Obesity Management: Starting the Conversation: Tips for Assessment, Counseling and Reimbursement

Why do so few patients with obesity receive behavioral counseling? Physicians are not taught how to create a dialogue with patients, and reimbursement for obesity counseling tends to be low. In this interactive workshop, you will learn:

• How to assess obesity in a health check up
• How to provide obesity counseling using the 5 As (Assess, Advise, Agree, Assist and Arrange)
• How to document 5 As obesity counseling based on Medicare preventive service criteria

This workshop will also include a discussion on reimbursement for obesity counseling. During the discussion you will learn:

• CMS guidelines for weight management in clinical setting
• Documentation for optimal reimbursement
• CPT and E/M code impressions

By the end of this interactive workshop, participants will be able to:

• Understand the 5As model (Assess, Advise, Agree, Assist, Arrange) and how it can be used to Primary care practice to manage obesity
• Use motivational interviewing tools and SMART goals to improve likelihood of engaging patients in weight management activities
• Address barriers to behavior change including health literacy
• Document 5As counseling for Medicare reimbursement
• Use obesity guidelines to improve patient care

Workshop Leaders:
Mary DiGiorgi, MPH, PhD, Assistant Professor of Human Nutrition in Surgery; Associate Director, Medical Nutrition Program for Health Professionals, Institute of Human Nutrition, Columbia University, is an educator and clinical investigator whose research focuses on health outcomes of weight loss surgery. She will address the current obesity management guidelines.

Melanie Jay, MD, MS, Assistant Professor of Medicine and Population Health Departments of Medicine and Population Health, NYU School of Medicine / Veterans Affairs Medical Center, is a general internist and clinical investigator whose research focuses on improving how we treat and prevent obesity in primary care. She has studied the impact of 5As-based training interventions on patient weight loss. She is currently testing a technology-assisted 5As intervention for health care teams. She will provide an overview of the 5As model, discuss the evidence behind the model, and how it can be used in every day practice to improve patient care, using counseling strategies.

Shonna Yin, MD, MS, Assistant Professor of Pediatrics and Population Health Departments of Pediatrics and Population Health, NYU School of Medicine / Bellevue Hospital Center, is a general pediatrician, health literacy expert, and researcher focused on the design and evaluation of health literacy-informed interventions; much of her work has focused on improving provider-parent communication. She will discuss health literacy barriers to effective obesity counseling.

Shari LeFauve, MS, PA-C, Physician Assistant, General Medicine, will share her experience with obtaining reimbursement for obesity management as a primary care provider. She will also contribute tips for practitioners to help patients incorporate diet and lifestyle changes into their busy schedules during the interactive session.

About the Workshop Leaders:
Mary DiGiorgi, MPH, PhD, is an Assistant Professor of Human Nutrition in the Department of Surgery at Columbia University Medical Center, with a research interest in long term outcomes of bariatric surgery, including weight regain and re-emergence of diabetes. She is also the Associate Director of the Medical Nutrition Program for Health Professionals at Columbia's Institute of Human Nutrition, where she teaches courses in behavior counseling, clinical nutrition, medical nutrition management, and research methodology, and also mentors many graduate and health professional students. She studied Human Nutrition, Epidemiology and Nutritional Epidemiology at Columbia University.

Shari LeFauve, MS, PA-C, is a physician assistant and graduate of the Yale Physician Associate Program with more than 25 years of clinical medicine experience in Western New York, a region with some of the highest rates of obesity and cardiovascular disease in New York State. In order to be more effective in the provision of weight management directives, she completed her Master’s Degree at Columbia University’s Institute of Human Nutrition. She has focused her practice on obesity management and has documented her personal experience with implementing the 2013 AHA/ACC/TOS Obesity Management Guidelines. In her solo practice, she has demonstrated that despite barriers, her severely obese patients did achieve significant behavioral change and reduction in waist circumference. Her findings were presented at The Obesity Society conference in Los Angeles, November 2-7, 2015 where her clinical strategy as well as reimbursement experience received considerable attention.

Melanie Jay, MD, MS, is a general internist whose research focuses on the treatment and prevention of obesity in primary care. She graduated from the University of Pennsylvania in 1994 where she received a bachelor's degree in the Biological Basis of Behavior. She completed medical school, residency, and chief residency at New York University School of Medicine. While in residency, she became interested in improving obesity care and started a multidisciplinary weight management program at Bellevue hospital. After residency, she started a similar program at Gouverneur Hospital. Realizing that she wanted to pursue a research career, Dr. Jay completed a CDC-funded fellowship in Medicine and Public Health Research from 2007-2009 where she received a Master's Degree in clinical investigation. She currently has a career development award through the Department of Veterans’ Affairs to develop 5As-based weight management interventions within the Veteran’s Affairs patient-centered medical home model of primary care.

Shonna Yin, MD, MSc, is a general pediatrician and an Assistant Professor of Pediatrics and Population Health at the NYU School of Medicine. She is a NIH-funded investigator whose research interest centers on the issue of health literacy and its implications for child health. A large focus of her work involves designing and evaluating low literacy strategies to improve child health outcomes. Areas of expertise include medication safety, asthma management and obesity prevention. Dr. Yin was a Robert Wood Johnson Foundation Physician Faculty Scholar (2009-2012), and recipient of the Pfizer Fellowship in Health Literacy / Clear Health Communication (2007-2009).  She serves on the FDA’s Risk Communication Advisory Committee as well as the Executive Committee of the AAP’s Committee on Quality Improvement and Patient Safety.