In the first analysis of its kind, a team of researchers at Indiana University-Purdue University Indianapolis has found that health insurance companies could save money on care for patients with high blood pressure if they supported the use of home blood pressure monitoring kits by reimbursing patients for the cost of the equipment. In findings published this month in the American Heart Association’s journal Hypertension, the authors conclude that patients who use home blood pressure monitoring devices can enjoy improved health care quality and lower health care costs; their physicians can more accurately diagnose and treat high blood pressure; and health insurance companies can save money by paying for home blood pressure monitoring kits. With so many benefits associated with home blood pressure monitoring, the authors believe that insurance company reimbursement of home blood pressure monitoring devices should become commonplace in the United States.
In 2011, Dr. Stephen Jay, professor in the department of health policy and management at the IU Richard M. Fairbanks School of Public Health, convened a team of researchers that included Dr. John Woods, senior investigator at Indiana University Health’s Methodist Research Institute and an adjunct professor at the IU Richard M. Fairbanks School of Public Health, Dr. Alejandro Arrieta, then a health economist with the IU Richard M. Fairbanks School of Public Health, and Ms. Nan Qiao, a graduate student in the IUPUI department of economics.
According to Dr. Jay, the team asked themselves how they could link the research on the benefits of home blood pressure monitoring with reimbursement policy in order to facilitate the adoption and widespread use of monitoring. They knew that some patients experience ‘white coat syndrome,’ which causes them to register higher than normal blood pressures in the doctor’s office, which can result in over diagnosis and treatment of hypertension. Other patients have ‘masked hypertension,’ which is missed when measured by the doctor. Those patients are undertreated, which can lead to heart attacks and stroke. The team believed that lack of reimbursement discouraged people from buying blood-pressure monitors and measuring their blood pressure at home.
To test their theories, the research team analyzed claims data from more than 32,000 members of a private employee health plan and a Medicare Advantage health plan. The analysis revealed that high blood pressure affected 6 percent of the employee plan’s members ages 20 to 44 and 34 percent of those 45 to 64. In the Medicare plan, in which all members were 65 or older, 60 percent had high blood pressure. Depending on the insurance plan and age group, net savings associated with home blood pressure monitoring ranged from $33 to $166 per member in the first year, and from $415 to $1,364 over 10 years. The results also indicated that home blood pressure monitoring is generally most cost-beneficial when it is used to diagnose high blood pressure in younger individuals and to monitor high blood pressure treatment in older individuals.
The researchers concluded that reimbursement of home blood pressure monitoring by insurance companies would be expected to generate overall net savings and a positive return on investment for the company in the first year, and that these savings and ROIs would tend to grow over time.