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TRANSCRIPT
S
Obesity Management Greenville Postgraduate Seminar
April 2015
More than one-
third of U.S. adults
(35.7%) are obese
In 2008, medical costs associated with obesity were estimated at $147 billion
Non-Hispanic blacks have the highest age-adjusted rates of obesity (49.5%) compared with Mexican Americans (40.4%), all Hispanics (39.1%) and non-Hispanic whites (34.3%)
CDC’s
strategies to
combat obesity
You
Family
Community
Centers for Medicaid and
Medicare Services
S Obesity: body mass index (BMI) ≥ 30 kg/m2
S Intensive behavioral therapy for obesity is:
S Reasonable and necessary for prevention or
early detection of illness or disability
G0447
S Face-to-face behavioral counseling for obesity,
15 minutes
S 1 visit every week for the 1st month
S 1 visit every other week for months 2-6
S 1 visit every month for months 7-12
S *If lost 3 kg (6.6 pounds) in the first 6
months
G0447
S Counseling by any qualified primary care
practitioner
S Must be consistent with the 5 A’s
S Ask
S Assess
S Advise
S Assist
S Arrange
5 A’s of Intervention
S 1. Ask
S What have you done to progress towards your
ideal body weight?
S 2. Assess
S Record weight and blood pressure
S Have you kept an exercise log? How many
minutes?
S Have you kept a diet log? What improvements?
5 A’s of Intervention
S 3. Advise
S Presentation/Class Discussion
S Nutrition
S Exercise
S Behavioral counseling
S Question and answer
5 A’s of Intervention
S 4. Assist
S What is your biggest obstacle to achieving your
ideal body weight?
S Address patient specific impediments
S 5. Arrange
S What do you want to accomplish by the next
visit?
S Review Medicare policy and follow up
Weight
Management
Classes
Every Thursday 12:30-1:30
Group Class Results
0
5
10
15
20
25
30
t < 6 months(N=46)
t = 6 month(N=11)
6 < t < 12months(N=10)
t = 12 months(N=9)
3.37 1.27 11.8
25.56
Ave
rage
We
igh
t Lo
ss p
er
Pe
rso
n [
lbs/
pe
rso
n]
Duration of Enrollment (t) [months]
Comparing Average Weight Loss Against Length of Participation
Group vs. Individual
0
10
20
30
40
50
60
70
80
90
100
Group (N=85) Individual (N=98)
48.2 %
26.5 %
Pe
rce
nt
[%]
Amount of People that Lost at Least 6.6 lbs by 6 Months
Group vs. Individual
0
1
2
3
4
5
6
7
8
Group (N=85) Individual (N=98)
5.89
2.79
Ave
rage
We
igh
t Lo
ss p
er
Pe
rso
n [
lbs/
pe
rso
n] Average Weight Loss per Person for All Participants
Reimbursement
S Medicare pays $23.89 per person per visit
S First year of classes
S Total Receipts: $19,394.11
Documentation
G0774: Obesity behavioral counseling, 15 minutes on DATE
Reimbursement requires correct diagnosis and BMI
Obesity Code / BMI specific code
278.00 or 278.05 V85.30 etc up to V85.39 or V85.40
Obese or Morbid Obesity BMI or Morbid
How to Make it Work
Office Champion -Recruits participants
-Organizes class materials
-Obtain weight / BP
-Disseminate / Collate 5A Q’s
- Documentation
-Gathers long term outcome data
-Follow up calls
Lifestyle Coach -Educate
-Motivate
-Delegate
-Generate handouts
-Facilitate discussion
- Promote record keeping
- Incorporate technology
[email protected] Jack
[email protected] Oscar
Medicare
Changes 2016
Prepare Patients
-Group health visits
-Focus on health
Practice
-Prevention
Case Management