The Wisconsin Medical Society (WisMed) is pleased to share that Wisconsin Medicaid has expanded its coverage benefits to include home blood pressure devices and reimbursement for Self-Measured Blood Pressure (SMBP) clinical services.
SMBP has emerged as a crucial tool for both physicians and patients to manage and improve control of hypertension. Patients are able to measure and monitor their blood pressure frequently and accurately, allowing for more data points to be collected and reviewed by their care team for clinical decision making. This proactive approach allows patients to have agency in managing their own health and learning about their blood pressure (BP) numbers, and leads to better management of hypertension, reducing the risk of cardiovascular events and ultimately improves patient outcomes.
The new home BP device coverage benefit also extends to hypertensive disorders in pregnancy, childbirth, or the puerperium period, such as pre-eclampsia, to help improve maternal health outcomes, as hypertensive disorders are the leading cause of maternal mortality.
The decision to cover SMBP aligns with established clinical guidelines that are recommended by leading medical organizations such as the American Medical Association (AMA) and the American Heart Association (AHA). These guidelines emphasize the importance of SMBP in both diagnosing and managing hypertension, highlighting its efficacy in improving health care delivery and patient well-being.
SMBP can also be a cost saving intervention, when offered with initial patient training and ongoing clinical support. Studies have shown that SMBP leads to reduced health care utilization, fewer hospitalizations, and lower overall health care costs.
WisMed wants to raise awareness about the expanded Medicaid benefit and ensure physicians and care teams have the necessary resources to help their patients take advantage of this new coverage. Ensuring that patients have access to evidence-based preventive care coverage is one of the most impactful health care interventions and has the potential to save millions of lives.
For additional details on Wisconsin Medicaid policy and guidance on integrating SMBP into clinical care, visit the AMA's resources:
Self-measured blood pressure benefits for patients with Medicaid: Wisconsin
ForwardHealth Changes to Blood Pressure Monitoring Equipment Requirement no. 2025-21 (PDF)
ForwardHealth Medical Records Policy Relating to DME Dispensing
Pharmacy Society of Wisconsin SMBP Education & Billing Guide (PDF)
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