Dedicated to reducing childhood obesity through collaborative clinical and community services, the Minnesota Partnership on Pediatric Obesity Care and Coverage (MPPOCC) was convened from 2012- 2018 by the MN Chapter of the American Academy of Pediatrics and the MN Council of Health Plans. Funding to staff MPPOCC was provided by the Minnesota Statewide Health Improvement Partnership
(SHIP). MPPOCC membership included clinicians, health plans, state and local public health, the MN Department of Human Services, and community-based pediatric obesity service providers. These organizations worked together to understand and improve reimbursement for clinic- and community-based services for children with overweight and obesity. Through increasing understanding of best
practices, collaborative decision making and pilot testing, MPPOCC built practices and tools to help providers deliver and bill health plans for best practice pediatric obesity services, including a toolkit for Community Health Worker (CHW) provision of family-based pediatric obesity services.
Recommended intensive behavioral interventions for pediatric obesity are covered
- 31.8% of US children are overweight or obese,1 and a November, 2017 study2 projects 57% of US
kids will be obese by age 35.
- The United States Preventive Services Task Force (USPSTF) recommends that “clinicians screen for
obesity in children and adolescents 6 years and older and offer or refer them to comprehensive,
intensive behavioral interventions to promote improvements in weight status.”3 These services are
required to be covered by insurance (public and private), without copays or deductibles to members.
- There are effective interventions to curb obesity trends long-term by working with kids and families in
clinic- and community-based settings, helping them adopt healthier lifestyles.
- Community Health Workers (CHWs) are uniquely trained and qualified to provide health education
and self-management support services. In MN, CHW services are reimbursed by MN Health Care
Programs, which can be a key component to service sustainability.
- The MPPOCC CHW Toolkit highlights two evidence-based models to serve children with overweight
and obesity and their families: MEND (Mind, Exercise, Nutrition…Do It!) and Smart Moves.
Sign up for semiannual pediatric obesity newsletter
The next step is for Minnesota’s clinic- and community-based providers to use MPPOCC’s tools to expand their services. Renee Gust, PHN, Hennepin County Public Health, is maintaining a list of MPPOCC members and others interested in tracking the progress of Minnesota’s pediatric obesity services implementation. Renee will also send out a semiannual newsletter to people on the list.
Contact Renee if you’d like to be added to the contact list: firstname.lastname@example.org.
Formed in 2012, MPPOCC’s purpose was to gain a better understanding of (1) clinics’ childhood obesity coverage and service packages; and (2) what the health plans would need to do to support these packages. The mission of MPPOCC was to improve pediatric obesity care and coverage by identifying effective referral pathways and advocating for reimbursement for necessary, evidence-based services.
MPPOCC participants included:
- Blue Cross Blue Shield/Blue Plus of MN
- Children’s Hospitals and Clinics
- Entira Family Clinics
- Essentia Health
- Fairview Health Services
- Hennepin County Medical Center
- Hennepin County Public Health
- Mayo Clinic
- Minneapolis Health Department
- MN Academy of Family Physicians
- Minnesota Academy of Pediatrics
- MN Dept. of Health
- MN Community Measurement
- MN Council of Health Plans
- MN Medical Association
- Park Nicollet
- Sanford Health
- Sartell Pediatrics
- University of Minnesota Health – Children’s Hospital
- YMCA – Twin Cities
- Youth Determined to Succeed
- YWCA of Minneapolis
MPPOCC Learning Collaborative learning objectives
- Increase knowledge of the formats, content and sustainability approaches of effective community-based pediatric obesity services in MN and elsewhere
- Build skills in delivering sustainable community-based pediatric obesity services
- Share MPPOCC’s efforts, accomplishments, and impacts with others in MN and around the US
Articulate policy approaches that would support an expansion of community-based pediatric obesity services.
MPPOCC Learning Collaborative materials and resources
MPPOCC Learning Collaborative Meeting: KidShape and Allina Health (January 2018)
Webinar | Allina Health KTYA Review | Allina Kids and Teens
MPPOCC Learning Collaborative Meeting: MEND follow-up, Billing and Policy (September 2017)
MPPOCC Learning Collaborative Meeting: MEND (Mind, Exercise, Nutrition, Do It!) and YMCA Healthy Weight and Your Child Pilot (July, 2017)
Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement (June 20, 2017)
“Only Through Ongoing Partnership Can We Provide Sustainable, Accessible Obesity Services for Minnesota Children,” MetroDoctors (July/Aug 2017)
MPPOCC Learning Collaborative Meeting: Evaluation (May 2017): Webinar
MPPOCC Learning Collaborative Meeting: Health Care 101 and CHW Panel (March 2017): Webinar
Pediatric Obesity Services: What’s Covered? (January 2015)
Listen to podcast | Download slides
If you have questions about MPPOCC or coverage of pediatric obesity services, email MPPOCC contact Megan Ellingson at email@example.com
If you have questions specific to individual health plans, contact provider services at:
- MN Department of Human Services 651-431-2700 or 800-366-5411
- Blue Cross Blue Shield/Blue Plus of MN 800-676-BLUE (2583)
- HealthPartners: 952-883-7699
- Medica 800-458-5512
- PreferredOne 783-847-4477 or 800-997-1750
- UCare 612-676-3300 or 888-531-1493
Providing and Billing for Childhood Obesity Services Delivered by Community Health Workers (CHWs)
31.8% of US children are overweight or obese (National NHANES data, for children 2-19 years old Ogden et. al. 2014). In November 2017, a study published in the New England Journal of Medicine projected that 57% of US kids will be obese by age 35. There are effective interventions to help curb this trend long-term by working with kids and families in clinic- and community-based settings. These services help them adopt healthier lifestyles. Community Health Workers (CHWs) are well-suited to delivering these best practice services because their focus and training is on delivering education and self-management support within a social context. In MN, CHW services are reimbursed through Medical Assistance, which can be a key component to service sustainability.
The US Preventive Service Task Force (USPSTF) recommends that “clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status.” (Intensive behavioral interventions are defined as >26 hours over 6 months.) These services are required to be covered by insurance, without copays or deductibles to the members.
This toolkit has been developed to help you decrease childhood obesity in your community by delivering CHW-led evidence-based services. It provides a step-by-step guide to adopt an evidence-based model, recruit CHWs to your team, provide intensive pediatric obesity behavioral services, and bill insurance providers for those services. The goal of this toolkit is to build healthier kids and families and to help service providers cover the costs of delivering services.
This toolkit highlights two evidence-based curricula with multiple Randomized Controlled Trials (RCTs):
There are other research-based curricula that meet the standards of CHW best practices that can also be used. For example:
It’s also important to note that kids and families need to be highly motivated to participate and succeed. Recruitment and attendance is an important issue. (The toolkit does not specifically cover this topic.)
MPPOCC Toolkit Talking Points
TOOLKIT Slides | TOOLKIT slides presentation to MPPOCC Learning Collaborative, May 16, 2018
TOOLKIT Supporting Documents
Pediatric Obesity: Referrals to Weight Management Clinics
Below are clinic- and community-based weight management programs.
Clinic-based programs Minneapolis:
YMCA Diabetes Prevention Programs
Open to non-members. Designed specifically for people who are overweight and have “pre-diabetes” or are at risk for acquiring Type 2 diabetes. Groups meet weekly for 4 months, then monthly for 8 months and cover nutrition, physical activity and behavior modification. Class locations vary. Pricing discounts/scholarships are available with proof of low income.
FIIT Kids (Families in it Together)
HealthPartners dieticians and pediatric clinicians have created a four-visit program for grade school children struggling with weight issues. This innovative new program tackles both food and activity. All clinicians can refer to this program using the Fiit Kids questionnaire. Please call HealthPartners Nutrition Services at (952) 967-6708 with any questions.
Park Nicollet Pediatric Endocrinology
Offers specialized services for children and adolescents with diabetes (type 1 and type 2), metabolic disorders related to childhood obesity, growth and puberty disorders, stimulation testing and all other endocrine disorders, including thyroid disease and adrenal disease. Call 952-993-3900 for appointments and nurse support, 8:30 a.m. to 5 p.m., Monday through Friday. Current patients can call 952-993-3123 for emergency endocrine advice outside of business hours.
Pediatric Weight Management Program at University of Minnesota
University of Minnesota’s multidisciplinary Pediatric Weight Management team offers comprehensive, sensitive, and research-based treatment to improve the health and weight status of children and adolescents
Hennepin Healthcare Taking Steps Together
Taking Steps Together (TST) is a nutrition and healthy lifestyle education program for families who are living with or are concerned about childhood obesity. Through weekly goal-setting, your family will work toward healthy lifestyle changes. Families will share their experiences, learn from each other and contribute to the growth of the program.
Clinic-based programs St. Paul:
YMCA Diabetes Prevention Programs
Open to non-members. Designed specifically for people who are overweight and have “pre-diabetes” or are at risk for acquiring Type 2 diabetes. Groups meet weekly for 4 months, then monthly for 8 months and cover nutrition, physical activity, and behavior modification. Class locations vary. Pricing discounts/scholarships are available with proof of low income.
Pediatric Weight Management Program at University of Minnesota
University of Minnesota’s multidisciplinary Pediatric Weight Management team offers comprehensive, sensitive, and research-based treatment to improve the health and weight status of children and adolescents.
HealthEast Ways to Wellness
A variety of programs and services offered.
Pediatric Endocrinology at Mayo Clinic
The Division of Pediatric Endocrinology evaluates and treats children who have glandular problems and/or inborn errors of metabolism, including those with obesity. The division is certified as a Center of Excellence by the American Diabetes Association, and uses a team approach to diabetes management, including the expertise of physicians, nurses, dietitians, social workers, and psychologists.
ACMC Bariatrics & Weight Control Center
Medical and surgical weight loss program for adults and children of all ages. Physician-supervised. Referrals are welcome, but not necessary for new patients. Clinics in Willmar and Marshall.
The IHCWSC is a small working group of the Institute that will be actively involved in moving the initiatives of the Institute forward. The Steering Committee (SC) will help translate the strategic priorities of the Institute into actual programs and initiatives.
NICHQ’s childhood obesity resources, including prevention, assessment, family, office tools and much more.
A variety of resources and materials for use in the healthcare setting.
Practical information about how to assess weight, balance calories, lose weight and prevent weight gain.