Analysis

As shown in Table 1, more than three out of four Minnesotans aged 18-85 with diagnosed high blood pressure had their blood pressure under control. The measure definition changed slightly beginning in 2014, making it difficult to compare results prior to that date. In addition, MDH employed a more conservative method for calculating the 95% confidence interval in 2017. However, since 2014, there has been a very small improvement in the control of high blood pressure.

Table 1: Controlling High Blood Pressure by Year, 2011-2017

Year	Percent with Blood Pressure Under Control	95% Confidence Interval
2011	75.0%	(74.2-75.7%)
2012	75.1%	(74.3-75.8%)
2013	75.6%	(74.9-76.2%)
2014*	76.2%	(75.6-76.8%)
2015	76.0%	(75.3-76.6%)
2016	77.5%	(76.9-78.2%)
2017	78.2%	(76.8-79.6%)

*Measure definition changed in 2014, requiring adults aged 60-85 without diabetes to only meet a 150/90 mm Hg threshold

Table 2 shows that hypertensive Minnesotans with insurance coverage through Minnesota Health Care Programs (MHCP) have lower rates of blood pressure control than those with other types of insurance, including commercial insurance and Medicare. These blood pressure control improvements have narrowed the gap between MHCP patients and patients on other types of insurance from more than 8 percentage points in 2014 to just 4 percentage points in 2017.

Table 2: Controlling High Blood Pressure by Minnesota Health Care Program Insurance Status, 2014-2017

Year	MN Health Care Program	Other types of Insurance
2014	69.6%	77.7%
2015	70.1%	76.1%
2016	72.2%	77.3%
2017	72.7%	76.9%

Table 3 shows that White adults with MHCP insurance have a rate of blood pressure control that is significantly higher than the MHCP statewide rate (74% vs 73%). The rate for the Black or African American group is significantly lower than the MHCP statewide rate (57% vs 73%). Other race and ethnic groups with MHCP insurance do not have a significantly different rate of blood pressure control than the state.

Table 3: Controlling High Blood Pressure by Race and Ethnicity, Minnesota Health Care Program Members, 2017

Race	Rate	Comparison to State Rate
American Indian/Alaskan Native	69%	No difference*
Black/African American	57%	Lower
Asian	72%	No difference*
White	74%	Higher
Ethnicity	Rate	Comparison to State Rate
Hispanic	74%	No difference*

*Difference from state is not statistically significant.

Other Resources

• Minnesota Community Measurement’s Health Care Quality Report
  The Health Care Quality Report has been produced since 2004 and features statewide and medical group performance on a number of clinical quality measures, including Controlling High Blood Pressure.


• Minnesota Community Measurement’s Disparities by Insurance Type Report
  The Disparities by Insurance Type Report (previously named the Health Care Disparities Report) has been produced since 2007 and highlights differences by insurance type (Minnesota Health Care Programs vs. other types of insurance) for a number of clinical quality measures, including Controlling High Blood Pressure.


• Minnesota Department of Health Managed Care Section HEDIS Reports
  The Minnesota Department of Health Managed Care Section provides links to downloadable annual reports including dozens of quality measures for Health Plans operating in Minnesota, including Controlling High Blood Pressure.

Data Source

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool created by the National Committee for Quality Assurance (NCQA) to collect data about the quality of care and services provided by managed care health plans (including Commercial, Minnesota Health Care Programs and Medicare). NCQA requires health plans to collect this information in the same manner so that results can be fairly compared to one another.

Data collected for this measure are from health plan claims and medical record review. Measure results are calculated from a sample of less than 10% of the total eligible managed care population.

Measure Definition

This measures the percentage of patients ages 18-85 with a diagnosis of hypertension, or high blood pressure, whose blood pressure was adequately controlled based on the following criteria:

• Patients ages 18-59 whose blood pressure was less than 140/90 mmHg
• Patients ages 60-85 with a diagnosis of diabetes whose blood pressure was less than 140/90 mmHg
• Patients ages 60-85 without a diagnosis of diabetes whose blood pressure was less than 150/90 mmHg

The representative blood pressure is the most recent blood pressure reading during the measurement year (as long as the blood pressure reading occurred following the hypertension diagnosis).