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Today s Agenda 1. Understand goals of the Measure Up/Pressure Down national campaign 2. Learn key care processes for improving blood pressure control 3. Identify Measure Up/Pressure Down resources that could assist your efforts

Meet the Campaign Team Jerry Penso, MD, MBA Chief Medical and Quality Officer jpenso@amga.org (703) 838-0033 x356 Kendra Gaskins Campaign Director kgaskins@amga.org (703) 838-0033 x346 Sherry Greenwood Fundraising Manager sgreenwood@amga.org (703) 838-0033 x352 John Cuddeback Chief Medical Information Officer jcuddeback@amga.org (703) 838-0033 x359 Shannon Walsh Communications & Partnership Coordinator swalsh@amga.org (703) 838-0033 x377 Joyce Jones Quality Program Coordinator jjones@amga.org (703) 838-0033 x340

What if AMGA member medical groups and health systems including the likes of Kaiser, Cleveland Clinic, Intermountain, and Mayo agreed to work together to address one of the nation s most important public health challenges?

National Reach AMGA s 430 medical groups Treat one in three Americans Represent 125,000 physicians Deliver care to 130 million patients in 49 states

Why High Blood Pressure? 1 in 3 U.S. adults (68 million) have high blood pressure, meaning that millions of Americans are at increased risk for heart disease and stroke Nationally, only half of all patients have their condition in control. High blood pressure contributes to nearly 1,000 deaths a day By 2030, an estimated 100 million adults in the U.S. will have high blood pressure, resulting in increases in health care costs, disability, and lost productivity.

National Steering Committee Lawrence Casalino, MD, PhD Chief, Division of Outcomes and Effectiveness Research Weill Cornell Physician Organization Janet Corrigan, PhD, MBA President and Chief Executive Officer National Quality Forum Francis J Crosson, MD Vice President, Physician Satisfaction: Care Delivery American Medical Association Guy Mansueto VP of Marketing Phytel, Inc. Robert Matthews Executive Director PriMed Physicians Kevin McDermott, MBA Vice President, Managed Markets Aptalis Pharma Michael L Millenson President Health Quality Advisors Michael Rakotz, MD Northshore University Health System Medical Group Carleton T Rider AMGF Director and Former Chair Brooks College of Health University of North Florida Marie Schall Director Institute for Healthcare Improvement Paul Speigelman Founder & CEO BerylHealth Karol E. Watson, MD Associate Professor of Medicine and Co-Director, UCLA Center for Cholesterol and Lipid Management Lucius F Wright, MD The Jackson Clinic, P.A. Kathleen Yaremchuk, MD VP Clinical Practice Performance Henry Ford Medical Group

Scientific Advisory Council Lawrence Casalino, MD, PhD Chief, Division of Outcomes and Effectiveness Research Weill Cornell Physician Organization John Cuddeback, MD, PhD Chief Medical Information Officer Anceta Lawrence J. Fine MD, DrPH Chief, Clinical Applications and Prevention Branch Division of Cardiovascular Sciences National Heart, Lung, and Blood Institute Hector Rodriguez, PhD, MPH Associate Professor Health Services UCLA School of Public Health Sandra Taler, MD Consultant, Division of Nephrology /Hypertension Associate Professor of Medicine Mayo Medical School Mayo Clinic Kimberly Westrich, MS Director, Health Services Research National Pharmaceutical Council Harold S Luft, PhD Director Palo Alto Medical Foundation Research Institute UC San Francisco School of Medicine

Campaign Goals Primary Mobilize medical groups to achieve measurable improvements in high blood pressure prevention, detection, and control 80% of patients at goal by 2016 50% of AMGA membership adopt at least one campaign plank Secondary Engage and empower patients to actively manage their health Raise awareness of the dangers of uncontrolled high blood pressure Encourage consumers to obtain BP screenings, partner w/health care provider, make lifestyle changes, etc.

Campaign Planks

Plank #1 Direct Care Staff Trained in Accurate BP Measurement

Plank #2 Hypertension Guideline Used and Adherence Monitored

Plank #3 Blood Pressure Addressed for Every Hypertension Patient Every PC Visit

Plank #4 All Patients Not at Goal or New Rx Seen Within 30 days

Plank #5 Patient Engagement or Self-Management Program in Place

Plank #6 Registry to Identify and Track Hypertension Patients

Plank #7 All Team Members Trained in Importance of BP Goals

Plank #8 All Specialists Intervene with Patients Not in Control

Have you created a team for hypertension? 60% 54% 50% 46% 40% 30% 20% 10% 0% Yes No 19

Have you adopted any of the campaign planks? 70% 63% 60% 50% 40% 37% 30% 20% 10% 0% Yes No 20

Which planks have you adopted? Direct Care Staff Trained in Accurate BP Measurement BP Addressed for Every Hypertension Patient at Every Primary Care or Cardiology Visit Hypertension Registry Used to Track Patients Hypertension Guideline Used and Adherence Monitored All Team Members Trained in Importance of BP Goals and Metrics Prevention, Engagement and Self-Management Program in Place All Specialties Intervene with Patients Not in Control All Patients Not at Goal or with New Hypertension Rx Seen within 30 Days 0% 10% 20% 30% 40% 50% 60% 70% 80% 21

Has your organization formally adopted hypertension goals? 60% 57% 50% 43% 40% 30% 20% 10% 0% Yes No 22

Do you have a group-level hypertension measurement? 70% 60% 61% 50% 40% 39% 30% 20% 10% 0% Yes No 23

Do you report hypertension results to any external organization? 60% 54% 50% 46% 40% 30% 20% 10% 0% Yes No 24

Campaign Strategy Medical Groups Patients & Consumers Medical groups are being challenged to adopt one or more evidence-based care processes that lead to measurable improvements in blood pressure control. Patients and consumers are receiving information and tools to help control blood pressure provided via website, physician s offices, community-based screenings and educational events, and retail partners such as chain drugstores or supermarkets. Strategic Partnerships Collaborative partnerships continue to be formed with government, nonprofit and private sector organizations designed to broaden the reach of and strengthen engagement efforts with health care providers and patients. Employers Opportunities to engage employees in workplace wellness activities (e.g., onsite blood pressure screenings, competition between employers) and sign-on to employer planks. Media A national media campaign consisting of media events, ongoing media outreach, and publication of research findings.

Official Launch

November 29, 2012 National Press Club Washington DC

Campaign Resources www.measureuppressuredown.com

Campaign Resources Developed a Provider Toolkit that provides tools, tips, and resources Organized around each of the eight campaign planks

Campaign webinars Date Topic Plank Speaker Jan 17, 2013 Getting started with QI Institute of Healthcare Improvement Feb 21, 2013 Direct Care Staff trained in accurate BP measurement 1 Cleveland Clinic Mar 21, 2013 Hypertension Guideline used and adherence monitored 2 Kaiser Permanente Mid-Atlantic Apr 18, 2013 May 16, 2013 Jun 20, 2013 BP addressed for every hypertension patient, every primary care visit All patients not at goal and with new Rx seen within 30 days Prevention, engagement, and self -management program in place 3 PriMed Physicians 4 Sharp Rees-Stealy Medical Group 5 Mercy Clinics Iowa Jul 18, 2013 Registry used to identify and track hypertension patients 6 Anceta Aug 15, 2013 All specialties intervene with patients not in control 8 Park Nicollet Health Services Sep 19, 2013 All team members trained in importance of BP goals 7 Billings Clinic Oct 17, 2013 Physician Engagement Columbia St Mary s Physicians Nov 21, 2013 Equity Association of Black Cardiologists Dec 19, 2013 Pharmacist role Marshfield 32

Social Media www.twitter.com/mupdcampaign www.facebook.com/measureuppressuredown www.flickr.com/photos/measureuppressuredown

Campaign Media Coverage Generated significant media exposure, including: Interviews with print publications such as, American Medical News, Managed Healthcare Executive Magazine, Modern Medicine, Congressional Quarterly Local radio broadcast stations and local media outlets (e.g., Missoulian, Sun Journal, and Billings Gazette). Several online healthcare publications (e.g., MedPage Today, Medical News Today, and The Daily Journal) Recently, AMGA s Chief Medical and Quality Officer Jerry Penso, authored Creating a National Campaign to Improve Hypertension Control for Premier s Economic Outlook publication.

Delivering care to more than 42 million patients Participating Medical Groups Adirondack Internal Medicine & Pediatrics, P.C. Advocate Medical Group Advocate Physician Partners Alegent Creighton Clinic Allina Medical Clinic Arch Health Partners Aurora Health Care Austin Diagnostic Clinic, P.A. Austin Regional Clinic, P.A. Baptist Health Medical Group Baptist Memorial Medical Group Baton Rouge Clinic Baylor Health Care System/HealthTexas Provider Network Bend Memorial Clinic, P.C. Benefis Medical Group Billings Clinic Brown & Toland Physicians Carilion Clinic Carolinas Healthcare System Catholic Health Initiatives Central Utah Clinic Centura Health Physician Group Christie Clinic, LLC Clackamas County Health Centers Cleveland Clinic Coastal Carolina Health Care, PA Colorado Springs Health Partners, P.C. Community Clinic, Inc Community Physicians of Indiana Cornerstone Health Care, P.A. Crystal Run Healthcare Dartmouth-Hitchcock Clinic Deaconess Clinic Dean Health System, Inc. Essentia Health Fairview Health Services Florida Medical Clinic, P.A. Geisinger Health System Group Health Cooperative of South Central Wisconsin Hartford Healthcare Medical Group Hattiesburg Clinic, P.A. Hawaii Pacific Health Health First Physicians HealthCare Partners Medical Group HealthEast Care System HealthPartners HealthPartners HealthPoint Medical Group Henry Ford Medical Group Heritage Valley Medical Group, Inc. Holston Medical Group Hospital Sisters Health System Medical Group INOVA Health System INTEGRIS Medical Group Intermountain Medical Group Johns Hopkins Community Physicians, Inc. Kelsey-Seybold Clinic Kish Health Physician Group Lahey Clinic Lakeshore Clinic, PLLC Lakeshore Health Partners LeBauer HealthCare / Moses Cone Health System Maitland Family Practice Mankato Clinic, Ltd. Mayo Clinic - Rochester Medical Associates Medical Associates Clinic MedStar Physician Partners Mercy Clinic-East Communities Mercy Clinics Mercy Medical Clinic - NWA Meritage Medical Network Mid Hudson Medical Group Mid-Atlantic Permanente Medical Group, PC Mount Kisco Medical Group Mountain View Medical Group, P.C. NEA Baptist Clinic New West Physicians, P.C. North Mississippi Medical Clinics, Inc. North Texas Specialty Physicians NorthShore University HealthSystem Northwest Primary Care Group, P.C. Novant Medical Group Ochsner Health System Oregon Medical Group, P.C. OU Physicians Pacific Medical Centers Palo Alto Medical Foundation Parkview Physicians' Group PeaceHealth Medical Group Piedmont Healthcare Piedmont HealthCare, P.A. Portland IPA Premier Medical Associates, P.C. Prevea Health Services PriMed Physicians ProHealth Physicians, Inc. Puget Sound Family Physicians Quincy Medical Group Reliant Medical Group, Inc. Rio Grande Medicine Riverside Medical Clinic Riverside Medical Group Rockford Health Physicians Sacramento Family Medical Centers Scripps Coastal Medical Group Scripps Medical Foundation Sentara Medical Group Shannon Health System Sharp Rees-Stealy Medical Group, Inc. Shaw Center for Women's Health, PA Springfield Clinic St. Anthony's Physician Services St. Luke's Physician Group State of Franklin Healthcare Associates, PLLC Stern Cardiovascular Foundation Summa Physicians Inc. Summit Medical Group, P.A. Susquehanna Health Medical Group Sutter Independent Physicians Sutter Medical Foundation SwedishAmerican Health System The Everett Clinic The Iowa Clinic, P.C. The Jackson Clinic, P.A. The Permanente Medical Group, Inc. The Polyclinic ThedaCare Physicians TriHealth Physician Enterprise Corporation UnityPoint Clinic University of North Texas Health Science Center University of Utah Community Clinics Upper Valley Medical Center Washington Township Medical Foundation Watson Clinic, LLP Weill Cornell Physician Organization Wellmont Medical Associates WellStar Health System Wenatchee Valley Medical Center Western Montana Clinic WESTMED Medical Group, P.C. Wheaton Franciscan Medical Group Wilmington Health

Moving the Needle The campaign will conduct a two-phase evaluation process involving quantitative data management consisting of quarterly reporting and data analysis and an expanded qualitative component. 36

Blood Pressure Recording D D

Early Results

Campaign Sponsors Presenting Sponsors

Campaign Sponsors Pilot Program Sponsor Contributing Sponsors Benefactor Endorsing Sponsors

Campaign Partners

Today s Agenda 1. Understand goals of the Measure Up/Pressure Down national campaign 2. Learn key care processes for improving blood pressure control 3. Identify Measure Up/Pressure Down resources that could assist your efforts