Medicare Advantage can save lives, money by covering blood pressure monitors | Opinion
The U.S. agency responsible overseeing Medicare and Medicaid recently decided to allow Medicare Advantage plans to cover non-medical services that can improve patient health.
When Medicare open enrollment begins on Oct. 15, we’ll learn what kinds of non-medical services Medicare Advantage plans decide to cover and we’re hoping that home blood pressure monitors will be included.
About a third of Michigan adults have been told that they have high blood pressure. While many may not notice symptoms, continued high blood pressure (above 130/80 mm Hg) can damage hearts, kidneys, and brains over time.
High blood pressure carries a huge economic cost for society: estimates suggest $48.6 billion in the U.S. annually, including the cost of medication and missed days of work. The burdens of high blood pressure are particularly acute for African Americans, who are at increased risk for developing high blood pressure, tend to develop it earlier in life, and tend to have greater severity.
Lifestyle modifications and medications can effectively lower blood pressure; but, for a variety of reasons, more than half of those with high blood pressure remain uncontrolled.
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By regularly checking blood pressure at home, people tend to make better health choices, and blood pressure monitoring has been shown to improve long-term control of hypertension. Home monitoring can also help healthcare providers understand how well (or poorly) blood pressure is being controlled outside of clinical settings, which can help physicians make better treatment decisions with their patients.
Basic, good quality home blood pressure monitors can be purchased for as little as $25 to $50. For a little more, some blood pressure monitors can sync with free or low-cost smartphone apps, Fitbit activity trackers, and smart scales, allowing people to manage their health in new and promising ways.
Yet, even at $25, the cost of a good quality home monitor is out of reach for many Michiganders, especially those covered by Medicare or Medicaid. Furthermore, even if Medicare Advantage decides to cover home blood pressure monitors, two-thirds of Medicare enrollees — those who can’t afford Medicare Advantage coverage — could be left out.
Health plans, particularly those that serve the people at greatest risk for problems caused by high blood pressure, can help.
While many plans pay for medications to treat high blood pressure, few pay for proven behavioral treatments such as home monitoring. These treatments also make business sense for health plans — home monitoring puts patients in the driver’s seat and has been shown to decrease medical costs by up to $148 per person, per year.
Michigan has an opportunity to lead the nation in better treatment of high blood pressure by encouraging private health plans and Medicaid plans to pay for home monitors for enrollees with high blood pressure.
Home monitoring can directly reduce high blood pressure treatment costs and can prevent or delay additional, more serious conditions caused by persistently high blood pressures. Making sure that every Michigander with hypertension has a home blood pressure monitor is simply the smart thing to do.
Lorraine Buis is an assistant professor at the University of Michigan Department of Family Medicine. Phillip Levy is a professor of emergency medicine and assistant vice president for Translational Science and Clinical Research Innovation at Wayne State University.