INTRODUCTION: This study uses microsimulation to estimate 10-year health and economic outcomes that may be achieved by widely adopting the American Medical Association's Measure Accurately, Act Rapidly, and Partner with Patients hypertension (AMA MAP(TM) HTN) quality improvement program.
METHODS: A microsimulation model was adapted to conduct "what if" analyses for adopting the MAP HTN program nationwide and in care delivery systems of varying size. The analysis was conducted in 2020-2024, and the microsimulation model was constructed using various data sources from 1948 to 2019. Modeled outcomes over 10 years included prevalence of systolic blood pressure (SBP) ≥ 140 mmHg; incidence of cardiovascular disease (CVD) events and CVD-related mortality; averted medical costs by payer in 2021 U.S. dollars; and net costs.
RESULTS: For patients with hypertension over 10 years, nationwide adoption of the MAP HTN program was predicted to improve mean BP control by 4.3% and prevent 601 thousand CVD events and 120 thousand CVD deaths. Most of the estimated $17.9 billion in averted disease costs were observed in patients with Medicare. Total costs associated with implementing the MAP HTN program totaled $12.6 billion, resulting in a predicted $5.3 billion in net savings to the health care sector over 10 years. Small and large care delivery organizations could economically benefit from implementing the MAP HTN program at varying levels (5-50%) of shared cost savings from payers.
CONCLUSIONS: There is promise for quality improvement programs targeting BP management, but more research is needed to affirm the assumptions and findings of this analysis.