The impact of the new HEDIS guidelines: Practical considerations

There are several compelling reasons to focus on the control of diagnosed hypertension as a quality of care measure. Hypertension is a very prevalent disease, with substantial associated morbidity, mortality, and costs. Although the benefits of adequate blood pressure control are well documented, numerous studies have shown that blood pressure is poorly controlled in the United States. With the institution of the new Health Employer Data and Information Set (HEDIS) hypertension measure in January 2000, health maintenance organizations become publicly accountable for their performance in controlling blood pressure in their enrollees who have diagnosed hypertension. Although the new HEDIS hypertension measure - the proportion of eligible patients whose representative blood pressure is less than 140/90 mm Hg - seems simple on the surface, there are dozens of complexities underlying it. Identification of eligible enrollees with diagnosed hypertension and appropriate data collection are key. Many believe that physicians are likely to be more receptive to providing blood pressure data on their patients if they receive something meaningful in return and if data collection is easy, not too time consuming, and not too costly or disruptive.