2

Click here to load reader

PopHealthManager PH_CMWLarticle_final2_April_2016

Embed Size (px)

Citation preview

Page 1: PopHealthManager PH_CMWLarticle_final2_April_2016

CHANGES THE GAME FOR POPULATION HEALTH MANAGEMENT

The phrase “population health” is increasingly being used by medical technology companies, researchers,

practitioners, health care and public health policymakers, and other providers in the health care field.

Seek a definition and you will receive various answers. Although their interpretation of this phrase may

differ, what remains consistent is the intent to improve health outcomes in the communities they serve.

To accomplish this, it is essential for providers to include an effective obesity medicine program.

Why obesity medicine? Obesity is not only a chronic

disease that affects over 35% of adults in the US, but it is

often the root cause or associated with over 59

comorbidities that are included in the $255 billion direct

and indirect annual obesity-related health care costs.

As indicated by multiple research studies, the key to

reversing the trends of this health epidemic is effective

intensive obesity behavioral counseling. It is

recommended both as a front-line treatment and in

concert with other treatment modalities. Yet historically,

the lack of provider time, training and/or

reimbursement has limited the provision of obesity

counseling services in the health care setting - until now.

Obesity TX, powered by PondusHealth and The Center

for Medical Weight Loss (CMWL) is the first scalable,

interactive system for the prevention and treatment of

obesity in a collaborative clinical setting. The medical

provider-directed Obesity Treatment System (Obesity

TX) and platform includes screening technology and personalized treatment options centered around

intensive behavioral interventions. Through Obesity TX, employers, health care organizations, primary

care and medical providers are able to track employee progress, risk factors and measurable outcomes in

an aggregated, HIPAA-compliant reporting format. Outcomes and data supporting those outcomes are

the crucial difference in a successful Population Health Management program.

New policies and practice guidelines have laid the groundwork for primary care providers to take the lead

in obesity care. These include:

In June 2012, the U.S. Preventive Services Task Force (USPSTF) recommended that primary care providers screen all adults for obesity and offer or refer those individuals with a BMI>30 to high-intensity interventions. This recommendation was based on a review of 38 studies demonstrating that behavioral interventions have a positive impact on weight loss at 12 and 18 months. 1

In February 2013, final ACA rules defining essential health benefits included guidance allowing health plans or issuers to use “reasonable medical management techniques” to design prevention benefits, including obesity counseling.2

In June 2013, the American Medical Association recognized obesity as a chronic disease requiring a range of medical interventions.

In November 2013, an expert panel convened by the American College of Cardiology, the American Heart Association and The Obesity Society released five new practice guidelines for the treatment of overweight and obesity in adults. 3

Page 2: PopHealthManager PH_CMWLarticle_final2_April_2016

Adherence to the guidelines established by the US

Preventive Services Task Force regarding the

implementation of obesity screening and counseling for

adults will result in impactful outcomes for obese patient

populations.

By leveraging the primary care and medical provider

patient relationship, employers and health care

organizations can address obesity effectively when

managing their high-risk obese patient population, (BMI

30+).

Obesity TX allows providers to screen patients and

provide clinically-proven care as published in the

American Journal of Medicine in 2012.4 Short-term,

patients lose 11% in the first 12 weeks. At 12 months, they

lose 15% and at 24 months average weight loss is 25lbs. or

12% weight loss maintained.5 Compliance, sustainability

and outcomes data are three key competitive differences

with Obesity TX.

Medical providers’ no longer need to feel ill equipped or uncomfortable having discussions with their patients about the health risks associated with obesity. With a red, yellow, green iconic identification protocol, patient’s risk factors are identified and addressed in their screening process and prescribed a personalized program to help them through their individual health improvement journey. And it is covered by insurance. The Affordable Care Act is helping to increase patient access to medical weight loss services by requiring insurance plans to cover screening and counseling for obesity with no patient cost sharing. CMS covers up to 22 visits for Medicare patients with a BMI of 30+6. For corporate onsite clinics that do not charge their patients it may be a non-issue, but for those that process visits as claims it makes a big difference. Obesity TX is a complement to existing wellness programs, easy to integrate into any clinical care setting and addresses gaps in current Population Health Management programs. Obesity TX delivers.

For more information contact PondusHealth at: 877.808.5329 or [email protected].

1 Screening for and Management of Obesity in Adults: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal

Medicine. 2012;157(5):373-378. 2 Federal Register. Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards

Related to Exchanges. 45 C.F.R. § 156.125. 3 Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of

overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines,

and The Obesity Society. J Am Coll Cardiol. 2013; online. 4Haas W; Moore J; Kaplan M; Lazorick S. Outcomes from a Medical Weight Loss

Program: Primary Care Clinic Versus Weight Loss Clinics. The American Journal of Medicine. 2012: 125 (6), pg. 602.e7-603.e11. 5 2-Year research

based on data collection over 30 months starting with 5499 new patients following the CMWL program. 6 https://www.cms.gov/Outreach-and-

Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM8874.pdf .