Medicaid Managed Care Performance Improvement Projects

2009-2010 Pediatric Obesity-Summary of Projects

Provider and Contact Project Description
Americhoice by United Healthcare
Catherine Lopez
Catherine_lopez@uhc.com		 Improving Care for Pediatric Members with Obesity 2009-2010
The project aims to: provide education for parents and children regarding the significance of an adequate diet and the importance of physical activity, include assessment for obesity at all well child care visits for children aged 3-17 years using Body Mass Index (BMI) and providing anticipatory guidance through evidence based messaging regarding nutrition, physical activity and screen time, provide community resources for members and clinicians for weight management and nutrition, identify overweight/obese members through claims and provide proactive case management/disease management for high risk patients.
Amerigroup NY, LLC
Catherine Ramirez
cramire@amerigroupcorp.com		 Childhood Obesity 2009-2010
Amerigroup's goal is to increase member, provider, health plan and community/school awareness of the importance of body mass index (BMI) screening, nutrition and exercise related to childhood obesity by partnering with at least ten pediatricians in this two year project. We expect to increase provider utilization of BMI screening, nutrition and exercise counseling, and public awareness. Member activities include outreach to encourage parents/guardians of selected members 7-11 yrs. old who are in need of a well visit to visit a doctor. For these members at risk provide Amerigroup's Power Zone Pak.
Broome Max
Linda Taylor
ltaylor@co.broome.ny.us		 Improving Identification and Management of Obesity in Low Income Children and Adolescents Age 3 to 17
The eligible population will include all children/adolescents in the plan, 3 to 17 years of age. Broome Max will partner with Corporate Care Management, Broome County Department of Social Services and Broome County Steps to a Healthier New York. All Family Practice and Pediatric affiliated sites will participate in the study. High risk children will receive educational materials, community information on physical activity/weight management programs and will be encouraged to make follow-up counseling appointments with their primary care providers.
CDPHP
Jeanne Westcott
jwestcot@cdphp.com		 Improving the Care of Children at Risk for Obesity in Managed Medicaid Population
CDPHP seeks to improve the rate of screening, detection, and treatment of overweight and obesity in its Medicaid pediatric population. The plan will develop multiple levels of interventions to support both members (and their parents) and providers. Members will be educated about the importance of BMI measurement, healthy eating and shopping, and exercise. Providers will receive screening tools to support documentation of BMI's and counseling, and education about communication strategies. Both members and providers will receive reminders about the importance of annual well visits. In addition, educational outreach to pregnant members on the benefits of breastfeeding and healthy weight gain in pregnancy and outreach to school health professionals and dieticians to discuss menu offerings will be conducted.
EmblemHealth (GHI / HIP)
Meredith Clark
mclark@emblemhealth.com		 Improving Pediatric Obesity Assessment, Treatment and Prevention for our Members and Providers
EmblemHealth aims to give providers the tools, skills and knowledge they need to identify and screen children for overweight/obesity, e.g. BMI education and screening tools. The health plan will develop a registry of high risk enrollees for targeted outreach. In addition they will link members to evidence based interventions and will seek to empower parents, members and their families with the knowledge and skills to take action and improve their lifestyle choices and health status. High-risk children and their families will receive a member toolkit. For pregnant members education will be provided about healthy weight gain in pregnancy and healthy weight gain among infants and children. EmblemHealth will identify and make available a guide for members, parents and clinicians, which identifies community based nutrition and physical activity clubs, classes, and programs.
Excellus BCBS Rochester / MVP Health Care / Preferred Care
Jeanette Flynn-Weiss
jflynnweiss@preferredcare.org		 'Staying in the Range' program: Focus on nutrition, healthy behaviors, and weight gain during pregnancy and encouragement of breast feeding practices.
The plans primary aim will be on disseminating the Perinatal Network of Monroe County's community-based 'Staying in the Range' program. The program is a provider-facilitated patient self-management program focused on healthy habits and weight management during pregnancy. In addition, the plans will incorporate breast feeding promotion and education for members and providers, and evaluate provider nutritionist referrals.
Fidelis
Kristin Sainato
Ksainato@fideliscare.org		 Promotion of Breastfeeding and Healthy Pregnancy Weight to Reduce Pediatric Obesity
The goal of the Fidelis project is to increase education among pregnant women, mothers, and providers which stresses the importance of healthy pregnancy weight and breastfeeding in the first years of life. These factors are considered positive contributing factors in promoting healthy weight and development of healthy eating patterns in the infant and toddler stages, with overall impact on weight gain in the later pediatric stages. Utilizing Fidelis' MaternalCare and BabyCare™ program processes, the project will target all pregnant members to promote healthy weight gain and breastfeeding and promote provider encouragement of breastfeeding.
HealthFirst
Lani Alison
Lalison@healthfirst.org		 Improving the Process of Identification of Obesity Risk in the 2-18 years old Medicaid population: A Two Year Pilot Study
The project is aimed at improving the process of identification of children and adolescents who are at risk for obesity and appropriate counseling on nutrition, physical activity or exercise. The plan will target four high volume practices and provide onsite education and training regarding implementation of the Expert Committee recommendations, as well as appropriate coding of BMI percentile stratification. Healthfirst will partner with these pilot provider groups to provide complete funding for nutritionists and community outreach workers to better serve their member populations. The plan will also host community events such as an Obesity Awareness Day and a Farmers Market series to increase obesity awareness in the community. Billboards advertising the seriousness of obesity will be strategically placed within the provider neighborhoods to complement these efforts. In addition, the plan will develop a registry of members who are overweight and obese, and members who are at risk will be targeted for outreach for referral to the Got 2B Fit program and assistance with appointment scheduling and follow-up. Targeted members and providers will be provided with a list of community resources for nutrition and physical activity as well as referral sources for Nutritionists and Mental Health Specialists.
Health Now
Lisa Zakes
Zakes.Lisa@healthnow.org		 Addressing Pediatric Obesity
The aim is to improve the healthy weight of our pediatric Medicaid members though improved awareness, screening and counseling of BMI, nutrition and physical activity by healthcare providers and members. An obesity awareness campaign will be conducted. Provider interventions include revising medical records standards and an educational campaign on these standards. Plan interventions include revision of pediatric health risk assessment. Member interventions include Distribution of the Healthy Family Tool Kit to address inactivity and poor dietary practices, and coverage for youth community health education classes and a discount program for child and family fitness centers. Sponsorship of the "What Moves U" campaign and the Grass Roots Gardens of Buffalo. Support a school outreach worker at a selected school district. Promote Healthy Family Lifestyles at a selected clinic site. Support for various community programs and promotion of breastfeeding
HealthPlus
Eric Wentz
ewentz@healthplus-ny.org		 Turning the Tide: Neighborhood Collaborative to Assist Overweight Adolescents in Sunset Park, New York
Health Plus and Lutheran Health System have initiated a comprehensive program to identify and address the medical, nutritional and physical activity needs of overweight and obese adolescents. The program is open to members who are cared for at one of the Lutheran Family Health Center clinics in the Sunset Park area of Brooklyn or attend one of five elementary or middle schools in Sunset Park. The focus will be on increasing provider awareness and identification of obese children, increasing screening for diabetes/pre-diabetes in high-risk children, and increasing referrals to specialized weight loss/behavior modification programs. In the school setting the goal is to increase awareness of obesity and offer an after-school exercise program for overweight children.
Hudson Health Plan
Karen Pennar
kpennar@Hudsonhealthplan.org		 Identifying and Addressing Obesity in the Pediatric Population
A provider intervention will aim at improving provider identification and recognition of overweight, obese and morbidly obese 2-17 year-old members. Providers will be offered a simple toolkit. The plan will provide information and brochures that primary care providers can distribute to members and families, and sponsor a community-based pediatric health and fitness fair.
Independent Health Association
Stephen Radel
sradel@independenthealth.com		 Pediatric Obesity Initiative-Fitness for Kids Challenge
The aim of the project is to collaborate with multiple community partners to develop, implement and evaluate a program that will address obesity in young children. The Fitness for Kids program will engage children 14 years of age and younger, their families and schools in the city of Buffalo and all the 8 Western New York counties. Interventions will utilize strategies to increase behavioral change with education, physical activity programs and competition in conjunction with the schools. The goal of the program is to improve the awareness of a healthy diet and the importance of a regular exercise program. Pediatric obesity will also be incorporated into the patient centered medical home initiative.
MetroPlus
Maurice Sahar
Saharm@nychhc.org		 An Assessment of Three Models of Care for Treating Pediatric Obesity
The goal is to evaluate three models of care and identify barriers and best practices from each model. The plan will develop a set of interventions for identification and treatment of obesity that can be disseminated throughout the network and meet the needs of different provider types. In addition the plan aims to increase the diagnosis, documentation and use of obesity diagnosis codes to improve the identification of at risk members. An assessment of the prevalence of overweight/obesity in the plans' pediatric members will be completed.
Neighborhood Health Providers
Karilin Salcedo
Karilins@royalhc.com		 Improvement in Diagnosis and Treatment for Children with Obesity
Neighborhood's project aims to: provide education for parents and children regarding the significance of an adequate diet and the importance of physical activity, include assessment for obesity at all well child care visits for children aged 0-17 years using Body Mass Index (BMI) and providing anticipatory guidance regarding nutrition, physical activity and screen time, provide community resources for members and clinicians for weight management and nutrition, identify overweight/obese members and provide proactive case management/disease management for high risk patients. The Plan will provide educational material to school clinics in regard to nutrition and physical activity and will develop a compendium of community resources for members and clinicians regarding weight management and nutrition resources and post it on their website
Southern Tier Pediatrics
BJ Butler
bjbutler@stny@rr.com		 BMI use in a Pediatric Population in the Southern Tier of NYS
The goals are to increase the healthcare provider knowledge and utilization of BMI and to increase the patient population's knowledge of BMI. Patients and their families will be supplied with educational information and resources which may include written or web-based materials along with information on the BMI value. A provider tool kit containing clinical guidelines regarding the evaluation of obesity, as well as, local resources for treatment will be distributed.
Southern Tier Priority Healthcare, Inc.
Laura Huffman
thealthc@stny.rr.com		 Raising Awareness- Childhood Obesity
The goal is to identify children at risk for obesity through increasing awareness of our enrollees and providers and requesting BMI documentation of all children between 2-17 years of age at well-checks or annually. The plan will distribute educational material to families enrolling with children and will provide the same material to provider's offices.
Total Care
Catherine Brigden
cmb1@totalcareny.com		 Pediatric Obesity
The goal is to increase screening for pediatric obesity by Primary Care Physicians through the use of BMI measurement. For high-risk members the plan will facilitate a referral for treatment. The plan will work with selected provider groups to implement documentation tools in their practice and will provide training to clinical staff responsible for performing the BMI measurement. The plan will identify community resources and local programs for weight management and physical activity for providers and members.
Univera Buffalo Community Health
Beth Gawronski
Beth.gawronski@excellus.com		 Univera Healthcare's Fun 2B Fit® – Promoting Healthy Lifestyle Choices in the 2nd and 3rd Grade Population
The plan will implement a community/school based program focusing on the underserved population that encourages children and their families to make healthier food choices by trying new foods, increasing their level of physical activity, shopping for healthy foods, and preparing meals together. This school based healthy lifestyle initiative will focus on second and third graders and their families. A toolkit in support of the program will be distributed. The health plan will also identify physician practices and orient those offices to the program.
WellCare
Robert Futterman
Robert.Futterman@wellcare.com		 Pediatric Obesity
WellCare will focus its interventions on: disseminating information regarding the health risks of and diseases associated with overweight and obesity; promoting routine monitoring of BMI by primary care providers; promoting counseling regarding maintenance of a healthy weight; and promoting counseling regarding physical activity. The plan will aim to increase awareness among parents of members aged 2-19 years, of overweight and obesity as a public health threat. The plan will remind parents of the 2-19 year old members when a well visit is due and offer a member incentive program. In one borough of NYC the plan will identify free or low-cost local exercise and/or diet management programs and conduct a targeted mailing to high risk adolescent-age members informing them of these programs and encouraging them to attend. The plan will send all households with obese members an informational packet with materials addressing BMI, nutrition and physical activity. The providers will receive a toolkit to assist with BMI measurement, nutrition and exercise counseling.