 |
|
|
|
Type 2 Diabetes and Obesity
Weight loss can improve HbA1c levels and glycemic control.47
The percentage of diabetics tested twice a year for HbA1c is included as a test measure in HEDIS
(Health Employer Data Information Set) 3.0. 40
Hypertension and Obesity
Weight loss can reduce both diastolic and systolic blood pressures.
48
The percentage of hypertensive plan members with adequately controlled blood pressure (less than 140/90)
is also a proposed HEDIS 3.0 criterion measure.
Hypercholesterolemia and Obesity
Weight loss can reduce cholesterol levels and improve the LDL/HDL ratio,
thereby reducing the risk of coronary artery disease.
Specific steps that MCOs might take to improve their quality of care for obese members include:
- Identify the prevalence of concurrent obesity and comorbidities
- Generate member BMI values and cross-tabulate with disease descriptors or ICD9, CPT, AHFS and USP codes.
- Assess the health risk of obesity and its comorbidities
- Provide an obesity screener for health care providers to enable appropriate patient selection
for weight management.
- Identify appropriate markers associated with obesity and its related health risks.
- Manage obesity
- Provide education and support tools to help members develop a healthy lifestyle -
one that includes a low-fat, high-fiber diet and regular activity -
with psychosocial and behavioral skills that enhance life in ways that are not dependent on eating.
- Consider adjunctive pharmacological therapy to assist in reaching a realistic weight-loss goal.54
- Implement a weight-management program
- Offering a weight-management program that helps obese members achieve a healthier lifestyle
and control weight could work not only to reduce clinical risks
but also to enhance member satisfaction.
Suggested goal outcomes for such a program are:
- Achieving at least a 5% to 10% weight loss, or a reduction of at least 1 BMI unit
- Maintaining weight loss for at least 1 year
- Achieving clinically significant improvement in risk factors related to comorbidities (e.g.,
blood pressure, blood glucose, insulin resistance, and blood lipids)
- Improving diet, physical activity and other lifestyle factors
|
