AMA Opens Door to Addressing Obesity in Primary Care

Any regular reader of these pages by now must be well aware of the complexity of obesity and its management.

Not only is obesity often the “root cause” of other chronic conditions, but the paths to obesity are multiple and the management strategies are anything but straightforward (though effective when implemented correctly).

Furthermore, as I have always proposed, long-term management of obesity belongs in primary care.

It is therefore only fitting that since April 1 2009, the Alberta Medical Association has introduced a new health service (billing) code for family physicians who deal with complex obese patients (click here for fact sheet).

According to this code (03.04J), family doctors are allowed to bill an extra $206.70 annually per patient for the extra time taken to develop and monitor a complex care plan that includes specific interventions and goals, especially with the involvement of allied health team members. The care plan should be specific and must be signed by both doctor and patient (click here for template).

The code can be claimed for any obese patient who presents with hypertension, diabetes, COPD, asthma, heart failure, or ischemic heart disease.

Importantly, this code does not prevent the doctor from also claiming the usual codes (and complex modifiers) for these conditions.

For patients with obesity and complications (= Edmonton Obesity Stage 2 or greater), this code will hopefully provide reimbursement for time spent on discussing the contributors, barriers and interventions for weight management (and not just optimization of the comorbidity).

Will doctors know how to appropriately address obesity? Most probably don’t, but at least now there is a clear financial incentive for them to learn how to begin managing this important health issue.

Recently the Canadian Medical Association recognized the Canadian Obesity Network as its key partner in rolling out obesity prevention and management strategies (CMA Looks to CON for Obesity Solutions, Aug 29, 2008). Clearly, now is the time for the Network to partner with the Alberta Medical Association to ensure that complex patients struggling with obesity-related chronic disease receive evidence-based advise and support from their family physicians and their care teams to manage their weight.

Edmonton, Alberta