Medicaid Managed Care and Childhood Obesity Prevention: A MultiLevel Intervention Model

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Medicaid Managed Care and Childhood Obesity
Prevention A Multi-Level Intervention Model

• Nancy Wongvipat, MPH
• Anita Keneipp, MS
• Bruce Chernof, MD, FACP
• Peggy Haines, RN
• Health Net of California
• State Health Programs
• Presentation to
• American Public Health Association
• 131st Annual Meeting, San Francisco
• November 19, 2003

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Overview

• Health Net
• Overview of Childhood Obesity
• Weight Management-Be In Charge!sm Program for
  Children and Adolescents
• Teen Body Image Pilot Intervention
• Community Partnerships

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Background (HNT)

• Health Net, Inc. (HNT) is one of the nations
  largest publicly traded managed health care
  companies. Its mission is to help people be
  healthy, secure and comfortable.
• 5.3 million members in 15 states through group,
  individual, Medicare, Medicaid and TRICARE
  programs.

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Background (HN-CA)

• Health Net of California (HN-CA), a subsidiary of
  Health Net, Inc., is one of the largest
  network-model health plans in California, serving
  more than 2 million members statewide.
• Contracts with approximately 44,000 physicians,
  400 hospitals and 4,300 pharmacies.

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HN-CAs State Health Programs

• CA Department of Health Services (DHS) and the
  Managed Risk Medical Insurance Board (MRMIB) for
  Medi-Cal (MC) and Healthy Families Program (HFP)
  services.
• MC and HFP operations in seven (7) California
  counties and (44) service areas. 600,000
  MC/100,000 HFP members.

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SHPs Health Education Dept

• Provides appropriate health education programs,
  materials, and services to its MC and HFP members
  based on community health, cultural, and
  linguistic needs.
• Works closely with medical management, community
  relations, quality improvement and cultural and
  linguistics services teams.

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Prevalence of Overweight Among U.S. Children and
Adolescents (Ages 6-19 Years)
CDC/NCHS, NHES and NHANES
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Obesity-Associated Annual Hospital Costs
(Aged 6 to 17 Years)
Wang, G, Dietz W, Economic burden of obesity in
youths aged 6 to 17 years1979-1999. Pediatrics,
1095 May 2002.
Pediatrics, 1095 May 2002
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Weight Management-Be In Charge!sm
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Weight Management-Be In Charge!sm
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Teen Body Image Pilot-Overview

• Whats Up With Body Image magazine
• 1000 teen members ages 12-17 in LA
• 10-item evaluation survey BRC with 10 Tower
  Records incentive to first 20
• 52 evaluation survey respondents

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Teen Body Image Pilot-Evaluation Highlights

• Profile age 15, 53, 128lbs, 75 female, 22.5
  BMI 33His/31Af/19As/17Cau
• 62green/15orange/17red/6underwt
• 29 reported having tried ways to lose or gain
  wt.
• Self-ranking of satisfaction with body image
  after reading the magazine significantly
  increased (paired-samples test).
• Eating habits are decided by what my parents
  serve me (67) and if I feel hungry (69).
• I get most of my health info from my doctor (56).

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Teen Body Image Pilot-Evaluation Highlights
(cont.)

• Minority teens tended to be more overweight than
  Caucasian teens (23-29 As/Af/Hisp in red vs. 0
  Caucasian), while males tended to be more
  overweight than females (38 males in red vs. 19
  females)
• 85 found info in magazine very or somewhat
  useful.
• 35 reported making changes to own body image in
  last six months, with change as exercise or
  healthier eating.

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Community Partnerships

• FITWIC Task Force Nutrition Subcommittee
• LA Region Project LEAN
• 5 -A- Day POWERPLAY
• Los Angeles Collaboration for Healthy Active
  Children
• Sacramento childhood obesity Prevention Task
  Force
• Coalition on Children and Weight-San Diego County
• Fresno/Madera Medical Society Alliance
• Health fairs and health education classes
  (Headstart, other CBOs)