ASH SPECIALIST PROGRAM REPORT

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ASH SPECIALIST PROGRAM REPORT

• Thomas D. Giles, MD, President of the ASH
  Specialist Program Inc.,

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Designated Specialists

• TOTAL NUMBER OF DESIGNATED SPECIALISTS IN
  CLINICAL HYPERTENSION 1,344
• 2009 101
• 2007 128
• 2005 153
• 2003 - 176
• 2001- 200
• Initially Designated Specialists -- 586

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CHANGE IN EXAM SCHEDULE

• HYPERTENSION EXAMINATION TO BE GIVEN ANNUALLY ON
  COMPUTER AT MULTI SITES
• DATE AND SITE OF 2010 HYPERTENSION EXAMINATION TO
  BE SET SHORTLY

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REDESIGNATION OF PHYSICIANS ORIGINALLY
DESIGNATED AS HYPERTENSION SPECIALISTS IN 1999
AND 2000

• The ASH Specialist Program has issues new
  certificates without an expiration date for those
  physicians originally designated as Hypertension
  Specialists in 1999 and 2000, without requiring
  any re-examination or other criteria.

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ASSOCIATION OF HYPERTENSION SPECIALISTS

• The ASH Specialists Program Inc. and ASH
  established the Association of Hypertension
  Specialists (AHS) as a Special Interest Group
  within ASH to serve as an advocacy group
  dedicated to promoting increased recognition for
  expertise in the diagnosis and treatment of
  hypertension and providing increased resources
  for the care of patients with hypertension
• The AHS held its 1st meeting on May 6, 2009,
  after the Hypertension Highlights Session at
  the 2009 ASH Annual Scientific Meeting in San
  Francisco.

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Initial goals of the Association of Hypertension
Specialists (AHS)

• To obtain a medical specialty code description
  from CMS to identify a hypertension specialist.
• To meet with members of the medical insurance
  industry to negotiate and promote recognition and
  increased reimbursement for hypertension
  specialists.
• To host forums during the annual meeting of the
  American Society of Hypertension, and at other
  meetings, to learn of ways to improve the
  practice of the hypertension specialists,
  including the incorporation of new technology.
• To devise brief presentations that may be used by
  national and local speakers to use when
  presenting to policy makers, i.e. government,
  insurance industry, hospital staffs, etc.

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ASH Specialist Program, Inc. and ASH have
launched an initiative to

• 1 To have hypertension recognized as a body of
  knowledge sufficient to be the foundation for a
  specialist practitioner.
• 2 To obtain identifier codes for physicians
  who are Designated Specialists in Clinical
  Hypertension
• Health Care Provider Taxonomy Code-- National
  Uniform Claim Committee (NUCC)
• Health Care Provider Specialty Code for
  Hypertension Specialists---(Center for Medicare
  Management (CMS)
• 3 To develop and implement criteria to
  designate and certify hypertension centers,
  since this is often a pathway utilized by CMSS
  and other payers to reimburse for certain
  specialty services

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HYPERTENSION SPECIALIST

• Hypertension is a complex illness that varies
  greatly in severity. Approximately 15 of those
  with hypertension are difficult to treat
  (resistant). Moreover, approximately 5 of
  those with hypertension have a secondary (known
  etiology) form of the disease.
• There are currently only 1,500 individuals who
  have become certified as hypertension specialists
  by passing the examination given by the ASH
  Specialist Program. Thus, it is apparent that to
  meet the demand for patient care, many more
  hypertension specialists will be required.
  Because of the important role that these
  hypertension specialists will play in the
  prevention of cardiovascular and renal disease,
  it is necessary to describe the characteristics
  of the speciality in addition to the passage of
  the examination.

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HYPERTENSION SPECIALIST

• II. Criteria to be designated as a Specialist in
  Clinical Hypertension
• Degrees (MD or equivalent, DO)
• Parent Specialty (Internal Medicine, Cardiology,
  Nephrology, Endocrinology, Family Medicine,
  Pediatrics, etc)
• Competent with all modalities for the treatment
  of HTN
• Passage of Hypertension Specialist Examination

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HYPERTENSION SPECIALIST

• A. Referral source for difficult to manage
  (resistant) hypertension
• B. Referral source for investigation for
  secondary causes of hypertension
• C. Referral source for investigation of White
  Coat and Masked HTN
• D. Referral for assessment of global
  cardiovascular and renal risk using sophisticated
  techniques
• III. Clinical Function of Hypertension
  Specialist (It is expected that a majority (at
  least 50) of the clinicians practice will be
  devoted to care of patients with hypertension and
  related disorders.
• E. Serve as community resource for HTN and
  related disorders, e.g. formulary committees,
  credentialing committees, training programs,
  medical insurance companies, outreach programs
• F. Integrate lifestyle modification in HTN
  treatment strategies

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HYPERTENSION CENTERS

• Hypertension Centers will be accredited at three
  levels, with Level III being the most complete.
  One over-arching criterion for accreditation of a
  Hypertension Center is that the facility will be
  directed by a physician who has received
  designation as a Hypertension Specialist by the
  Hypertension Specialist Program of ASH.

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HYPERTENSION CENTERS

• Level I
• Director must be an ASH Designated Specialist in
  Clinical Hypertension
• gt50 of practice devoted to patients with
  hypertension and related disorders
• Personnel are certified in recording blood
  pressure and in maintaining equipment for both
  the Center and self monitoring for patients.
• Performs and interprets for 24-hour ambulatory
  blood pressure recording.
• Availability for cardiovascular risk assessment
  including, but not limited to quantitative
  echocardiography, exercise testing, measurement
  of arterial compliance, ankle-brachial index
• Participation in investigator-initiated research
  and/or in appropriate multi-center trials and
  observational studies
• Recognition as referral and treatment resource
  for resistant hypertensives secondary
  hypertensives, and alternative therapies.
• Performs ongoing quality improvement

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HYPERTENSION CENTERS

• Level II
• Level II Centers will be located in either
  academic medical centers or in large
  multi-specialty clinics. These centers may exist
  independently or as part of large division(s).
  In addition to all of the above criteria, these
  centers will have the following criteria
• Meets Level I criteria
• Director should hold an academic appointment of
  Associate Professor or higher
• Center should have the ability to perform
  extensive multi-specialty examination and
  treatment
• Center should be involved in research, both basic
  and applied
• Center should be involved in the training of
  those interested in hypertension as a specialty
• Center should be involved in the publication of
  scholarly articles related to the field of
  hypertension and related disorders