2018 company members · 2018. 6. 12. · surgery is not the answer for all patients, but can be...

2018 Company Members

The leading resource for Houston employers dedicated to providing health care at a sustainable costwhile improving the quality and

experience in their delivery

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Agenda

• 8:30-8:40 Welcome & Introductions• 8:40-9:15 Obesity as a Disease – Impact & Implications• 9:15-9:30 A Physician's Perspective• 9:30-9:50 A Health Plan’s Perspective• 9:50-10:05 Break• 10:05-10:25 A Need to Improve ICD-10 Coding• 10:25-11:00 Provider Panel Discussion• 11:00-11:30 Employer Panel Q&A• 11:30-11:50 Houston NDPP Update

Collective Influence

• eValue8 Health Plan Benchmarking• Leapfrog Group Health System Benchmarking• Specialty Pharmacy SWAT• Houston Employer NDPP

Obesity as a Disease vs. a Condition: Employer Impact and ImplicationsBRUCE SHERMAN, MD

CHIEF MEDICAL OFFICER

NATIONAL ALL IANCE OF HEALTHCARE PURCHASER COALIT IONS

Obesity trends among US adults

Obesity-related comorbidities

Nearly 21% of healthcare costs are spent on obesity-related conditions

- - - - with diabetes______ without diabetes

Annual healthcare costs by BMI and diabetes

Cawley J, et al. Pharmacoeconomics 2015

Condition-related medical cost drivers – actual client data

• Enrolled population >71,000 individuals• How well does this report capture obesity-related healthcare costs???

Clinical Condition

Client Incurred Jan. 2017 - Dec. 2017; paid thru Mar. 2018

• Obese employees have twice the number of WC claims than non-obese• WC component costs are higher for obese individuals – and increase with higher BMI

OSTBYE T, ET AL. OBESITY AND WORKERS COMPENSATION COSTS. ARCH INT MED, 2007. 15

Obesity adds to Workers Compensation costsD

olla

rs p

er c

laim

Lost workdays per claim

6000

5000

4000

3000

2000

1000

0

12

10

8

6

4

2

0

16

Obesity – employer total cost analysis

Henke RM, et al. J Occ Environ Med, 2010.

Employer costs of obesity include more than healthcare

• Workplace accommodations for overweight/obese individuals• Hiring concerns related to physical work capabilities• Turnover issues for individuals in physically demanding jobs

17

Recognition will likely help support:• reimbursement for anti-obesity treatment• implementation of weight loss strategies• efforts to reduce risk of CV disease, diabetes and other obesity-associated comorbidities

Smoking vs. obesity – an intriguing comparisonSmoking Obesity

Behavior or disease? Behavior – with addiction potential Behavior – with addiction potential

Stress as a mediator Potentially significant Potentially significant

Social component Yes Yes

Associated medical complications

Yes Yes

Manufacturer’s role Significant contributor Significant contributor

Physician’s role Guidance – resource and pharmacotherapy support

Guidance – resource and pharmacotherapy support

Employer’s role Benefits offerings / workplace considerations

Benefits offerings / workplaceconsiderations

Community role Significant Opportunities exist

20

Employer benefits approach to obesity

As BMI increases so does the eligibility for intervention methods1,2

1. American Gastroenterological Association. 2002; 2. Wadden and Stunkard, eds. 2012.

BMI Category 18.5–24.9 25–29.9 30–34.9 35-39.9 > 40

Disease Risk Low Increased High High Very High Very High Extremely High

Nutrition Counseling ● ● ● ● ● ● ●Ensure Appropriate Physical Activity ● ● ● ● ● ● ●BehavioralWeight Management ● ● ● ● ● ●Medication ● ● ● ● ●Surgery ● ●

21

Most employers feel that current obesity management practices haven’t been particularly effective…

Employer perceptions of the overall effectiveness of their obesity management strategy

0%

10%

20%

30%

40%

50%

1 2 3 4 5 6 7 8

1 2 3 4 5 6 7 8

Not at all effective

Somewhateffective

Extremelyeffective

Don’t know

Source: ACTION Study, 2017

Source: ACTION Study, 2017 22

…and employees seem to feel the same way

23

Weight management is a community issue –needing a community-level focus

What can employers do?

24

The main points of leverage for employer impact:◦ Implement supportive benefit designs that encourage healthy

behaviors – and address well-being priorities◦ Promote a culture of health at work ◦ Provide workplace environment support for healthy lifestyles◦ Support community and family connections

25

Factors that stress people most intensely

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Family Changes

Personal Health Condition

Health Condition of Family

Personal/Family Commitments

Influence/Control Over Work

Work Relationship

Work Schedule

Work Changes

Financial Situation

The Consumer Health Mindset Survey. Aon/NBGH/the futures co. , 2016.

What does this mean for prioritization of personal health issues?

Summary• Is obesity a disease or a condition? The debate continues…• Irrespective of categorization, the health impact is significant• Employers can derive benefit by providing meaningful resource

support for weight management• This is not an individual problem – it a major societal concern

ResourcesCenters for Disease Control and Prevention: www.cdc.gov/obesity/index.html

American Heart Association: Resources for Success www.heart.org

State of Obesity-Texas (RWJF): https://stateofobesity.org/states/tx

Novo Nordisk: www.novonordiskworks.com

Obesity Action Coalition: www.obesityaction.org

http://www.cdc.gov/obesity/index.htmlhttp://www.heart.org/https://stateofobesity.org/states/txhttp://www.novonordiskworks.com/http://www.obesityaction.org/

ByGary J. Sheppard, M.D.

Houston Academy of MedicineVice President

There is no single or simple solution to the obesity epidemic. It’s a complex problem and there has to be a multifaceted approach. Policy makers, state and local organizations, business and community leaders, school, childcare and healthcare professionals, and individuals must work together to create an environment that supports a healthy lifestyle.

Corpulence is not only a disease itself, but a harbinger of others Hippocrates 400 BC

DefinitionsObesity: Body Mass Index (BMI) of 30 or

higher.

Body Mass Index (BMI): A measure of an adult’s weight in relation to his or her height, calculated by using the adult’s weight in kilograms divided by the square of his or her height in meters.

¶ Prevalence estimates reflect BRFSS methodological changes started in 2011. These estimates should not be compared to prevalence estimates before 2011.

*Sample size

Summary No state had a prevalence of obesity less than 20%. 3 states and the District of Columbia had a prevalence of

obesity between 20% and

What do they need? Peer support- Weight Watchers, TOPS Convenient food choices- Jenny Craig, NutriSystem Low-calorie, limited food options- Meal replacement

(OPTIFAST, HMR, Medifast, Robard)

Treatments BMI25-26.9

BMI27-29.9

BMI 30-34.9

BMI35-39.9

BMI40+

Diet, PA, & Behavioral Therapy

WithCo-

morbidities

WithCo-morbidities

+ + +

Pharmacotherapy WithCo-morbidities

+ + +

Weight Loss Surgery With

Co-morbidities

WithCo-

morbidities

Consider pharmacotherapy only if a patient has not lost 1 pound per week after 6 months of combined lifestyle therapy.

The + represents the use of indicated treatment regardless of co-morbidities.

Listen to patient cues about hunger, satiety, and side effects to drive weight management.

Continue to encourage healthy lifestyle behaviors as weight loss medications should serve an adjunct to these.

If a patient has a superior response to medication (5-10% of total body weight loss), continue medications indefinitely.

Advise women of childbearing age about discontinuing medication prior to conception.

Just because we have an ICD-10 code, obesity treatment hasn’t been made easier. Decrease in obesity can prevent or enhance treatment of other serious

cardiovascular, metabolic and musculoskeletal conditions. Management of obesity is a multi-factorial, chronic, individualized treatment. Surgery is not the answer for all patients, but can be beneficial in some patients. Insurance coverage for nutrition consultation, medications, weight programs and

surgery is needed. Always think Team Approach for obesity therapy.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

A Health Plan’s Perspective onObesity Challenges & OpportunitiesJUNE 12, 2018 ROBERT MORROW, MD, MBA

MARKET PRESIDENT, HOUSTON AND SOUTHEAST TEXAS

@DrBobMorrow

1 Centers for Medicare and Medicaid Services Office of the Actuary, September 2013 2 Centers for Disease Control and Prevention, 20053 2012: 17th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care 4 Institute of Medicine, September 2012

Health care spending inthe United States now tops$2.9 trillion annually1

1 in 2 Americanslives with a chronic condition that is largely preventable2

Chronic conditions account for3 out of 4 U.S. dollars spent

on health care3

In one study, more than 60% of patients said they had no idea about the cost of their care until they received a bill4

43THE STATISTICS ARE DRAMATIC

@DrBobMorrow

Top 5 Most Expensive Chronic Conditions

Health Conditions

Oncology

Musculoskeletal

HeartRespiratory

Diabetes

@DrBobMorrow

Challenges• Workplace environments can pose challenges.• Weight is a private and sensitive matter, which

can make outreach difficult. • Lack of obesity awareness and education can

hinder engagement levels. • Weight loss is challenging to accomplish which

requires long-term coaching and engagement. • Few physicians formally diagnose obesity through

CPT codes. • Chronic health conditions receive a greater

emphasis than obesity prevention.

45

@DrBobMorrow

OpportunitiesProactive:• Health Risk Assessments• Biometric screenings• Wellness coaching• Incentives / Disincentives• Onsite clinical nurse• Workplace assessment

Reactive:• Weight loss programs• Bariatric surgery

46

@DrBobMorrow


Identifying Members Through Claims

Identify Current Member Activity using real time referrals initiated by:

• Emergency room visits• Preauthorization/notification• Self referral• Provider referrals• Human Resources staff• Pharmacy Data• 24/7 Nurseline

Proactive Identification of Members

< < < Supported by Clinical Intelligence Rules > > >

CollectClaim History with Predictive Modeling

Historical claims data is included in a scheduled predictive modeling run

1 2Member Stratification

Complex Catastrophic Care

High-Risk MultipleDiseases

Moderate-Risk

Low-Risk

Well Members

3

@DrBobMorrow

ALL GAPS MATTER – Just some of the hundreds of gaps

• Lack of immunizations, mammograms, cervical screenings, colonoscopies

• No emergency action plan in place for asthma, or condition-specific screenings done

• Member not following physician's treatment plan

• Physical inactivity / poor nutrition / BMI>=25

• Tobacco use• Abnormal cholesterol

• Positive depression screen• Inadequate financial, family

or other resources• Cultural or religious barriers

• Member does not understand need to track blood pressure readings or how to read

• Member does not know how to use peak flow meter

• No beta blocker use with Coronary Artery Disease diagnosis

• Asthmatic not on controller meds • Diabetic not taking diabetic meds

Preventive Gaps Lifestyle Gaps Condition-Specific Gaps

Psychosocial Gaps Knowledge Gaps Medication Compliance

► ► ►

►► ►


Proactive Approaches for Employers

What is the most clinically and financially effective way to

manage an illness?

@DrBobMorrow

To prevent it!!

A Suite of Wellness OptionsENGAGING EVERYONE• Blue PointsSM

• ondemand client website• Healthy Worksite consultation*• Personalized member communications**• Fitness device integration

52

*Buy-up dependent **Available with BCC EnhancedSMBlue Points Program Rules are subject to change without prior notice. See the Program Rules on the Well onTarget Member Wellness Portal at wellontarget.com for further information

CLIENT REPORTING• Weekly utilization reporting• Aggregate and member-level reporting

ASSESSING HEALTH• Health Assessment• Personal Wellness Report• Biometric screenings* • One-on-one coaching

WORKSITE WELLNESS• Events and seminars*• Health fairs*• Monthly Challenge competitions**• Wellness coordinators*

WELLNESS COACHING• Dedicated coaching• Goal-setting tools• Online and telephonic support

MEMBER WEB PORTAL• Well onTarget portal• AlwaysOn® mobile app• Self-directed courses• Trackers• Health articles• Interactive Symptom Checker• Fitness Program• Social networking• Text messaging


Solving for Obesity in the Workplace

The Mug Experiment

Source: Kahneman, Thinking Fast and Slow, 2011

Class AGiven a coffee mug at the beginning of class, and then at the end of class, offered to switch mug for a bar of Swiss chocolate.

Class BGiven a bar of Swisschocolate at the beginning of class,and then at the endof class, offered toswitch for the mug.

Class COffered the choice between a coffee mug and a bar of Swiss chocolate at the beginning of class.

@DrBobMorrow

89%Chose Coffee Mug

10%Chose Coffee Mug

59%Chose Coffee Mug

Incentive Research

• People feel loss twice as much as they feel gain.

• Reframing a question in terms of a loss instead of a gain changes the response.

55

@DrBobMorrow

@DrBobMorrow

Incentives are necessary

Chocolate vs Radish Experiment

• The set up: a room full of recently bakedchocolate chip cookies, and a basket of radishes.

• Group A: Eat Radishes (while not eating cookies)• Group B: Eat Cookies• Try to solve an unsolvable tracing puzzle

Results

Time beforegiving up

Radishes:

Attempts beforegiving up

@DrBobMorrow

Cookies:

8 minutes

19 minutes

19 attempts

34 attemptsCookies:

Radishes:

59

Diets Don’t Work.Lifestyle Changes Do.The Science of Ego Depletion

@DrBobMorrow

Weight Loss ProgramAirline Client Results 2015-2018

8 NS Classes21,786 Participants80%+ Completion

Rate

>155,000 lbs Lost So Far9 lbs Avg 10-Week Weight Loss>10,000 participants lost more

than 5% body weight

65% Lowered Diabetes Risk

39% Metabolic Syndrome (MetS) Reversal

@DrBobMorrow

Weight Loss ProgramSuccess at a University System (2015-2017)

@DrBobMorrow

45,000+ lbsLost and counting. Participants averaged a 10 lb. weight loss at 10 weeks in the program. 60%

MetS Reversal5,000+ Participants

Real world clinical results with employers, published in two peer-reviewed journals

Metabolic Syndrome

-50.7% Type II Diabetes

Risk

-55%

Blood PressureRisk

-50%

Losing 5%+ of bodyweight

-44%

1. Evaluation of a Voluntary Work Site Weight Loss Program on Metabolic Syndrome. Conrad P. Earnest, PhD; Timothy S. Church, MPH, MD, PhD. October Issue 2015 (N=3880)

2. Evaluation of a Voluntary Work Site Weight Loss Program on Hypertension. Conrad P. Earnest, PhD; Timothy S. Church, MPH, MD, PhD. December Issue 2016 (N=5988)

Journal of Metabolic Syndrome and Related Disorders1

Journal of Occupational and Environmental Medicine2

Weight Loss Program

Quality Bariatric Surgery

All savings results, BCBSA data; BDC+ eligible facilities vs. relevant comparison group. Results based on most recent designation cycle for each specialty. Savings based on total episode cost. To learn more about Blue Distinction Centers for Specialty Care, please visit www.bcbs.com or contact your Local Plan.

1. All quality results, BCBSA data; BDC/BDC+ eligible facilities vs. relevant comparison group; results based on most recent designation cycle for each specialty.2. AHRQ-sponsored Health Cost and Utilization Project (HCUP), 2014 (reflects all privately insured).

32% lowerER visit rate

21% lowerReadmission rate

48-73% lowerSurgical site infection rate

29% savingsoverall

$4,300 savingsgastric banding

$3,200 savingsgastric sleeve

$4,900 savingsgastric roux-en-y

64

Courcoulas, JAMA Surgery 2015

Consider Covering Bariatric Surgery

@DrBobMorrow Klein, obesity | VOLUME 19 NUMBER 3 | March 2011

Total diabetes medication costs decreased significantly

among surgery patients.

Bariatric surgery with low-level lifestyle intervention resulted in more disease

remission than did lifestyle intervention alone.

65

Follow @DrBobMorrowon Twitter

INSIDE Obesity Management

Houston Business Coalition on Health

Luigi Meneghini, MD, MBAProfessor, UT Southwestern Medical Center

Executive Director, Global Diabetes Program, Parkland Health & Hospital System

• Baseline data collection & analysis from EMR• Quality Improvement (QI) training & education• Three regional CME/CE conducted by ADA, KOL & clinical site faculty• Patient education• Ongoing data collection & analysis• Publications & presentations

INSIDEQuality Improvement Project

Program Overview: Improve the clinical management of patients with obesity

Agreed with sponsoring partners to focus attention on overweight/obese patients with pre-diabetes

RATIONALE• Intervention on weight directly impacts risk of developing type 2 diabetes• Diabetes Prevention Program (DPP) proven intervention for delaying type 2 diabetes through

weight loss & lifestyle modifications• Delaying type 2 diabetes can have beneficial impact on morbidity & fiscal burden of disease

Challenge: Most patients with pre-diabetes have not been identified

Baseline data collection & analysis

Analyzed 91,574 patients with 454k encounters over 36 months

• Lack data on • Diet, exercise, patient adherence

• Some data/exclusion criteria incomplete, unhelpful, or un-curatedLimitations

Care Quality: EHR Landscape Survey

Age, gender Height, weight, BMIMedications ICD codesHbA1c, glucose, OGTTNephropathy screening

BP, lipid panel, LFTsEthnicity/race, education

Population sample: Age 18-89 with PCP visit < 18 months AND BMI c/w overweight OR Age≥45

Population Demographics

Min: 19

Max: 90+

Median: 53Mean: 52

35% Male / 65% Female

• Seen: 2014-2016 for 1-65 visits, median 4• 56% Hispanic white, 27% Black, 10% Non-

Hispanic white, 4% Asian

AgeInsurance65%

14%8% 7% 5%

Charity Medicare Medicaid Commercial Self Pay

ICD Diagnoses Associated with Obesity (BMI≥30)

65%35%

43%

29% 28%

23%

5%2%

Only 5% have ICD prediabetes codes6%

Only 6% have ICD obesity codes

28% have prediabetes by lab tests

ADA Criteria for Prediabetes/Diabetes Testing in Undiagnosed Adults

79%

21%

% testing in undiagnosed, eligible patients

97% of undiagnosed sample eligible for testing; 79% tested

65%35%

% prediabetes in all undiagnosed patients

23%14,598

23% of undiagnosed sample meets ADA criteria for prediabetes

Diabetes Screening at Parkland• Approximately 61% of Parkland COPC patients without diagnosed

diabetes/prediabetes have been screened in the past 2 years• We are doing BETTER than the National average (53%)

• Of Parkland patients screened Diabetes:• 49% normal glycemic status• 38% Prediabetes• 13% Diabetes

• Although we are doing a good job, nearly half (46%) of COPC patients we have not screened in clinical practice have either prediabetes or diabetes

• Determined by inviting COPC patients in for a screening study

PRE-DIABETES REGISTRY

HIGH RISK Pool

Is patient part of

Diabetes Registry?

Provider Order

NO

Order screening test(Random A1C or fasting

plasma glucose)

Automated result

reporting to ordering

provider

Pre-DM

Diabetes Prevention Program Intervention

(Education materials, local COPC intervention, community program

[YMCA])

No further action

Alert COPC provider &

staff

Diabetes Normal

Assign appropriate ICD10 code (R73.09 for PDM) (E66.x for obesity)

[automated] to Problem List

12

3

45

6

7 8

PHHS EPIC Population

Does patient have pre-DM

by labs (A1C/FPG) &

is not on anti-DM meds*

&/or obesity by BMI?

* With the exception of metformin, GLP-1 RA, pioglitazone or acarbose

YES

Glycemic Risk Surveillance (Bowen Risk Tool)

LOW RISK Pool

Visit-Based DM Screening BPA

(Garland)

Population Health DM Screening (Vickery)

Screening Outreach by Population Health Team

DIABETES REGISTRY

Glycemic Risk Surveillance/ Re-screening (Bowen Tool)

OBESITYREGISTRY

Challenges with ICD coding of obesity & pre-diabetes population• No automated option for patients identified with condition

• ICD code entry would need to be manually entered• Pre-diabetes & overweight/obesity are dynamic conditions

• Will probably change over time making the prior ICD code incorrect• Establishing registries for the condition based on A1C scores (pre-

diabetes) and BMI category makes sense• Registries can be periodically updated to add/remove patients

• Laboratory-based A1C within past 2 years (5.7-6.4%)• Exclude use of FPG or OGTT

• Exclude anyone in the diabetes registry• No antidiabetic medications with exception of metformin

Preliminary Pre-Diabetes Registry Stand-Up

PRE-DIABETES REGISTRY

OBESITY REGISTRY MODIFIED OBESITY REGISTRY

Is patient part of

Diabetes Registry?

Has patient had PCP visit

in past 18 months?

Identify high DM risk patients (EPIC tool, ADA questionnaire,

Bowen study)

YES

NO

Order screening test(Random A1C or fasting

plasma glucose)

Is patient at high risk for DM or pre-

DM?

Interpret test result

Pre-DM

Diabetes Prevention Program Intervention(Education materials, local COPC intervention,

community program [YMCA])

No further actionAlert COPC provider & staff

Diabetes Normal

YES

Assign appropriate ICD10 code (R73.09)

Houston Employer DPP 2018 Pilot

TOP 10 REASONS FOR PARTICIPATING IN THE HOUSTON EMPLOYER DIABETES PREVENTION PROGRAM (DPP) PILOT

CDC Diabetes Prevention ProgramCurriculum

• Eligibility• 35% BMI & Blood Test, 65% BMI & CDC Screening Evaluation

• Initial 6-month phase, 16 sessions over 16-26 weeks• Second 6-month phase, 6 sessions delivered monthly• Regular opportunities for direct, individual or group interaction• Body weight collected at in-person sessions & data elements recorded• Body weights objectively obtained for virtual sessions• Providers evaluated on objective criteria, e.g. sessions attended, body

weights obtained, physical activity, weight loss obtained, etc.

CDC Diabetes Prevention Program- CurriculumWeeks 1-26 Weeks 27-52

Welcome to the DPP Welcome to the Second Phase

Self-monitoring weight and food intake Healthy eating: taking it one meal at a time

Eating less Making active choices

Healthy eating Balancing thoughts for long-term maintenance

Intro to physical activity Healthy eating with variety & balance

Overcoming barriers to physical activity Handling holidays, vacations, and special events

Balancing calorie intake and output More volume, fewer calories

Environmental cues to eating and physical activity Dietary fats

Problems solving Stress and time management

Strategies for healthy eating out Healthy cooking

Reversing negative thoughts Physical activity barriers

Dealing with slips in lifestyle change Preventing stress

Mixing up physical activity: aerobic fitness Heart health

Social cues Life with type 2 diabetes

Managing stress Looking back and looking forward

Staying motivated

Houston DPP Participants

Employer EmployeesCity of Houston 22,000DOW ChemicalFriedkin GroupKBR 3000Harris Health 9300Harris County 16,000Latham & WatkinsNoble Energy 1100Rice University 3400

Total Lives Covered

Slide Number 1Slide Number 2Slide Number 3Slide Number 4Social MediaThank You to Our Sponsors��AgendaCollective InfluenceSlide Number 9Obesity as a Disease vs. a Condition: Employer Impact and ImplicationsObesity trends among US adultsObesity-related comorbiditiesSlide Number 13Condition-related medical cost drivers – actual client dataObesity adds to Workers Compensation costsObesity – employer total cost analysisEmployer costs of obesity include more than healthcareSlide Number 18Smoking vs. obesity – an intriguing comparisonEmployer benefits approach to obesityMost employers feel that current obesity management practices haven’t been particularly effective……and employees seem to feel the same wayWeight management is a community issue – �needing a community-level focusWhat can employers do?Factors that stress people most intenselySummaryResourcesSlide Number 28A Practicing Physician’s Perspective on �Obesity ManagementSlide Number 30Slide Number 31Prevalence of Self-Reported Obesity Among �U.S. Adults by State and TerritoryPrevalence¶ of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2016�Prevalence¶ of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2016Who is overweight?Slide Number 36Commercial Program OptionsGuidelines for Selecting Obesity TreatmentsPoints to Remember With Medication TherapyFinal ThoughtsSlide Number 41A Health Plan’s Perspective on�Obesity Challenges & OpportunitiesSlide Number 43Top 5 Most Expensive Chronic ConditionsChallengesOpportunitiesIdentifying Members Through Claims Proactive Identification of MembersSlide Number 49Proactive Approaches for EmployersSlide Number 51A Suite of Wellness OptionsSolving for Obesity in the WorkplaceThe Mug ExperimentIncentive ResearchIncentives are necessaryChocolate vs Radish ExperimentSlide Number 58Slide Number 59Weight Loss Program�Airline Client Results 2015-2018Weight Loss Program�Success at a University System (2015-2017)Real world clinical results with employers, �published in two peer-reviewed journalsQuality Bariatric SurgerySlide Number 64Slide Number 65Slide Number 68INSIDE Obesity ManagementSlide Number 70Agreed with sponsoring partners to focus attention on overweight/obese patients with pre-diabetesBaseline data collection & analysisCare Quality: EHR Landscape SurveyPopulation DemographicsICD Diagnoses Associated with Obesity (BMI≥30)ADA Criteria for Prediabetes/Diabetes Testing in Undiagnosed AdultsSlide Number 77Slide Number 78Challenges with ICD coding of obesity & pre-diabetes populationSlide Number 80Slide Number 81Slide Number 82Slide Number 83Houston Employer DPP 2018 PilotTOP 10 REASONS FOR PARTICIPATING IN THE HOUSTON EMPLOYER DIABETES PREVENTION PROGRAM (DPP) PILOTTOP 10 REASONS FOR PARTICIPATING IN THE HOUSTON EMPLOYER DIABETES PREVENTION PROGRAM (DPP) PILOTCDC Diabetes Prevention Program�CurriculumCDC Diabetes Prevention Program- CurriculumHouston DPP Participants

2018 company members · 2018. 6. 12. · surgery is not the answer for all patients, but can be...

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