Million Hearts Recognizes Hypertension Control
Dr. Kenneth Cohen, MD, FACP, Chief Medical Officer
New West Physicians
Through continual focus on the mission to enhance the physical, mental and spiritual health of patients by delivering primary care with a coordinated, patient-centered approach, New West Physicians has been a leader for 25 years improving the quality of patients’ lives.
New West Physicians is a physician-led enterprise engaging more than 130 physicians in 22 locations throughout the Denver metro area, whose vision is to “change the face of healthcare delivery.”
The highly-qualified group of board certified family practice and internal medicine physicians, hospitalists, cardiologist, gastroenterologist, psychiatrist, endocrinologist, neurologist, physician assistants and nurse practitioners are committed to providing excellent service to every patient … every time.
For the past 20 years, putting quality measures into alignment with meaningful incentives has driven the evolution of New West Physicians.
Linking quality to powerful motivators, transparent quality reporting and compensation, as well as providing the right tools and education so our clinicians may realize success, has benefited our more than 200,000 patients in the Denver area.
Transparent reporting and a relentless drive for improvement in disease management and resource utilization have put our organization in the national spotlight more than once.
Most recently, we earned recognition from the Department of Health and Human Services Million Hearts® campaign as a 2017 champion for hypertension control.
In 2017, clinicians at New West achieved a successful management rate of over 83% — a full 13% higher than the benchmark set by the campaign. This score ranked us among the top 83 clinics and health systems in the U.S.
Blood pressure management as a priority
Unchecked, hypertension manifests a host of cardiovascular-mediated diseases.
From heart disease, which causes 1 in 4 deaths in the United States, to stroke, kidney disease and peripheral artery disease*, the repercussions of uncontrolled hypertension are among the costliest health conditions in the nation, in terms of health care dollars, morbidity, and mortality.
Prevention is the uncontested domain of primary care, and as such, managing patient blood pressure is a priority for every primary care clinician.
Even so, high blood pressure can be a challenge to tackle. Most often it is a “silent” condition.
Without symptomatic indicators such as pain to reinforce its danger, clinicians may struggle to engage patients in taking blood pressure medication, monitoring regularly, and staying within goal range.
Pharmacological resistance and economic concerns further complicate the picture. Not shy of a challenge and knowing the positive impact that healthy blood pressure has on our patients, New West uses a strategic approach to managing hypertension.
Reliable management of critical measures
Blood pressure control is built on three categories:
- Each exam room has a poster displaying the “green” “yellow” and “red” zones for systolic and diastolic blood pressure. Familiarity with safe ranges helps patients put their own measurements into context.
- Patients are encouraged to monitor blood pressure at home using a digital device.
- Case managers check in with patients on their home measurements, offering support to both patient and clinician with challenges in blood pressure management.
- Education is given on non-pharmacological options for reducing blood pressure.
Clinical transparency, accountability, and linking compensation to achievement
- Clinician-specific data on critical population health measures, including blood pressure management, are published within the practice three times annually.
This affords each clinician the opportunity to recognize successful interventions and seek education and support if they do not reach goals.
- Practice accountability: participation with nationwide programs such as the Million Hearts Challenge shows value and good health management for patients. This identifies the practice as a leader in the field of primary care and brings accolades to all members of the organization.
- One-third of clinician compensation is tied to their performance on designated measures of quality and utilization. The key being an alignment between patient results and compensation.
Robust clinician support systems, including education and tools for improving performance
- Clinicians have access to the evidence-based hypertension control algorithm drawn from the latest medical science with New West’s “Bench to Bedside” rapid incorporation of evidence-based medicine.
- In cases of medication non-compliance, tools include case management to engage patients, pharmacoeconomic education that raises clinician awareness of how medication cost can be a barrier to compliance, and strategies on how to lower costs.
- In cases of medication pseudo-resistance, tools include pharmacologist to review case and offer expert advice on tailored pharmacotherapies.
- In cases of complex metabolic syndrome, tools include assistance for weight loss, nutritional counseling, and follow-up with case management.
New West Physicians benefits from having made the decision decades ago to put aside increasingly complex incentives and make our guiding principle giving the best possible care to our patients.
With that core value, we have implemented strategies and solutions that make good care the most significant motivator driving clinicians at our practice.
As a result of years of measurement, transparent performance evaluation, and supporting clinicians and patients in the many dimensions of primary medicine, we are proud to be recognized as one of the best in the nation.
This publication is informational and for educational purposes only. The views and opinions expressed herein are those of the authors and do not necessarily represent the views of OptumCare®. The views and opinions expressed may change without notice.
*Kung HC, Xu JQ. Hypertension-related mortality in the United States, 2000–2013. NCHS data brief, no. 193. Hyattsville, MD: National Center for Health Statistics. 2015.