08-03-2023_BoardBook

Recommendations/Next steps

1) Follow efforts of the MNCM obesity measure development

The Minnesota Community Measurement (MNCM) is currently working in collaboration with the Endocrine Society with grant funding from Novo Nordisk to develop and test obesity related measures. MNCM began with reviewing the measures tested during the Obesity Care Model Collaborative by the American Medical Group Association (AMGA). MNCM convened a small working group of clinical experts (Specifications Engineering Group - SEG) and a larger Technical Expert Panel to review specifications of these and other measures. They narrowed the number of measures and solicited public comment in January 2022. Pilot testing for feasibility and value of the measures began in 2023.

The four measures currently being tested are:

1. Obesity Prediabetes and Diabetes A1c Control 2. Obesity Diagnosis 3. Obesity Weight Loss with Medications 4. Obesity BP Control

The measures are being tested to assess their reliability, validity, feasibility and demonstrable variability and opportunity for improvement. This pilot testing should conclude the end of 2023, and they expect pilot results in mid-2024. If there are any measures that come out of the testing that they think are ready for consideration, MNCM will have the opportunity to submit them to the CMS Measures Under Consideration (MUC). The deadline to be submitted to the MUC is May 15, 2024. It could be another year after that before we know if CMS will add it as a candidate measure. We have had two follow up conversations with the staff at MNCM and the Endocrine Society, who are the stewards of this measure development. They told us that there is no funding currently available for moving forward with the measure development process after the pilot testing phase ends. It will be important to follow what happens at the conclusion of the pilot testing and determine if there is interest in supporting a measure(s) for consideration by the MUC. Such support may require additional funding.

2) Convene a meeting to reach consensus on measures of obesity for pediatrics and adults

During the working group meetings, there were robust discussions about BMI and the problems with using BMI to diagnosis obesity. Participants noted research that has shown it is important for patients to receive a diagnosis of obesity to be successful with treatment of their obesity. The group discussed other options besides BMI that could be used to classify a patient’s obesity (Class 1, 2,3) at diagnosis.

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