• The annual reported rate captures activity during the previous calendar year. 
• This is a Healthcare Effectiveness & Data Information Set (HEDIS) hybrid measure.
• The DVHA Quality Unit did not complete a medical record review (MRR) for this measure in 2017. 
• The target trend line is the 50th percentile national benchmark for Medicaid programs.

This measure assesses the percentage of members 18-74 years of age who had an outpatient office visit and had their body mass index (BMI) documented during the measurement year or the year before the measurement year.

It is an important measure to monitor because obesity is the 2nd leading cause of preventable death in the United States. It is a complex, multifaceted, chronic disease that is affected by environmental, genetic, physiological, metabolic, behavioral and psychological components. Obesity affects every ethnicity, socioeconomic class and geographic region in the U.S. It is estimated that the aggregate cost of obesity ranges from 5-7% of the total of annual medical expenditures in the U.S. The rise in obesity is directly correlated to drastic increases in three major conditions: diabetes, hyperlipidemia and heart disease.

Vermont Medicaid has consistently performed below the 50th percentile national benchmark for all Medicaid programs (the measure was not produced in 2017). This measure was retired by NCQA and will be removed from the CMS Adult Core Set for the 2021 reporting period.  Reasons for retiring the measure included: loss of relevance given that automatic calculation of BMI in EHRs is now a common standard of practice and occurs at most outpatient visits. Also, the measure did not assess counseling or follow-up for patients either “at risk” or diagnosed as overweight or obese, and documentation of BMI assessment alone sets a relatively low threshold for quality care to address the nation’s ongoing obesity epidemic.  NCQA is working to identify opportunities to develop or adapt a more suitable measure.

Last updated:  April 2021

• DVHA contracted with Verscend to complete the record retrieval and rate calculations for hybrid measures.