{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:48:32Z","timestamp":1782391712537,"version":"3.54.5"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Population Health Management"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:p>\n                    Blood pressure (BP) control is a core quality metric in value-based care (VBC). The Healthcare Effectiveness Data and Information Set (HEDIS) Controlling High Blood Pressure (CBP) measure uses the final BP reading of the calendar year, a method that overlooks well-documented seasonal variation\u2014BP declines in summer and rises in winter. We evaluated the impact of this pattern on measured performance in a large health system. We conducted a retrospective analysis of monthly BP control rates (July 2019 to December 2025) across the Jefferson Health-Lehigh ambulatory network, totaling 78 months and approximately 7.6 million patient-months. Summer (June to August) and winter (December to February) rates were compared using paired\n                    <jats:italic toggle=\"yes\">t<\/jats:italic>\n                    -tests and ordinary least square regression with seasonal adjustment. Year-end performance was assessed using both the HEDIS final-reading (December rate) and a rolling Q4 average (October to December mean). Standard VBC quality improvement initiatives with Q4 intensification were in place. BP control rates were significantly higher in summer (75.2%; 95% confidence interval [CI]: 73.5%\u201377.0%) than winter (73.1%; 95% CI: 71.2%\u201375.1%), a 2.1-percentage-point difference (paired\n                    <jats:italic toggle=\"yes\">t<\/jats:italic>\n                    = 5.13,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.002). This pattern was consistent across all 7 years. Within-year peak-to-trough amplitude averaged 2.8 percentage points in nonpandemic years. The rolling Q4 average exceeded the December-only rate in all years, with differences of 0.06\u20130.59 percentage points, reclassifying 60\u2013520 additional patients as controlled annually. Seasonal BP variation is robust and inadequately addressed by current quality measures. Multi-reading or seasonally adjusted methods would improve measurement accuracy and fairness. Engagement with NCQA and CMS to pilot redesigned measures is recommended.\n                  <\/jats:p>","DOI":"10.1177\/19427891261445716","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T16:23:06Z","timestamp":1777134186000},"page":"256-262","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rethinking Blood Pressure Quality Measurement: Accounting for Seasonal Variation in Value-Based Care"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2723-0389","authenticated-orcid":false,"given":"Jennifer","family":"Stephens","sequence":"first","affiliation":[{"name":"Department of Medicine, Jefferson Health, Allentown, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Carter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Jefferson Health, Allentown, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Careyva","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Jefferson Health, Allentown, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Gertner","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jefferson Health, Allentown, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathryn","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of LVPG Clinical Services, Jefferson Health, Allentown, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001123"},{"key":"e_1_3_2_3_2","unstructured":"National Committee for Quality Assurance. Blood Pressure Control for Patients with Hypertension (BPC-E). NCQA. Available from: https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/blood-pressure-control-for-patients-with-hypertension-bpc-e\/ [Accessed: December 12 2025]."},{"key":"e_1_3_2_4_2","unstructured":"National Committee for Quality Assurance. Controlling High Blood Pressure (CBP). NCQA. Available from: https:\/\/www.ncqa.org\/report-cards\/health-plans\/state-of-health-care-quality-report\/controlling-high-blood-pressure-cbp\/ [Accessed: December 12 2025]."},{"key":"e_1_3_2_5_2","unstructured":"Blue Cross Blue Shield of Michigan. Star Measure Tip Sheet: Controlling High Blood Pressure. 2025. Available from: https:\/\/www.bcbsm.com\/amslibs\/content\/dam\/public\/providers\/documents\/star-measure-tip-sheet-controlling-high-blood-pressure.pdf"},{"key":"e_1_3_2_6_2","unstructured":"Anthem. Controlling High Blood Pressure (CBP) 2025. Available from: https:\/\/files.providernews.anthem.com\/6143\/MULTI-BCBS-CR-075508-24-CPN74974-Controlling-High-Blood-Pressure-CBP-2025_FINAL.pdf"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000002355"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-021-00732-z"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2008.512"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.00315"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2014.4"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0113500"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308062"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpaa056"},{"key":"e_1_3_2_15_2","unstructured":"BCBS. Controlling High Blood Pressure (CBP). Tip Sheet. 2025. Available from: https:\/\/www.bcbsm.com\/amslibs\/content\/dam\/public\/providers\/documents\/star-measure-tip-sheet-controlling-high-blood-pressure.pdf"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003396"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/MBP.0b013e3280b083f4"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017351"},{"key":"e_1_3_2_19_2","unstructured":"NCQA. Proposed New Measure BPC-E (Blood Pressure Control for Patients with Hypertension). Measurement Year. 2025. Available from: https:\/\/wpcdn.ncqa.org\/www-prod\/wp-content\/uploads\/02.-BPC-E.pdf"}],"container-title":["Population Health Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19427891261445716","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19427891261445716","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19427891261445716","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:48:16Z","timestamp":1782388096000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19427891261445716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,25]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8,1]]}},"alternative-id":["10.1177\/19427891261445716"],"URL":"https:\/\/doi.org\/10.1177\/19427891261445716","relation":{},"ISSN":["1942-7891","1942-7905"],"issn-type":[{"value":"1942-7891","type":"print"},{"value":"1942-7905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,25]]}}}