Predicted Nationwide Health and Economic Impacts of the AMA MAPTM Hypertension Program to Improve Hypertension Control
Abstract Body: Introduction Lack of actionable blood pressure (BP) measurements, therapeutic inertia, and suboptimal patient self-management are three key barriers to better BP control. To help address these barriers, the American Medical Association developed the Measure Accurately, Act Rapidly, and Partner with Patients Hypertension (MAPTM HTN) quality improvement program.
Methods To estimate the 10-year health and economic outcomes achieved when healthcare delivery systems adopt MAP HTN, HealthPartners Institute's ModelHealth™: Cardiovascular disease (CVD) microsimulation model was applied to conduct “what if” analyses for adopting MAP HTN nationwide and in care delivery systems of varying size. MAP HTN targets patients aged 18 to 85 years with diagnosed hypertension. To account for newly diagnosed hypertensive patients over time and outcomes that follow exposure to the program after age 85, the simulation model predicted outcomes for a dynamic cross-section of U.S. adults aged 18 to 100 years. This study was conducted from the health care sector perspective, including that of the payers for medical services and the health care delivery system that provides these services.
Risk equations to predict the incidence of CVD events were derived from Framingham Heart Study data and are based upon the following risk factors: age, sex, body mass index, systolic BP (SBP), lipid levels, smoking status, diabetes status, and CVD history. Modeled outcomes over 10 years included prevalence of SBP ≥140 mmHg; incidence of cardiovascular disease (CVD) events and CVD-related mortality; averted medical costs in 2021 U.S. dollars; and net costs.
Results Nationwide adoption of MAP HTN was predicted to improve mean BP control by 4.3% and prevent 601000 CVD events, with 85000 fewer myocardial infarctions, 164000 fewer strokes and 120000 fewer CVD deaths over 10 years as compared to usual care. The majority (93%) of the estimated $17.9 billion in averted costs were among Medicare beneficiaries. Total costs of implementing MAP HTN was $12.6 billion, resulting in a predicted $5.3 billion in net savings to the health care sector over 10 years. Small and large care delivery organizations could economically benefit from implementing MAP HTN at varying levels (5-50%) of shared cost savings from payers.
Conclusions The model demonstrates that AMA’s MAP HTN has the potential to improve population health and provide a positive business case by averting future myocardial infarctions, strokes, and CVD deaths.
Wozniak, Gregory
( American Medical Association
, Chicago
, Illinois
, United States
)
Dehmer, Steven
( HealthPartners Institute
, Minneapolis
, Minnesota
, United States
)
Egan, Brent
( American Medical Association
, Chicago
, Illinois
, United States
)
Hardy, Blaine
( HealthPartners Institute
, Minneapolis
, Minnesota
, United States
)
Maciosek, Michael
( HealthPartners Institute
, Minneapolis
, Minnesota
, United States
)
Sutherland, Susan
( American Medical Association
, Chicago
, Illinois
, United States
)
Tsipas, Stavros
( American Medical Association
, Chicago
, Illinois
, United States
)
Author Disclosures:
Gregory Wozniak:DO NOT have relevant financial relationships
| Steven Dehmer:No Answer
| Brent Egan:DO have relevant financial relationships
;
Other (please indicate in the box next to the company name):Rockefeller University (DSMB):Active (exists now)
; Consultant:Mineralys:Past (completed)
| Blaine Hardy:No Answer
| Michael Maciosek:No Answer
| Susan Sutherland:DO NOT have relevant financial relationships
| Stavros Tsipas:No Answer