ProCare Health Plan, Inc. (ProCare) is asking for your collaboration in managing obesity among our children and adults. Pro Care is continually implementing new quality initiatives to
assist our practitioners with providing quality care to our members. Pro Care has developed and
implemented several outreach programs that include Smoking Cessation, Diabetes, Asthma, Childhood/Adolescent Immunizations and Mommy & Me.
The Michigan Department of Community Health (MDCH) and the National Committee for Quality Assurance (NCQA) requires health plans, through the Healthcare Effectiveness Data Information Set (HEDIS), to ensure members have a Body Mass Index (BMI) measurement performed. The guidelines require adults between the ages of 18 to 74 have a BMI measurement annually and children between the ages of 2 to 17 to have a BMI percentile performed. Provider offices are to provide counseling tips for nutrition and physical activity with documented evidence placed in the members medical record.
Medical Record documentation must include:
Adults 18 to 74 years old:
- Date BMI was performed
- BMI Value
- Counseling for nutrition
- Counseling for physical activities
Children less than 17 years
- BMI percentile documented as a value (85th percentile) or
- BMI percentile plotted on an age-growth chart
- Counseling for nutrition and physical activity
Pro Care constantly strives to meet your needs and the needs of our members. Pro Care’s goal over the next three (3) years is to reduce obesity among children and adults. We welcome any suggestions and questions you may have related to the BMI initiatives. Our partnership will help to improve the health of your patients.
If you have any questions regarding this initiative, please feel free to contact Ms. Gerri Toney
R.N., Director-Quality Improvement at (313) 267-0306 or toll free at 877-255-3005 or by email
at
gtoney@procarehp.com.
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