08-03-2023_BoardBook

Appendix 3. White Paper

Obesity Quality Measure Landscape and Project Update

Tracy ML Zvenyach, PhD, MS, RN, Christine Gallagher, MPAff, William H Dietz, MD, PhD

Abstract

Obesity disease severity and chronicity have worsened across the population, year over year.

Healthcare quality measures linked to value have become more common in payer policies, but they

remain widely absent in the context of obesity care. There are two process measures used in federal and

state healthcare quality reporting and payment programs. No obesity outcome quality measure has ever

reached endorsement or implementation into payment programs. Recent obesity quality measure

projects have made progress in the development process. Experts and stakeholders must come together

to reach alignment on a roadmap and strategy for obesity quality measure development and

implementation efforts.

Introduction

In the United States (U.S.), measurement of obesity prevalence is well established with population

data collection since the 1960s. Obesity has reached new heights in adults (42%), and even higher rates

among non-Hispanic Black (49.9%) and Hispanic adults (45.6%) (NHANES, 2021). Obesity is increasingly

recognized as a complex and chronically progressive disease. Nonetheless, obesity care and treatment

coverage are scarce, while disease severity and chronicity worsen year over year across groups.

Alternative payment models were established as a major policy reform to improve healthcare

quality by changing payment and clinical care delivery incentives. Pay-for-reporting and pay-for

performance programs have increased payments linked to value and quality measurement. In 2021, the

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