Hypertension Control Challenge Rules & Eligibility
The 2017 Million Hearts® Hypertension Control Challenge nomination submission is open from Friday April 7, 2017, through Friday June 2, 2017.
About the Challenge
Authority for the Private Sector (15 U.S.C. § 3719) COMPETES Act
Data Validation Process
Selecting the Champions
CDC Judges Panel
About the Challenge Top>
The Million Hearts® Hypertension Control Challenge is a competition to identify clinicians, practices, and health systems that have demonstrated exceptional achievements in working with their patients to control hypertension. The Challenge is open to public and private clinicians, medical practices, and health systems. Strategies used by Champions that support hypertension control may be written into a success story and posted on this website.
To date, CDC has recognized 59 Hypertension Control Champions.
Authority for the Private Sector (15 U.S.C. § 3719) COMPETES Act Top>
- Agency: Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services (HHS)
- Award Approving Official: Director, Centers for Disease Control and Prevention
- Who is eligible? The 2017 Million Hearts® Hypertension Control Challenge is intended to recognize public and private clinicians, practices, and systems that are successful in working with their patients to achieve exemplary hypertension control rates, improve understanding of successful implementation strategies at the health system level, and motivate national improvement in hypertension control.
- What is the deadline? The deadline to submit a nomination is June 2, 2017, at 11:59 PM EST. The 2017 Champions will be posted on this website in late 2017.
- What is Million Hearts®? Million Hearts® is a national initiative to prevent 1 million heart attacks and strokes by 2022. Achieving this goal means that 10 million more Americans will have their high blood pressure under control. Million Hearts® is working to control high blood pressure through clinical approaches, such as using health information technology to its fullest potential and integrating team-based approaches to health care, and community approaches, such as strengthening tobacco control and lowering sodium consumption.
Questions about the Challenge should be directed to firstname.lastname@example.org with the word "Challenge" in the subject line.
The Million Hearts® Hypertension Control Challenge is open to public and private individual clinicians, practices, and health systems providing health care services to patients in a U.S. state or territory. To be eligible to win the Challenge, the nominee must
- Be a U.S. licensed clinician, practicing in any U.S. setting, who provides continuing care for adult patients with hypertension. In the case of an individual, whether participating singly or in a group, the individual must be a citizen or permanent resident of the United States.
- Or be a U.S. incorporated clinical practice, defined as any practice with two or more U.S. licensed clinicians who by formal arrangement share responsibility for a common panel of patients, practice at the same physical location or street address, and provide continuing medical care for adult patients with hypertension.
- In the case of a private entity, the private entity shall be incorporated in and maintain a primary place of business in the U.S.
- Or be a health system that provides continuing medical care for adult patients with hypertension. In the case of a private entity, the private entity shall be incorporated in and maintain a primary place of business in the U.S.
- A health system provides a wide range of medical services and coordination of care for patients and their dependents.
- We encourage large health systems (those that comprise of a large number of geographically dispersed clinics or have multiple hospital locations, or both) to consider having one or a few of the highest performing clinics or regional affiliates apply individually instead of the health system applying as a whole.
- For purposes of this Challenge, an Accountable Care Organization (ACO) may apply as an ACO or one or more of its practices can apply independently.
In addition, the clinician, practice, or health system:
- Must treat all adult patients with hypertension in the practice seeking care, not a select subgroup of patients.
- Must treat a minimum of 500 adult patients annually.
- Must have completed the nomination in its entirety.
- Must have a hypertension control rate of at least 70% during the 12 month reporting period among the practice’s hypertensive patient population. Must have a data management system (electronic or paper) that allows for verification of data submitted.
- Must agree to:
- Participate in a data validation process to be conducted by a reputable independent contractor. To the extent applicable law allows, data will be kept confidential by the contractor and will be shared with the CDC in aggregate form only (i.e., the hypertension control rate for the practice not individual hypertension values).
- Agree to be recognized if selected, agree to accept the award if selected, and participate in award activities as described more fully below.
- Provide information through a 60 minute, or other similar, interview about their clinical strategies and protocol implementation for the development of a success story document.
- Complete, without revisions, the CDC contractor’s required HIPAA compliance Business Associate Agreement form.
- Individual nominees and individuals in a group practice must be free from convictions or pending investigations of criminal and health care fraud offenses such as felony health care fraud, patient abuse or neglect; felony convictions for other health care-related fraud, theft, or other financial misconduct; and felony convictions relating to unlawful manufacture, distribution, prescription, or dispensing of controlled substances as verified through the Office of the Inspector General List of Excluded Individuals and Entities. Individual nominees must be free from serious sanctions, such as those for misuse or mis-prescribing of prescription medications. Such serious sanctions will be determined at the discretion of the agency consistent with CDC’s public health mission. CDC’s contractor may perform background checks on individual clinicians or medical practices.
- Health systems must have a policy in place about conducting periodic background checks on all providers and taking appropriate action based on the results of the check. CDC’s contractor may also request the policy and any supporting information deemed necessary. Eligibility status, based upon the above-reference written policy, appropriate action, and background check, will be determined at the discretion of the CDC consistent with CDC’s public health mission. The background check should ensure that staff are free from convictions of pending investigations of criminal and health care fraud offenses such as felony health care fraud, patient abuse or neglect; felony convictions for other health care-related fraud, theft, or other financial misconduct; and felony convictions relating to unlawful manufacture, distribution prescribing, or dispensing of controlled substances as verified through the Office of the Inspector General List of Excluded Individuals and Entities. The policy must ensure that staff are free from serious sanctions, such as those for misuse or mis-prescribing of prescription medication. Such serious sanctions well be determined at the discretion of the CDC consistent with CDC’s public health mission. In addition, a health system background check will include a search for The Joint Commission sanctions and current investigations for serious institutional misconduct (e.g., investigations for professional medical misconduct). CDC’s contractor may request the policy and any supporting information deemed necessary.
- Centers for Disease Control and Prevention (CDC) employees are not eligible to apply. Contractors working on a CDC campus are not eligible. Neither the judges nor any individuals or entities participating in the development or implementation of the Challenge are eligible.
- A federal entity or federal employee acting within the scope of their employment are not eligible to apply.
- An HHS employee who wishes to submit a nomination shall not work on their applications or submissions during assigned duty hours.
- Champions previously recognized through prior challenges in the 2013, 2014, or 2015 Million Hearts® Hypertension Control Challenge retain their designation as “Champion” and are not eligible to be named a Champion in the 2017 Challenge.
Federal grantees may not use federal funds to develop COMPETES Act challenge applications unless consistent with the purpose of their grant award and specifically requested to do so due to competition design.
Federal contractors may not use federal funds from a contract to develop COMPETES Act challenge applications or to fund efforts in support of a COMPETES Act challenge.
An individual or entity shall not be deemed ineligible because the individual or entity used federal facilities or consulted with federal employees during a competition if the facilities and employees are made available to all individuals and entities participating in the competition on an equal basis.
- The Challenge recognizes clinicians, practices and health systems that achieve notable hypertension control rates across their adult patient population, not just for select patients. Applicants submitting research studies, pilot studies, or entries that limit hypertension control data submitted to a subset of the provider or health system population such as treatment cohorts, patients of a specific age range, or patients enrolled in limited quality improvement projects are not eligible.
- Federal grantees and contractors:
- Federal grantees may not use federal funds to develop COMPETES Act Challenge applications unless consistent with the purpose of their grant award and specifically requested to do so due to competition design, and as announced in the Federal Register.
- Federal contractors may not use federal funds from a contract to develop COMPETES Act Challenge applications or to fund efforts in support of a COMPETES Act Challenge submission. Costs associated with such activities are unallowable and are not allocable to government contracts.
- According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection or information unless it displays a valid OMB control number. The valid OMB Control number for this information collection is 0920-0976 which expires December 31, 2019. The time required to complete this information collection is estimated to be 30 minutes, including the time to review the instructions, search existing data resources, gather the data needed and complete and review the information collection. If you have comments concerning the accuracy or the time estimate(s) or suggestions for improving this form, please write to the U.S. Department of Health and Human Services, OS/OCIO/PRA, 200 Independence Ave SW, Suite 336-E. Washington, DC, 20201, Attention: PRA Reports Clearance Officer.
- By participating in this Challenge:
- An individual or organization agrees to assume any and all risks related to participating in the Challenge. Individuals or organizations also agree to waive claims against the Federal Government and its related entities, except in the case of willful misconduct, when participating in the Challenge, including claims for injury; death; damage; or loss of property, money, or profits, and including those risks caused by negligence or other causes.
- An individual or organization agrees to protect the Federal Government against third party claims for damages arising from or related to Challenge activities. Individuals and organizations are not required to hold liability insurance related to participation in this Challenge.
General Conditions Top>
HHS/CDC reserves the right to cancel, suspend, and/or modify the Challenge, or any part of it, for any reason, at HHS/CDC’s sole discretion. If the Challenge is cancelled, suspended, and/or modified, HHS/CDC will inform the public through the publication of a notice in the Federal Register.
Participation in this Contest constitutes a contestants’ full and unconditional agreement to abide by the Contest’s Official Rules found at www.Challenge.gov.
Submission Guidelines Top>
To enter the Challenge, participants must complete the nomination form by clicking the link at the bottom of this page. The nomination form is a combination of short answer responses, checkbox responses, and assurances.
Nomination information includes:
- The size of the nominee’s adult patient population defined as the number of adult patients served during the reporting year regardless of diagnosis, a summary of known patient demographics (e.g., age distribution), a description of some population characteristics that might present significant challenges and barriers in controlling hypertension (e.g., rural/urban location, % who belong to a minority population, percent whose primary language is not English, percent enrolled in Medicaid, and percent who have no health insurance), and any noteworthy patient population characteristics. The reporting year (12-months) should reflect the most currently available data with an end date no earlier than December 31, 2016.
- The percent of the nominee’s adult patient population identified above that were seen during the reporting year and had a hypertension diagnosis (i.e., hypertension prevalence). There are an estimated 11 million people who are unaware of their hypertension. Most of these people are hiding in plain sight—they are in clinical treatment with elevated blood pressure documented, but hypertension neither diagnosed nor treated. Nominees selected as finalists will have their reported hypertension prevalence (i.e., percentage of their practice or system population with the condition) assessed for alignment with their predicted hypertension prevalence. Initially, a rough estimate of the nominee’s predicted hypertension prevalence will be calculated using the reported age distribution of their patient population and hypertension prevalence findings from national studies, using the Million Hearts® Hypertension Prevalence Estimator Tool [Excel-88K]. If the nominee’s reported prevalence varies considerably from this rough estimate, the nominee may be asked to describe possible reasons for this disparity during the data validation process. If the reported hypertension prevalence is extreme and there is not a justifiable reason, the nominee may be excluded from further participation in the Challenge.
- The hypertension control rate should be for the provider’s or health system’s entire adult hypertensive patient population, not limited to a sample. Examples of ineligible data submissions include hypertension control rates that are limited to treatment cohorts from research studies or pilot studies, patients limited to a specific age range (such as 18-35), or patients enrolled in limited scale quality improvement projects.
- The nominee’s current hypertension control rate among their hypertensive population identified above during the reporting year. In addition, the hypertension control rate during the previous reporting year is also required. If the current reporting year is January 1, 2016 through December 31, 2016, then the previous reporting year is January 1, 2015 through December 31, 2015.
- In determining the hypertension control rate, CDC defines “hypertension control” as a blood pressure reading < 140 mmHg systolic and < 90 mmHg diastolic among adult hypertensive patients.
- A description of clinic systems or processes that support hypertension control. Completion of a checklist of sustainable clinic systems or processes that support hypertension control. These may include provider or patient incentives, dashboards, staffing characteristics, electronic record keeping systems, reminder or alert systems, clinician reporting, service modifications, etc. Checkbox responses may be supplemented by a short answer response. Supporting information about clinic systems is encouraged but not required.
- The nominee must agree to:
- Participate in a data validation process (described below), accept the award if selected, and participate in award activities.
- Complete, without revisions, the CDC contractor’s required HIPAA compliance Business Associate Agreement form and/or other forms that may be required by applicable law.
- Participate in a 1 to 2 hour interview or similar activity to gather information about their hypertension control strategies, and work with CDCC on the review of material to share clinical strategies. Strategies used by Champions that support hypertension control may be written into a success story, placed on this website, and attributed to Champions.
- Assume any and all risks and waive claims against the federal government and its related entities except in the case of willful misconduct, for any injury, death, damage, or loss of property, revenue or profits, whether direct, indirect or consequences, arising from participation in this prize contest, whether the injury, death, damage or loss arises through negligence or otherwise.
- Indemnify the federal government against third party claims for damages arising from or related to competition activities.
Nominees not agreeing to each of these items on the nomination form will be excluded from the Challenge.
Paper responses will not be accepted.
The estimated burden for completing the nomination form is 30 minutes.
Data Validation Process Top>
The nomination will be scored based on hypertension control rate and consistency of the control rate over the reporting year and the prior year, sustainable systems in the practice that support hypertension control, and consideration of patient population characteristics that might present significant challenges and barriers in controlling hypertension.
Nominees with the highest score will be required to participate in a two-phase process to verify their data. Nominees who are non-compliant or non-responsive with the data requests or timelines will be removed from further consideration.
Phase 1 includes verification of the hypertension prevalence and blood pressure control rate data submitted and a background check. For nominees whose Phase 1 data is verified as accurate, phase 2 consists of a medical chart review. In addition, background checks will be conducted by an independent source for individual or small practice nominees to ensure there are no serious sanctions or that other misconduct has occurred (as outlined in the Eligibility section). For large providers or health systems, their background check policy and implementation will be reviewed for compliance with the individual background check protocol. Some nominees may be eliminated base on these reviews. In addition, a health system background check will include a search for The Joint Commission’s sanctions and current investigations for serious institutional misconduct (e.g., investigations for professional medical misconduct).
Phase 2 of the validation, for nominees whose Phase 1 data is verified as accurate, consists of hypertension management validation via medical chart review.
Nominees must provide documents showing the criteria used to include patients as "controlled" and a list with each hypertensive patient found to have blood pressure in control. Eight patients will be selected randomly for file review for compliance, along with 32 additional patients whose records may be requested for review if needed (described below). For the eight records selected, electronic copies of all of the pertinent medical records will be submitted through a secure FTP site with a secure login. Criteria for compliance with the measure include having documentation of having at least one outpatient encounter with a diagnosis of hypertension during the first 6 months of the measurement period and evidence that the patient’s most recent blood pressure is adequately controlled (a reading of <140/90 mmHg).
If all eight patients are determined to be in compliance, then the proposed nominee is determined to be in HIGH compliance and the validation process is complete. If one or more of the initial eight patients’ records is out of compliance, then 22 randomly selected patient records, from the 32 patients identified above, will be required for review. For these nominees, 30 total patients’ records will be reviewed to assess compliance. The remaining 10 patients will serve as alternates to replace patients with records that do not meet inclusion criteria.
Performance categories: HIGH (90% – 100% of the records are in compliance with the review criteria); MEDIUM (60% – 89% in compliance); or LOW (less than 60% in compliance).
Up to 35 Champions will be recognized.
Champions will receive local and national recognition. No cash prize will be awarded.
In addition to recognition on the Million Hearts® and CDC websites, national press releases will be initiated to recognize and congratulate Champions. Documentation of clinical systems and strategies champions adopted that support hypertension control will be housed on this website and attributed to Champions.
Selecting the Champions Top>
A CDC-sponsored panel of three to five experts consisting of HHS/CDC staff will review the nominations that pass phase 2 to select Champions. Final selection of Champions will take into account all the information from the nomination form, the background check, and data verification. In the event of tie scores at any point in the selection process, geographic location may be taken into account to ensure a broad distribution of champions across rural or more populated areas, representing potentially underserved populations.
The first Round Finalists will be selected based on a composite score generated from the information on the nomination form. These nominees will participate in a data validation process.
Nominations will be scored and judged separately by size and type of nominee in the categories listed below. CDC does not guarantee that a specific proportion of Champions will be selected from each category.
- Small individual providers or practices (500-49,999 covered lives)
- Large providers or practices (50,000 or more covered lives)
- Health Systems
The nomination will be scored based on two hypertension control rates: one for your most recent 12-month reporting period ending not earlier than December 31, 2016, and consistency with a previous rate for a 12-month period 1 year before the current rate (at least 90% of score); sustainable systems in the practice that support hypertension control (up to 5% of score); and patient population characteristics that might present significant challenges and barriers in controlling hypertension (up to 5% of score).
Judges will confirm that there are no conflicts of interest with any nominees being considered as a Champion.
Some Champions will participate in a post-challenge telephone interview. The interview will include questions about the strategies employed by the individual or organization to achieve high rates of hypertension control, including barriers and facilitators for those strategies. The interview will focus on systems and processes and should not require preparation time by the Champion.The estimated time for the interview is two hours, which includes time to review the interview protocol with the interviewer, respond to the interview questions, and review a summary data about the Champion’s practices. The summary will be written as a success story and will be posted on the Million Hearts® website.
CDC Judges Panel Top>
Judges will be selected by CDC based on their knowledge of hypertension and hypertension control strategies. Judges may include at least three of the following:
- Million Hearts® Executive Director
- A Million Hearts® Senior Advisor
- A Representative of the CDC Director’s Office
- A Representative of the National Center for Chronic Disease Prevention and Health Promotion