Nearly half of adults have hypertension and an estimated 1 in 4 adults with hypertension have their hypertension under control according to the Centers for Disease Control and Prevention (CDC). One evidence-based intervention to improve blood pressure control is through self-measured blood pressure (SMBP) which is a partnership between patients and the physician that includes the use of a home blood pressure device.
Michigan Medicaid now covers blood pressure devices and reimburses for clinical services related to SMBP. This increased coverage, which went into effect in 2022 will improve access to some of the most vulnerable patient populations- the kinds of patients Michigan physician Latonya A. Riddle-Jones M.D. treats everyday.
“My patients work all the time, usually shift work and come from all socioeconomic backgrounds. Half are on Medicaid and as much as I would love for them all to be able to come in for regular appointments – it’s often difficult for them to get the time off work during our regular business hours because to do so means they are losing out on getting the hours they need to make ends meet.” said Dr. Riddle-Jones. “Many of my patients have multiple chronic diseases, it might be HIV, hypertension, high cholesterol, diabetes- and being able to teach them how to take their own BP measurements with a validated device at home and call in with their numbers is going to make a huge difference in keeping these conditions under control.”
With Medicaid coverage for SMBP devices and services, patients can now obtain a home blood pressure device at no cost, and physicians and their staff can be reimbursed for the time they spend in person or on the phone educating patients about device usage. collecting the patient’s SMBP readings data and discussing treatment changes if warranted.
Not only does use of SMBP allow the physician to gather more data points from the patient, it makes the in-office time physicians do get with their patient far more efficient- and promotes early intervention.
“My patients can take their readings twice a day at home and we can understand their baseline and adjust medications accordingly- allowing us to prevent heart attacks, strokes and other incidents that might normally land a patient in the ER just because they have a cuff at home and can call us with the numbers.”
SMBP coverage is on the rise across the U.S. as more lawmakers see the importance of it for managing chronic disease. According to the 2024 SMBP Landscape Assessment compiled by the American Medical Association (AMA), 42 states reported coverage for SMBP home devices and 36 of those also covered standalone SMBP cuffs, up from 38 and 31 in 2022. This expansion in coverage has the potential to impact an additional 1.4 million Medicaid beneficiaries across the U.S. with hypertension.
“There is a lot of distrust among some of the most vulnerable patient populations- especially those with more limited resources and communities of color. They often experience a white-coat effect when taking measurements in office which can make them nervous and make those measurements unreliable.” Said Dr. Dr. Riddle-Jones.
“Patients are often rushing to the office, in order to get an accurate measurement representative of their baseline blood pressure we need them to sit down and rest for about 15-20 minutes to get the best reading. This isn’t always long enough or reflective of their usual baseline reading because of circumstances and setting. At home readings give us more data points and often more accurate readings because the patient is more relaxed.”
Michigan State Medical Society and the AMA are working together to promote physician awareness of the increased Medicaid coverage now available for SMBP devices and clinical services in Michigan.
To learn more about what MSMS and the AMA are doing to promote adoption and prescribing of SMBP please check out AMA’s website for Michigan specific guidance on coverage and resources related to SMBP.