CMS expands ABPM coverage
Policy extended to incude masked hyptertension, lowers hypertension threshhold
Based on recommendations from the American Heart Association and American Medical Association.1 the Centers for Medicare & Medicaid Services (CMS) is expanding its national coverage of ABPM in two important ways. The new policy lowers the blood pressure (BP) threshold for hypertension from 140/90 down to 130/80, allowing more patients access to ABPM.2 Additionally, ABPM can now also be used for patients suspected of having lower than usual BP measurements when administered in clinical settings.
Previously, CMS only covered ABPM for patients with suspected “white-coat hypertension,” which occurs when a patient exhibits elevated BP levels due to anxiety from being in a clinical setting, but is normotensive at home. The new policy extends coverage to include the opposite phenomenon, known as “masked hypertension” (MHT). Defined as non-elevated BP in the clinic setting and elevated BP in a non-clinical environment, MHT is estimated to affect 12.3% of the adult population in the U.S. and is associated with increased risk of organ damage, cardiovascular disease, and mortality.3
ABPM is a proven, reliable tool
With 32% of Americans adults and 26% of the global adult population living with hypertension,4,5 access to the latest diagnostic cardiology technology is becoming an essential component for population health management. Recent studies suggest that ABPM is the most cost-effective monitoring strategy for most adults regardless of their initial clinic blood pressure screen results. 6
- ABPM data correlates better than office measurements with target organ injury
- ABPM illustrates the extent of blood pressure (BP) reduction during sleep; persons whose BP doesn’t drop at night are at increased risk for cardiovascular events
- Recent studies suggest that ABPM data more accurately reflects a patient’s actual BP than casual or in-office BP measurements
- Availability of ABPM data improves the physician’s ability to predict cardiovascular risk
- ABPM data diagnoses masked hypertension
- Increasingly ABP is being used in pediatrics in accordance with the guidelines for the screening and management of high blood pressure in children and adolescents7
OnTrak
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Our proprietary algorithm has been proven in over 20 years’ use in pediatric, adolescent, adult and elderly patients with a variety of disorders. Researchers have selected Spacelabs Healthcare’s ABP monitors for more than 500 clinical studies, including the landmark DASH, SYST-Eur and AASK** analyses.3
Combined with the Sentinel cardiology information management system, our ABPM solutions provide a secure and scalable solution for all your hypertension needs regardless of clinic location.
Sources
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- Decision Memo for Ambulatory Blood Pressure Monitoring (ABPM) (CAG-00067R2), July 2, 2019
https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?
NCAId=294 - CMS Expands Coverage of Ambulatory Blood Pressure Monitoring (ABPM), July 2, 2019 https://www.cms.gov/newsroom/press-releases/cms-expands-coverage-ambulatory-blood-pressure-monitoring-abpm
- Prevalence of Masked Hypertension Among US Adults With Nonelevated Clinic Blood Pressure, February 2017, https://www.ncbi.nlm.nih.gov/pubmed/28100465
- America’s Health Rankings, United Health Foundation https://www.ncbi.nlm.nih.gov/pubmed/28100465
- Medscape, February 22, 2019, https://www.medscape.com/answers/241381-7614/what-is-the-global-prevalence-of-hypertension-high-blood-pressure
- Comparative Cost-Effectiveness of Clinic, Home, or Ambulatory Blood Pressure Measurement for Hypertension Diagnosis in US Adults, HYPERTENSIONAHA.118.11715, January 2019
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.11715 - The Fourth Report on the Diagnosis, Evaluation, and Treatment of High BP in Children and Adolescents
https://www.nhlbi.nih.gov/files/docs/resources/heart/hbp_ped.pdf
- Decision Memo for Ambulatory Blood Pressure Monitoring (ABPM) (CAG-00067R2), July 2, 2019