Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.

Previous research indicates that patient self-measured blood pressure (SMBP) is a cost-effective strategy for improving hypertension (HTN) diagnosis and control. However, it is unknown which specific uses of SMBP produce the most value. Our goal is to estimate, from an insurance perspective, the ret...

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Autores principales:	Alejandro Arrieta, John Woods, Gregory Wozniak, Stavros Tsipas, Michael Rakotz, Stephen Jay
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ee16238b741c48f3b2587bc0d76728f0
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spelling	oai:doaj.org-article:ee16238b741c48f3b2587bc0d76728f02021-12-02T20:10:24ZReturn on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.1932-620310.1371/journal.pone.0252701https://doaj.org/article/ee16238b741c48f3b2587bc0d76728f02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252701https://doaj.org/toc/1932-6203Previous research indicates that patient self-measured blood pressure (SMBP) is a cost-effective strategy for improving hypertension (HTN) diagnosis and control. However, it is unknown which specific uses of SMBP produce the most value. Our goal is to estimate, from an insurance perspective, the return-on-investment (ROI) and net present value associated with coverage of SMBP devices when used (a) only to diagnose HTN, (b) only to select and titrate medication, (c) only to monitor HTN treatment, or (d) as a bundle with all three uses combined. We employed national sample of claims data, Framingham risk predictions, and published sensitivity-specificity values of SMBP and clinic blood-pressure measurement to extend a previously-developed local decision-analytic simulation model. We then used the extended model to determine which uses of SMBP produce the most economic value when scaled to the U.S. adult population. We found that coverage of SMBP devices yielded positive ROIs for insurers in the short-run and at lifetime horizon when the three uses of SMBP were considered together. When each use was evaluated separately, positive returns were seen when SMBP was used for diagnosis or for medication selection and titration. However, returns were negative when SMBP was used exclusively to monitor HTN treatment. When scaled to the U.S. population, adoption of SMBP would prevent nearly 16.5 million false positive HTN diagnoses, thereby improving quality of care while saving insurance plans $254 per member. A strong economic case exists for insurers to cover the cost of SMBP devices, but it matters how devices are used.Alejandro ArrietaJohn WoodsGregory WozniakStavros TsipasMichael RakotzStephen JayPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252701 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alejandro Arrieta John Woods Gregory Wozniak Stavros Tsipas Michael Rakotz Stephen Jay Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.
description	Previous research indicates that patient self-measured blood pressure (SMBP) is a cost-effective strategy for improving hypertension (HTN) diagnosis and control. However, it is unknown which specific uses of SMBP produce the most value. Our goal is to estimate, from an insurance perspective, the return-on-investment (ROI) and net present value associated with coverage of SMBP devices when used (a) only to diagnose HTN, (b) only to select and titrate medication, (c) only to monitor HTN treatment, or (d) as a bundle with all three uses combined. We employed national sample of claims data, Framingham risk predictions, and published sensitivity-specificity values of SMBP and clinic blood-pressure measurement to extend a previously-developed local decision-analytic simulation model. We then used the extended model to determine which uses of SMBP produce the most economic value when scaled to the U.S. adult population. We found that coverage of SMBP devices yielded positive ROIs for insurers in the short-run and at lifetime horizon when the three uses of SMBP were considered together. When each use was evaluated separately, positive returns were seen when SMBP was used for diagnosis or for medication selection and titration. However, returns were negative when SMBP was used exclusively to monitor HTN treatment. When scaled to the U.S. population, adoption of SMBP would prevent nearly 16.5 million false positive HTN diagnoses, thereby improving quality of care while saving insurance plans $254 per member. A strong economic case exists for insurers to cover the cost of SMBP devices, but it matters how devices are used.
format	article
author	Alejandro Arrieta John Woods Gregory Wozniak Stavros Tsipas Michael Rakotz Stephen Jay
author_facet	Alejandro Arrieta John Woods Gregory Wozniak Stavros Tsipas Michael Rakotz Stephen Jay
author_sort	Alejandro Arrieta
title	Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.
title_short	Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.
title_full	Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.
title_fullStr	Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.
title_full_unstemmed	Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.
title_sort	return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ee16238b741c48f3b2587bc0d76728f0
work_keys_str_mv	AT alejandroarrieta returnoninvestmentofselfmeasuredbloodpressureisassociatedwithitsuseinpreventingfalsediagnosesnotmonitoringhypertension AT johnwoods returnoninvestmentofselfmeasuredbloodpressureisassociatedwithitsuseinpreventingfalsediagnosesnotmonitoringhypertension AT gregorywozniak returnoninvestmentofselfmeasuredbloodpressureisassociatedwithitsuseinpreventingfalsediagnosesnotmonitoringhypertension AT stavrostsipas returnoninvestmentofselfmeasuredbloodpressureisassociatedwithitsuseinpreventingfalsediagnosesnotmonitoringhypertension AT michaelrakotz returnoninvestmentofselfmeasuredbloodpressureisassociatedwithitsuseinpreventingfalsediagnosesnotmonitoringhypertension AT stephenjay returnoninvestmentofselfmeasuredbloodpressureisassociatedwithitsuseinpreventingfalsediagnosesnotmonitoringhypertension
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Return on investment of self-measured blood pressure is associated with its use in preventing false diagnoses, not monitoring hypertension.

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