; measure-eligible population is 10,900. Rate was calculated by the state's EQRO.

KY: Rate includes managed care population (5 MCOs), representing 81 percent of the population. Rate excludes FFS population, representing 19 percent of the population. Denominator is the sample size; measure-eligible population is not available. Rate was calculated by the state's EQRO and data analytics contractor.

LA: Rate includes FFS and managed care populations (5 MCOs). Rate excludes Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 43,434.

MD: Rate includes managed care population (8 MCOs) ages 18 to 64, representing 75 percent of the population. Rate excludes FFS population (representing 25 percent of the population), including Medicare-Medicaid Dual Eligibles, individuals eligible on the basis of age or disability, and individuals in the Rare and Expensive Case Management program. Denominator is the sample size; measure-eligible population is 51,150. Rate was calculated by the state's EQRO.

MA: Rate includes managed care population (5 MCOs) ages 18 to 64, representing 51 percent of the population. Rate excludes PCCM and FFS populations (representing 49 percent of the population), but most FFS beneficiaries would not be eligible for the measure, including beneficiaries who have other insurance (commercial or Medicare), reside in a long-term care institution, or receive limited or temporary Medicaid benefits. Denominator is the sum of the samples; measure-eligible population is 41,588.

MS: Rate includes managed care population (2 MCOs), representing 68 percent of the population. Rate excludes FFS population (representing 32 percent of the population) as well as Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 22,248.

NH: Rate includes managed care population (2 MCOs), representing 79 percent of the population. Rate excludes FFS population (representing 21 percent of the population) as well as Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 4,703.

NJ: Rate includes managed care population (4 MCOs), representing 43 percent of the population. Rate excludes one MCO due to unreliable rates (representing 45 percent of the population) as well as the FFS population (representing 12 percent of the population) and Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 37,198.

NM: Rate includes managed care population (4 MCOs), representing 92 percent of the population. Rate excludes FFS population (representing 8 percent of the population) as well as Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 31,027.

NY: Rate includes managed care population (16 MCOs), representing 77 percent of the population. Rate excludes FFS population (representing 23 percent of the population) as well as Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 281,726.

OR: Rate includes managed care population (16 MCOs), representing 77 percent of the population. Rate excludes the FFS population, representing 23 percent of the population. State calculated the measure using EHRs and included all measure-eligible enrollees with available EHR data. Denominator is the included population.

PA: Rate includes managed care population (9 MCOs). Rate excludes Medicare-Medicaid Dual Eligibles. Denominator is the sum of the samples for the MCOs; measure-eligible population is 82,897. Data were submitted by MCOs and compiled by the state's EQRO.

RI: Rate includes managed care population (2 MCOs), representing more than 90 percent of the population. Rate excludes FFS population (representing less than 10 percent of the population) as well as Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 13,452.

TN: Rate includes managed care population (4 MCOs). Rate excludes Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 73,842. Rate was calculated by the state's EQRO.

TX: Rate includes managed care population (23 MCOs), representing 77 percent of the population. Rate excludes FFS population (23 percent of the population) as well as Medicare-Medicaid Dual Eligibles. Denominator is the sum of the samples for the MCOs; measure-eligible population is 61,463. Rate was calculated by the state's EQRO.

UT: Rate includes managed care population (4 MCOs), representing 74 percent of the population. Rate excludes FFS population, representing 26 percent of the population. Denominator is the sum of the samples for the MCOs; measure-eligible population is not available. Data source is audited HEDIS data submitted by the MCOs to the state.

VT: Rate includes FFS population. Denominator is the sample size; measure-eligible population is 10,837. Rate was calculated by the state's EQRO and data analytics contractor.

VA: Rate includes managed care population (6 MCOs), representing 36 percent of the population. Rate excludes FFS population (representing 22 percent of the population) as well as Medicaid beneficiaries eligible only for limited benefits, Program of All-Inclusive Care for the Elderly (PACE) enrollees, and Medicare-Medicaid Dual-Eligibles (representing 42 percent of the population). State obtained rate from the Quality Compass and denominator is not available.

WA: Rate includes managed care population (5 MCOs), representing 88 percent of the population. Rate excludes FFS population (representing 12 percent of the population) and Medicare-Medicaid Dual Eligibles. Denominator is the sum of the samples for the MCOs; measure-eligible population is 44,006.

WV: Rate includes managed care population (4 MCOs) ages 18 to 64, representing 44 percent of the population. Rate excludes FFS population (representing 56 percent of the population) and Medicare-Medicaid Dual Eligibles. Denominator is the sample size; measure-eligible population is 2,561. Rate was calculated by the state's EQRO and data analytics contractor.