4.19.2023 Board Book

disparities in obesity treatment and care, and promote equitable outcomes.

Step-by-step progress: • Payment for obesity treatment and support can be designed around a strategy for incremental, step by step progress. For example, Category 2 is a variation on traditional fee-for-service reimbursement (offering quality-based bonuses on top of fee-for-service reimbursement), while Categories 2 and 3 progress to more ambi tious risk-sharing between providers and payers. While the HCP-LAN framework promotes standardization of APM models in the U.S. health care system, the eight APM sub-categories in the framework are also a reminder that approaches can be varied in real world practice; for example, a PMPM-based model can be complemented with specific, quality-based bonuses. Models can be “mixed and matched.” Adapting Standard Models of Value-based Payment to Patient-Centered Obesity Treatment and Support The over-arching goal for obesity payment innovations will be support for greater pa tient access to obesity treatment and support, delivered with efficiency and according to guideline-based standards. The four stages of the patient’s journey through obesity treatment and care outlined above can serve as a template for adapting payment mod els to obesity care, and suggest at least four options for provider payment that could be considered for development, testing and ultimate implementation, all four consistent with basic precepts of the HCP-LAN framework Provider payment for delivery of a core standard of care This option will require definition of a core set of obesity care processes, as well as development and validation of appropriate metrics of performance. Payment would be linked to data reporting, to performance against quality benchmarks, or both. For example, recently published research found that routine documentation of patient Body Mass Index by clinicians by itself is associated with 5-10% of patient body weight in and of itself, suggesting that pay-for-reporting of documentation and diagnosis could be an early, pragmatic, and clinically meaningful step towards payment support

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Envisioning Value-based Provider Payment for Obesity Treatment and Support