Obesity Rates are Rising – Are Your RAF Scores?
The number of states with high obesity rates has almost doubled since 2018. Not every obese patient meets the CMS risk adjustment criteria for coding Morbid Obesity, but it is probable that as overall obesity rates rise, the subset of those patients meeting the CMS definition of Morbid Obesity will also rise.
To meet the CMS criteria for Morbid Obesity, the patient must either have a BMI equal or greater than 40, or have a BMI equal or greater than 35, and less than 40, in addition to documentation of a co-existing comorbid condition(s).
According to a recent statement from the CDC, in 2018 nine states had adult obesity regularity at or above 35 percent. In 2019, that number jumped to 12 states. The 12 states were Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia. The 2020 Adult Obesity Prevalence Maps show high obesity regularity in 16 states, with the latest additions of the states of Delaware, Iowa, Ohio, and Texas.
Data also shows that adults with obesity have a higher risk for many serious health problems like heart disease, poor mental health, type 2 diabetes, stroke, and some forms of cancer.
The combined data from 2018 to 2020 from the Behavioral Risk Factor Surveillance System (BRFSS) suggests continuing racial and ethnic differences in obesity, with the highest number of states reporting obesity commonness among Hispanic and non-Hispanic Black residents.
The report indicated no states had an obesity regularity at or above 35 percent among non-Hispanic Asians. Seven states had obesity regularity among non-Hispanic whites. While, twenty-two states had obesity regularity among Hispanics, and thirty-five states, including the District of Columbia, had an obesity regularity among non-Hispanic Blacks.
The COVID-19 pandemic has heightened health inequalities and social risk factors among ethnic and racial minorities. This has caused already vulnerable populations to be affected by the pandemic in worse ways than non-vulnerable populations. Research has associated the large differences to data that suggests Black and Hispanic adults are more likely to have an underlying health condition and therefore have an increased risk for severe COVID-19 illness.
At ForeSee Medical, we noticed our clients were missing opportunities to document Morbid Obesity, this of course negatively impacted their RAF score prior to the use of the ForeSee Medical platform. To assure your providers are detecting Morbid Obesity we invite you to try our HCC risk adjustment coding software to help you discover patients with BMI greater than 35 and less than 40, plus documentation of a co-existing comorbid condition(s).
Remember, just listing a BMI value is not the best practice – take the time to document that you have discussed the Morbid Obesity diagnosis with the patient and your treatment plan.
Blog by: The ForeSee Medical Team