Weight Assessment and Counseling
for Nutrition and Physical Activity for
Children and Adolescents
September 30, 2010
Presented by:
Healthcare Outcomes and Analysis
LA Care Health Plan
WCC Presentation
0
Presentation Purpose:
•Best Practices for documenting record for the new
measure “Weight Assessment and Counseling
for Nutrition and Physical Activity for
Children and Adolescents (WCC)”
•Proper documentation of WCC visit(s) reflect a better
quality of care for patients and a positive feedback for
providers’ participation to encourage children and
adolescent wellness.
WCC Presentation
1
WCC - Background:
Obesity In Children and Teens
The problem of childhood obesity in the
United States has grown considerably in recent
years.
Statistics/Facts:
•Between 16 and 33 percent of children and
adolescents are obese.
•Obesity is among the easiest medical conditions to
recognize but most difficult to treat.
•Unhealthy weight gain due to poor diet and lack
of exercise is responsible for over 30,000 deaths
each year.
•The annual cost to society is estimated at nearly $100 billion.
•Overweight children are much more likely to become overweight adults unless
they adopt and maintain healthier patterns of eating and exercise.
WCC Presentation
2
WCC – Background (contin.):
According to a study conducted by CDC in 2004, 16% of
children (over 9 million) 6-19 years of age are overweight or
“obese.” This number is three times the population in 1980. 1
In addition to the three-fold increase, obesity has “more than
doubled” in both children and adolescents from ages 2-5 and
also ages 12-19. Similarly, the population more than tripled
in children between 6-11 years old in the past three decades
(according to this same study). 2
References:
1. Obesity In Children and Teens, American Academy of Child and
Adolescent Psychiatry, May 2008
2. Prevalence of overweight and obesity among children and
adolescents: United States, CDC, 2004
WCC Presentation
3
WCC – Background (contin.):
Weight Assessment and Counseling for Nutrition
and Physical Activity for Children and Adolescents
(WCC):
• Is one of the newest HEDIS measures developed by
the National Committee for Quality Assurance (NCQA)
The measure consists of three (3) indicators:
•Body mass index (BMI)
•Counseling for Nutrition
•Counseling for Physical Activity
WCC Presentation
4
WCC - Body Mass Index (BMI)
Indicator Documentation:
1.
Body Mass Index – documentation in
the medical record should include
date and BMI percentile &/or value
depending upon the child’s age
•BMI norms vary for children between
the ages 3 to 15 years, so the BMI
percentile should be recorded, not
just the value.
•For 16-17 years of age, BMI value is
acceptable.
WCC Presentation
5
WCC - BMI Indicator Calculation:
The formula used to calculate BMI is as follows:
Weight in Pounds
BMI = ( (Height in inches) x (Height in inches) )x703
The pediatric height and weight charts can be found
on the CDC website at:
http://www.cdc.gov/growthcharts/data/set1clinical/set1color.pdf
WCC Presentation
6
WCC - Counseling for Nutrition
Indicator Documentation:
2. Counseling for Nutrition
Documentation must include a note indicating the date and
at least one of the following:
•Discussion of current nutrition behaviors
(e.g., eating and dieting behaviors)
•Checklist indicating nutrition was assessed
•Counseling or referral for nutrition education
•Member received educational materials on nutrition
•Anticipatory guidance for nutrition
WCC Presentation
7
WCC - Physical Activity Indicator
Documentation:
3. Counseling for Physical Activity
Documentation must include a note indicating the date
and at least one of the following:
•Discussion of current physical activity behaviors
(e.g., exercise routine, participation in sports
activities and exam for sports participation)
•Checklist indicating physical activity was addressed
•Counseling or referral for physical activity
•Member received educational materials on physical
activity
•Anticipatory guidance for physical activity
WCC Presentation
8
WCC – Best Practices for
Documentation:
• BMI Don’ts
• No BMI or BMI percentile
documented in the medical record
or plotted on age-growth chart
• Notation of height and weight
only
• BMI or BMI percentile noted
before or after the measurement
year
• Entries on the BMI growth charts
without an affiliated date
• Nutrition and Diet Don’ts
• No counseling/education on nutrition
and diet
• Counseling/education before or after
the measurement year
• Notation of “health education” or
“anticipatory guidance” without any
specific mention of nutrition
WCC Presentation
9
WCC – Best Practices for
Documentation (contin.):
• Physical Activity Don’ts
• No counseling/education on
physical activity
• Notation of “cleared for gym
class” alone without any
documentation of a discussion
• Counseling/education before or
after the measurement year
• Notation of “health education”
or “anticipatory guidance”
without any specific mention of
physical activity
WCC Presentation 10
WCC – Best Practices for
Documentation (contin.):
• Take advantage of any
type of member visit,
whether it’s for a wellchild visit or sick visit to
assess and counsel your
patient on their BMI,
nutrition, and physical
activity.
WCC Presentation 11
For questions, please contact:
Carina Yapyuco, RN
cyapyuco@lacare.org
Theresa Colom, LVN
tcolom@lacare.org
WCC Presentation 12