AHA to insurers: Home BP monitoring saves you money

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 - High blood pressure, hypertension

Medicare and private insurers take note: Home blood pressure (BP) monitoring for hypertension is cost effective. So cover it, the American Heart Association (AHA) advocates.

This recommendation followed research published July 14 in Hypertension comparing the potential costs and benefits of covering home blood pressure monitoring equipment through Medicare or private insurance. Support for coverage was echoed by the AHA.

“Home blood pressure monitors should be reimbursed, widely adopted across America and integrated into current clinical practice for diagnosis and treatment of hypertension,” said Alejandro Arrieta, PhD, of the Department of Health Policy and Management at Florida International University in Miami, in a press release. “Our study provides evidence that reimbursement makes business sense for an insurance company.”

Arrietta et al reviewed data from a private insurer and Medicare between 2008 and 2011, reviewing cases for prevalence of hypertension. The data then underwent a decision analytic model to determine cost-benefit and return on investment over time for three cohorts derived from the data: private insurance plan members aged between 20 and 44, private insurance plan members between 45 and 65, and Medicare members.

The cost benefits, according to Arrieta et al, increase over time. The longer the insured is covered, the more cost effective it becomes. However, there are factors to consider.

While the return on investment ranged from $0.85 to $3.77 per dollar in the first year and $7.50 to $19.34 per dollar invested at 10 years, many private insurance companies do not cover patients for that long a span. Also, whether the patient is being diagnosed or treated is also a major consideration. Home BP monitoring is most cost effective in diagnosing hypertension in the age 20-to-44 set. Meanwhile, if the technology is being used for treatment only, older plan members and Medicare patients were the ones for whom home BP monitoring was most cost effective.

Arrieta et al noted that in younger patients, proper diagnosis assisted in confirming hypertension, weeding out plan members who ultimately would not need lifelong treatment. Treating existing hypertension in older plan members and those on Medicare, savings accrued through ensuring BP control and avoiding future adverse events. Older plan members and Medicare patients have higher likelihood of longevity with their existing plan, higher cardiovascular disease risks and higher likelihood of having an event in the near future, translating to cost savings through ensuring continued health with home BP monitoring. 

Stratifying for risk against cost benefit, insurers can and should cover home BP monitoring devices for plan members, according to Arrietta et al.

Both the research team and the AHA recommended use of home BP monitoring be covered by insurance providers as a cost-effective alternative to repeated clinical testing and monitoring which may provide false hypertension-diagnosis positives.