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Assessing Weight Through Documentation of Body Mass Index (BMI) in Health Plan Populations

Sarah Sampsel, MPH Research Scientist June 2008. Assessing Weight Through Documentation of Body Mass Index (BMI) in Health Plan Populations. NCQA: Committed to Measurement, Transparency, Accountability. NCQA’s quality programs include: Accreditation of health plans using performance data

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Assessing Weight Through Documentation of Body Mass Index (BMI) in Health Plan Populations

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  1. Sarah Sampsel, MPH Research Scientist June 2008 Assessing Weight Through Documentation of Body Mass Index (BMI) in Health Plan Populations

  2. NCQA: Committed to Measurement, Transparency, Accountability • NCQA’s quality programs include: • Accreditation of health plans using performance data • HEDIS clinical measures • CAHPS consumer survey • Measurement of quality in provider groups • Physician Recognition • Quality measurement means: • Use of objective measures based on evidence • Results that are comparable across organizations • Impartial third-party evaluation and audit • Public Reporting

  3. Research Objective Explore the validity and feasibility of a performance measure assessing percentage of adult health plan members with documentation of BMI in a medical record over a 2-year period.

  4. Importance • Nearly two thirds of US adults are overweight (BMI  25), and over 30% are obese (BMI  30). • Nearly 18% of American children are overweight or obese (BMI > 95th percentile for age and gender). • Increased deaths per year due to poor diet/inactivity.

  5. NIH Obesity Treatment Algorithm Performancemeasurement opportunities

  6. NIH Obesity Treatment Algorithm Performance measurement #1: BMI capture

  7. BMI Assessment • Measure Description: • The percentage of members 18 – 74 years of age who had an outpatient office visit and who had their body mass index (BMI) documented in the measurement year or year prior. • Commercial, Medicaid and Medicare product lines • Constructed as a hybrid measure • ICD-9 codes exist for BMI Assessment, however, rarely used

  8. Field-Test Data Characteristics

  9. Member Demographics Gender Ages

  10. Office Visit Characteristics Commercial Plans Medicaid Plans Medicare Plans 86% of health plan members had at least one outpatient visit in 2005 or 2006 (Commercial = 85.4%; Medicaid = 84.4%; Medicare = 94.5%

  11. Plan Performance • Prevalence of BMI documentation • Ages 18-74 years • Outpatient visit in either 2005 or 2006 *Plan A – submitted utilizing EMR, all Medicaid

  12. BMI vs. Height/Weight Documentation

  13. Conclusions • Significant potential for improvement in tracking and monitoring BMI in adults • Use of EMR impacts rates… • Holding health plans accountable for working with clinicians to measure and document BMI is only the first stop in combating obesity

  14. When will there be national level data? • Awaiting final NCQA BOD approval • Publication in HEDIS Volume 2 – July 2008 • Plan reporting (measurement year 2009) – July 2009 • 1st year measure results (aggregate) – September 2009 • Determination of public reporting status for HEDIS 2010 – September 2009

  15. Acknowledgements • Special thanks to NCQA staff who participated on this project team: • Dana Rey, MPH • Greg Pawlson, MD • Sarah Hudson Scholle, MPH, DrPH • Rich Mierzejewski

  16. Adult Obesity MAP

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