A data-based foundation for managing hypertension services.

Publisher: Clinical Care Targeted Communications Group, LLC Country of Publication: United States NLM ID: 9613960 Publication Model: Electronic Cited Medium: Internet ISSN: 1936-2692 (Electronic) Linking ISSN: 10880224 NLM ISO Abbreviation: Am J Manag Care

Publication: Cranbury, NJ : Clinical Care Targeted Communications Group, LLC
Original Publication: Old Bridge, NJ : American Medical Pub., c1995-

Diabetes Mellitus, Type 2*/drug therapy ; Hypertension*/drug therapy ; Pharmaceutical Services*; Aged ; Antihypertensive Agents/therapeutic use ; Humans ; Medicare ; Retrospective Studies ; United States

Objectives: To understand primary care visits and medication utilization among older patients with hypertension to gauge opportunity for service redesign.
Study Design: Data came from 1,880,331 Medicare Advantage members with hypertension who had a primary care visit and a pharmacy claim for an antihypertensive, antidiabetic, or antilipemic medication. To determine activities associated with a primary care visit, we analyzed 43,258,454 medical claims, 245 procedure codes, and medication management associated with those visits. Models for predicting both hypertension visits and medication management were evaluated and applied.
Methods: Logistic regression was used to identify which features were predictive of a medication change or a provider visit.
Results: Almost 40% of visits were consultation only, not associated with a procedure, and 26.5% of individuals had no medication change in a year. For prescription changes, 75% were a return to a previously prescribed medication or a medication discontinuation. Twenty percent of the population accounted for 47.9% of visits. Type 2 diabetes and a prior medication change were the strongest predictors of a medication change. A previous medication change was also the strongest predictor of a subsequent provider visit.
Conclusions: Our analysis suggests that a significant portion of care-consultation-only visits-may be relatively low value. Further, much of medication management may not require an office-based visit. Finally, utilization behavior of patients with hypertension and predictive models are likely to allow informed provisioning of new service models to specific population segments.

0 (Antihypertensive Agents)

Date Created: 20220818 Date Completed: 20220822 Latest Revision: 20230123

20230123

10.37765/ajmc.2022.89201

35981128