Childhood Obesity: The Role of Health Policy - Association of ...

the coverage available, including provider education on available coding practices (including which codes
to use under which circumstance and in which settings) to support obesity-related services.
• All health care payers (including public, private and self-insured employer plans) should be innovative
in their coverage and reimbursement policies by providing incentives for providing obesity-related
services (e.g., the % of children in the practice for whom a BMI is recorded in the medical record) or
by making certain school- and community-based activities by physicians eligible for compensation or
incentives (e.g., participation in school wellness councils).
• The Federal Centers for Medicare and Medicaid Services (CMS), should make clear to states which
obesity-related services and activities (including disease prevention and health promotion) are eligible for
Federal Financial Participation (FFP) and at what level (e.g., 50% match or greater). This includes, but is
not limited to, reimbursements for clinical services provided in the clinical-, school-, or community-based
setting, and the development of a data infrastructure to address obesity (e.g., obesity registries).
• Congress should appropriate funding for CMS, and if necessary clarify CMS authority, to fund
demonstrations to determine the most effective approaches to addressing the epidemic.
• Employers should evaluate their benefit plan offerings and remove obstacles to the prevention and
treatment of childhood overweight, e.g., by considering coverage of dietitian services and specialized
treatment programs for children and teens.
• Employers should select health plans and providers that follow screening and treatment guidelines to
ensure identification and management of obese children and adolescents.
• Employers should select health plans that help providers make childhood obesity prevention,
identification and management a priority in all patient encounters.
• Employers should select or reward health plans that develop effective healthy weight and weight
reduction programs for children and families.
Strategy 4: Leverage regulatory and accreditation approaches in promoting clinician
engagement
• The American Board of Pediatrics and the American Board of Family Practice should increase the
number/scope of obesity-related content in their certification and maintenance of certification
(MOC) exams.
• Subspecialty boards in those disciplines seeing and treating obese children (e.g., cardiologists,
endocrinologists, surgeons) should also expand their content on childhood obesity and its
consequences in their certification and MOC exams. 14
• State Medical and Nursing Licensing Boards should mandate that at least two hours of the states’
CME/CEU licensing requirements be devoted to obesity, including childhood obesity, and how
interventions vary between adult and child patients.
• Accrediting bodies (such as the National Committee for Quality Assurance (NCQA), or the Joint
Commission for Accreditation of Health Care Organizations (JCAHCO) should develop and require
reporting on obesity-related measures from accredited providers or plans, as well as emphasize
quality improvement initiatives focused on obesity, including childhood obesity.
14 This approach is already used by a number of states for topics such as the prevention of medical errors, domestic violence and HIV/AIDS.
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