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New Medicaid Blood Pressure Policy will help Hoosiers

Thousands of Hoosiers with high blood pressure may now have easier access to monitoring devices that will allow them to check their own blood pressure, which could help them better control their blood pressure and lower their risk of heart disease, thanks to a change in state policy that was recommended by the American Heart Association.

 On Dec. 2, the Indiana Office of Medicaid Policy and Planning (OMPP) approved a policy request to expand coverage of blood pressure monitoring devices for the diagnosis and management of patients with hypertension and to address barriers to the implementation of self-measured blood pressure monitoring. The OMPP also removed a requirement for prior authorization, eliminating a barrier for patients receiving a device. 

Nearly half of Hoosier adults are estimated to have high blood pressure, consistent readings of 130/80 or higher, and for half of those individuals their hypertension is uncontrolled, doubling their risk for cardiovascular complications. 

Self-measured blood pressure monitoring, the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere, is a validated approach for out-of-office blood pressure measurement and is endorsed by several national and international hypertension guidelines, including the American Heart Association. The best available science supports the removal of patient exclusions and barriers to the use of self-measured blood pressure monitoring for improved diagnosis and management of high blood pressure by expanding coverage for clinical services to encourage provider utilization and use of validated automated blood pressure devices for home use.

 “High blood pressure is one of the biggest risk factors for heart disease and heart events,” said Dr. Sandeep Dube, a cardiologist who is president of the American Heart Association’s Indianapolis board of directors. “Growing evidence indicates that monitoring blood pressure outside of the doctor’s office, including self-measured blood pressure monitoring, confirms the diagnosis of hypertension and also helps people control their blood pressure. This policy move by the Office of Medicaid Policy and Planning is a critical step to expanding self-measured blood pressure monitoring and increasing coverage of patient- and provider-related costs.”

 “We’re excited to learn of this expansion of coverage,” said Tony Gillespie, vice president of public policy and engagement with the Indiana Minority Health Coalition. “Many Hoosiers, including racial and ethnic minorities who utilize Medicaid, face substantial barriers to accessing the healthcare services that could help them prevent or control risk factors for conditions including heart disease. By expanding access to devices which allow people to measure their own blood pressure, communities will be empowered to take control of their blood pressure and in turn live longer, healthier lives.”

 The American Heart Association believes everyone deserves adequate, accessible, and affordable health care. The Association published a presidential advisory earlier this year calling for eliminating inequities in the health care system, promoting diversity within the public health and health care workforce, and improving the health care system’s ability to address social determinants of health.

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