Be a HEDIS HERO for Childhood Wellness

The National Committee for Quality Assurance (NCQA) is a non-profit organization that measures the quality of healthcare across large populations. NCQA does this through its Health Effectiveness and Data Set, also known as HEDIS. HEDIS measures are a set of evidence based standards that Texas Children’s Health Plan is committed to improving upon in order to provide the best care for our members.

Making changes across your patient population is easier than you think! In fact, you can become a HEDIS HERO by simply providing preventative care to children and teens that addresses healthy habits.

The HEDIS “WCC” measure—Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents—was developed to address the ever-growing epidemic of childhood obesity. The health care provider plays a key role in guiding children and adolescents toward healthy behaviors. Use correct medical record documentation to ensure that your efforts are acknowledged.

Completing the following elements annually for all patients ages 3 to 17 will enable you to meet the WCC measure and improve your young patients’ chances at a healthier life:

MEASUREMENT OF BMI

• For children ages 3 to 17 years, this should be documented as a percentile or plotted on a growth chart.
• Ranges and thresholds such as 85-95% or >95% are not HEDIS-acceptable.

DISCUSSIONS OF CURRENT NUTRITION AND PHYSICAL ACTIVITY BEHAVIORS

• At a minimum, discuss eating habits, exercise/sports routines, and daily screen time.
• Document your own counseling, anticipatory guidance, and/or referrals to a nutritionist or a Texas Children’s Health Plan program such as “Keep Fit.” A weight or obesity counseling referral will satisfy both the nutrition and physical activity components.
• Have educational handouts available and document how your offices uses them. Materials can be obtained at BrightFutures.AAP.org, AgesAndStages.com, and CDC.gov.

TIPS FOR BEING A WCC MEASURE HEDIS HERO:

• Implement a checklist or health maintenance flow-sheet (EMR) to capture the dates of service upon which you addressed these topics.
• If you have patients who are challenged to arrange an annual well-visit, use sick visits as an opportunity to provide wellness-focused advice. To fulfill criteria, these counseling sessions cannot be geared toward the presenting complaint for which the visit was intended, and must occur each measurement year.