Ohio Early Childhood Health Network Healthcare Sub-committee MeetingMinutes

1. Federal Updates

*Federal push to improve health through an increased collaboration between healthcare and public health

* ACA increased coverage in US, therefore insurers need and will want to participate in prevention more

*therefore more focus on fee for service approach in public health, with more prevention services demonstrating effectiveness to be taken on by different stakeholders

2. Reviewed objectives discussed in last subcommittee mtg.

Need to define an “episode of care” of obesity management and/or obesity prevention would include

Consider Obesity registry – Big issue need better data for 6-12 and more generalizable data for 0-5. Options include…PedsNet, Cleveland Clinic model, ImpactSIIS or find out about CPCI (comprehensive primary care initiative) to see if can include pediatric BMI, OACHS – need baseline for these kids to monitor properly

Priority for identifying “modifiers” for obesity counseling decreased b/cModifiers are appropriate for old systems model.Medicaid said at Pediatric Care Council, that if you are coding for this you are getting paid for it.

PCMH metrics – confirmed that weight assessment will be included. How to tie CQR to QI program like PMP

MWA provided definition for CQR on “weight assessment” and how to define, as well as, add BMI to definition (see below).

Defining counseling – counseling included but need specifics or need tie-in to current programs

EMR prompts are effective. Could provide guidance on this based on PMP information.

3. Next Steps

*Expectation defined in PCMH guidelines below, need to figure out how to map PMP to this or another counseling support program

*Learn more about data gathering options and data mining options

* invite some missing individuals to join group, including those working on PEDsNet at NCH or other hospital, folks working on data at Case Western, State level PCMH individuals.

PCMH OBESITY MEASURE
MEDICAL RECORD SPECIFICATION:

  • BMI Percentile: BMI percentile during the measurement year Documentation must include height, weight and BMI percentile during
  • the measurement year. Either of the following meets criteria for BMI percentile.
  • BMI percentile, or BMI percentile plotted on age-growth chart
  • For members who are younger than 16 years of age on the date of service, only evidence of the BMI percentile or BMI percentileplotted on an age-growth chart meets criteria. A BMI value is not acceptable for this age range.
  • For adolescents 16–17 years on the date of service, documentation of a BMI value expressed as kg/m2 is acceptable.
  • Counseling for Nutrition: Documentation of counseling for nutrition or referral for nutrition education during the measurement year.
  • Documentation must include a note indicating the date and at least one of the following.
  • • Discussion of current nutrition behaviors (e.g., eating habits, dieting behaviors)
  • • Checklist indicating nutrition was addressed
  • • Counseling or referral for nutrition education
  • • Member received educational materials on nutrition
  • • Anticipatory guidance for nutrition
  • Counseling for Physical Activity: Documentation of counseling for physical activity or referral for physical activity during themeasurement year. Documentation must include a note indicating the date and at least one of the following.
  • • Discussion of current physical activity behaviors (e.g., exercise routine, participation in sports activities, exam for sports
  • participation)
  • • Checklist indicating physical activity was addressed
  • • Counseling or referral for physical activity
  • • Member received educational materials on physical activity
  • • Anticipatory guidance for physical activity