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    Addressing hypertension can aid value-based scores



    Encourage self-monitoring

    Asking patients to self-monitor blood pressure is another way physicians can improve their MIPS score, says Nancy Enos, CPC, CPMA, a coding and practice management consultant in Warwick, Rhode Island. The idea is that by having patients self-monitor their blood pressure, they may be more likely to improve it, she adds.

    “When patients see their own blood pressure measurements, it makes them more conscientious about taking their medications,” Tashko says, adding that he encourages patients to monitor their own blood pressure and bring their results with them to the office. “That way, I can see the trend over a period of time,” he says. “That makes the patient more responsible and more aware so they can ask questions.”

    Kahn gives patients a blood pressure log to help them track their blood pressure daily. She also provides patients with a list of health apps that can help with the tracking. Some can even take a patient’s blood pressure automatically by collecting and analyzing a photoelectric pulse wave signal.

    Tashko also uses 24-hour ambulatory blood pressure monitoring (ABPM) for patients with continually uncontrolled high blood pressure. With ABPM, patients are hooked up to a blood pressure cuff at home that takes a measurement every 20-30 minutes while awake or asleep. After wearing the device for 24 hours, patients bring it to their appointment the next day where staff members download the data, print out the results, and scan that information into the EHR for analysis. 

    Ask patients to align blood pressure measurements with certain activities (e.g., physical exertion, stress or anxiety), says Maxine Lewis, CPC, CPMA, a coding and practice management consultant in Cincinnati, Ohio, because doing so helps identify potential causes of fluctuations or spikes.


    Address medication non-adherence

    Cost is one reason why patients may not take their hypertension medication as prescribed, and addressing this barrier can help physicians improve their MIPS score. For example, Kahn prescribes generic medications when possible. She also directs patients to prescription coupons and savings cards. “You have to be willing to work with the patients,” she says. “You don’t want to prescribe something, and then the patient doesn’t take it because they can’t afford it.”

    Another challenge is that many patients don’t always make hypertension medications a priority, says Tashko. “Because hypertension is a silent condition. It’s a natural human response that if you don’t feel symptoms, maybe you don’t need the medication.”

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