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Modeling Health and Budgetary Impacts of Team-Based Care for High Blood Pressure

What is the burden of high blood pressure?

Nearly one in three U.S. adults have high blood pressure, or hypertension, and only about half of them have it controlled. Those with high blood pressure are 3 times more likely to die from heart disease and 4 times more likely to die from stroke. High blood pressure contributes to over 400,000 deaths with an estimated cost of over $48 billion each year.

What is team-based care?

Team-based care is an approach to control blood pressure where care is provided by a team of health professionals - including primary care providers, pharmacists, nurses, dietitians, or other health workers - rather than by a single doctor. Team members work together to help patients manage their medication, increase healthy behaviors, and follow their blood pressure control plan. The US Community Preventive Services Task Force recommends team-based care for uncontrolled high blood pressure based on evidence from 80 studies showing that these approaches can increase the number of patients with controlled blood pressure.

What could be the long term impact of providing team-based care?1

CDC partnered with the HealthPartners Institute, who adapted their ModelHealth™: Cardiovascular disease microsimulation model to project the long-term health and cost impacts of providing team-based care for patients with uncontrolled high blood pressure.

According to the model, providing team-based care would improve control of high blood pressure and reduce heart attacks, strokes, and congestive heart failure. If the cost of providing team-based care is an estimated $525 per enrollee per year, the model projects that using team-based care nationally would save costs for Medicare over ten years. Team-based care also may save money over ten years for private insurers and Medicaid if the intervention were less expensive. For more information on this model and analysis of the national level impacts, see the journal article in the footnotes.2

See for yourself...

Explore the projected health and budgetary impacts of universal adoption of team-based care to control high blood pressure...3

• After: 

• With a demographic makeup4 like the: 

• For population size: 

Age    <18  18-44  45-64  65+

Race/Ethnicity    Non-Hispanic White  Non-Hispanic Black  Hispanic  Other

Obesity    Not Overweight  Overweight  Obese

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Health impacts

Total CVD-related deaths prevented

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Total CVD-related events prevented

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Budgetary impacts

Explore how budgetary impacts for payers change as you vary intervention costs.

• Intervention cost is per enrollee per year.

Budgetary impact for all payers5

Intervention costs minus disease costs averted for all payers.

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Budgetary impacts by primary insurer6

Intervention costs minus disease costs averted by payer.

MEDICAID
  {{tbcData.medicaidSymbol}}{{tbcData.medicaid | number:2}}{{tbcData.totalChangeScale}}
MEDICARE
  {{tbcData.medicareSymbol}}{{tbcData.medicare | number:2}}{{tbcData.totalChangeScale}}
PRIVATE
  {{tbcData.privateSymbol}}{{tbcData.private | number:2}}{{tbcData.totalChangeScale}}

Summary of results

For population size of {{tbcData.population}} with a demographic makeup like that of the {{tbcData.region}}, universal adoption of team-based care would over {{tbcData.year}} years prevent {{tbcData.cvdDeathText | number}} deaths and {{tbcData.eventPreventedText | number}} cardiovascular disease-related events , reducing related disease costs for all payers by ${{tbcData.disease2 | number:2}} {{tbcData.scale}}.

For the total population of the {{tbcData.region2}} region of the US, universal adoption of team-based care would over {{tbcData.year}} years prevent {{tbcData.cvdDeathText | number}} deaths and {{tbcData.eventPreventedText | number}} cardiovascular disease-related events, reducing related disease costs for all payers by ${{tbcData.disease2 | number:2}} {{tbcData.scale}}.

If the cost of the intervention is {{tbcData.cost}} per enrollee per year, the total intervention cost for the population over {{tbcData.year}} years would be ${{tbcData.intervention | number:2}} {{tbcData.scale}} resulting in net {{tbcData.totalChangeNet}} of ${{tbcData.totalChange | number:2}} {{tbcData.scale}} from an all-payer perspective.

The payer-specific budgetary impacts would, however, vary with ${{tbcData.medicaid | number:2}} {{tbcData.scale}} in net {{tbcData.medicaidNet}} for Medicaid, ${{tbcData.medicare | number:2}} {{tbcData.scale}} in net {{tbcData.medicareNet}} for Medicare, and ${{tbcData.private | number:2}} {{tbcData.scale}} in net {{tbcData.privateNet}} for private insurers.5

  1. The numbers generated with this model should not be considered predictions of what will actually occur following implementation of a particular intervention. Rather, they should be treated as estimates of what could happen.
  2. Modeled health and economic impact of team-based care for hypertension. https://www.ncbi.nlm.nih.gov/pubmed?term=10.1016%2Fj.amepre.2016.01.027
  3. Results presented are for individuals aged 35-80, and may not align with the manuscript, which includes all individuals aged 35 and older.
  4. Demographics based on American Community Survey three-year sample (2011).
  5. All payers includes primary insurers (Medicaid, Medicare, and private), as well as other payers, such as those bearing the costs for the uninsured.
  6. Sum of budgetary impacts for primary insurers may not equal that for all payers.
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