Go! Club An Innovative Approach to Reducing Pediatric Obesity in Managed Care

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1 9 th Biennial Childhood Obesity Conference Powerful Partnerships Where Health Care and Community Connect Diane Dooley MD, MHS, FAAP May 31, 2017 Go! Club An Innovative Approach to Reducing Pediatric Obesity in Managed Care

2 Medicaid Health Plans and Pediatric Obesity Children covered by Medicaid are nearly six times more likely to be treated for a diagnosis of obesity than children covered by private insurance Average healthcare costs for children with obesity covered by Medicaid are over $6,700, compared to roughly $2,400 for children of normal weight covered by Medicaid Obese children are far more likely to be diagnosed with mental health disorders or bone and joint disorders than nonobese children Medicaid Health Plans have required reporting of quality measures and accreditation standards, as well as incentives of cost-savings

3 Pediatric Obesity Rates th graders % of Low income 5 th graders at risk All White Hispanic Black Asian California Physical Fitness Report Contra Costa County Healthy zone Needs Improvement Needs Improvement - Health Risk

4 Multi-layered Approach to Prevention and Treatment CCHP s Go!Club uses a multi-faceted approach to identify our population of obese children and work with families, children, medical providers and community partners to improve the health outcomes of children with obesity Local medical providers CCHP Go!Club RN and health education Registered dieticians and patient educators Group appointments Community Programs and Influences Dreamstime.com

5 Contra Costa Health Plan Go! Club Disease management program Enrollment Ages 2-11 years, BMI > 95% for age Proactive identification ages 2-5 years Referral ages 6-11 years 1508 patients March 2017 Staffing RN Patient Educator Program Manager Physician Director

6 Patient Support Education and Facilitated Access Welcome packet with health information Program nurse for counseling and scheduling appointments Quarterly educational mailings containing information on healthy foods, SSBs, screen time, physical activity, recipes. Materials are also posted on CCHP website Mailings of local resources e.g. free sports classes, parks maps, summer programs, food bank information Incentives and prizes for participation in programs and clinical resources Transportation to appointments if needed

7 Primary Care Initiatives Recognition of Obesity EHR calculation of BMI Accurate weights and heights Counseling tools and prompts Physical activity, nutrition and screen time prompts Low literacy, bilingual educational materials EHR templates and order panels for labs, referrals and follow-up Resources and Referrals Local clinical resources Specialty guidelines Treatment and evaluation algorithms

8 Optimizing Clinical Resources Patient educators Motivational interviewing training Low-literacy bilingual patient materials Registered dieticians Referral protocols Shared charting Group appointments Case-finding and incentives Program consistency Program capacity

9 Community Partnerships Resources Local physical activity programs Food bank, WIC and CalFresh information Parks Low-cost sports programs Social marketing Advocacy Park assessments and improvements Lactation accommodation Healthy food and physical activity policies

10 Measuring Effectiveness: Pediatric Obesity CCHP HEDIS rates of BMI measurement and counseling BMI % Nutrition PA

11 Satisfaction: Pediatric Obesity We mail surveys to program participants families annually: Pediatric Obesity Program Satisfaction Did the Go! Club program motivate you or your family to take healthy steps and take action? Have you taken a nutrition class or health workshop in the past year? Did you make a follow up appointment with your child's doctor to talk about your child's weight goal? Has the Go! Club program helped your child lose weight? Have you found the Go! Club program useful? Were the tip sheets clear and easy to understand? Did you find the mailed health tip sheets useful? 0% 20% 40% 60% 80% 100%

12 Recent Recognition Our Pediatric Obesity Program, the Go! Club, was recognized as a best practice by Childhood Obesity Prevention and Treatment (CHOPT) project and will be included in their forthcoming toolkit. CHOPT is a collaboration between the Institute for Medicaid Innovation (IMI), Medicaid Health Plans of America (MHPA), and the Association of Community-Affiliated Plans (ACAP).

13 Resources Contra Costa Health Plan Go! Club Patient educational materials Active and Healthy Families Group appointments Healthy and Active Before 5 Childhood Obesity Prevention and Treatment for Medicaid Medicaidinnovation.org Thank you! Diane.Dooley@hsd.cccounty.us