Help Your Medicare Patients “Bite into a Healthy Lifestyle”

CMS reminds health care professionals that March is National Nutrition Month®- a time to “Bite into a Healthy Lifestyle” with informed food choices now and throughout the year. This year’s theme encourages consumers to adopt a healthy lifestyle that is focused on consuming fewer calories, making informed food choices, and getting daily exercise in order to achieve and maintain a healthy weight, reduce the risk of chronic disease, and promote overall health.

Nutrition related health conditions are prevalent within the Medicare population. Twenty-eight percent of Medicare beneficiaries have diabetes and fifteen percent have chronic kidney disease. More than one-third of American men and women are obese, and adult obesity is associated with a number of serious health conditions, including heart disease, hypertension, diabetes, and some cancers.

Registered dietitians and nutrition professionals are key providers of nutrition services. They can play a critical role in helping your Medicare patients put together a comprehensive and achievable lifestyle-based eating plan based on their health history, food preferences and routine that can help improve their health and prevent and manage many health conditions.

Medicare provides coverage for the following nutrition-related health services:

  • Medical Nutrition Therapy (MNT)

Medicare provides coverage of MNT for certain beneficiaries diagnosed with diabetes and/or renal disease*, when referred by the treating physician and provided by a registered dietitian or nutrition professional.

  • Diabetes Self-Management Training (DSMT)

Medicare provides coverage of DSMT services for beneficiaries who have been diagnosed with diabetes. DSMT services are intended to educate beneficiaries in the successful self-management of diabetes. A qualified DSMT program includes among other services education about nutrition, diet, and exercise.

  • Intensive Behavioral Therapy (IBT) for Obesity

Medicare provides coverage of Intensive Behavioral Therapy for Obesity for qualifying beneficiaries whose body mass index (BMI) is equal or greater than 30 kg/m2. This coverage includes Screening for obesity in adults using measurement of BMI, a Dietary (nutritional) assessment, and intensive behavioral counseling and behavioral therapy to promote sustained weight loss through high intensity interventions on diet and exercise. This coverage includes one face-to-face visit every week for the first month, one face-to-face visit every other week for months 2-6, and one face-to-face visit every month for months 7-12, if the beneficiary meets the 3kg (6.6 lbs) weight loss requirement during the first 6 months.

  • Intensive Behavioral Therapy for Cardiovascular Disease

Medicare provides coverage of IBT for cardiovascular disease (referred to as a CVD risk reduction visit). The visit consists of the following three components:

  • Encouraging aspirin use for the primary prevention of cardiovascular disease when the benefits outweigh the risks for men age 45-79 years and women 55-79 years;
  • Screening for high blood pressure in adults age 18 years and older; and
  • Intensive behavioral counseling to promote a healthy diet for adults with hyperlipidemia, hypertension, advancing age, and other known risk factors for cardiovascular and diet-related chronic disease.
  • Annual Wellness Visit

The Annual Wellness Visit is a visit focused on prevention and provides health professionals the opportunity to provide eligible Medicare beneficiaries with personalized health advice, a written screening schedule (such as a checklist) and referrals, as appropriate, to health education, preventive counseling services, and community-based lifestyle interventions, focusing on reducing health risks and promoting self-management and wellness, including weight loss, physical activity, smoking cessation, fall prevention, and nutrition.

Your Help is Needed

As a health care professional who provides care to people with Medicare, you can help your Medicare patients live healthier lives in 2015 by encouraging the appropriate use of the above Medicare-covered services. These services present excellent opportunities to begin a dialogue with your Medicare patients about how their eating habits may affect their health, and make recommendations for preventive services that can help them reach their nutrition and dietary goals. Remember to provide any appropriate written referrals, such as referrals to registered dietitians or nutrition professionals for MNT services.

For More Information

* Note that, for the purpose of this benefit, renal disease means chronic renal insufficiency or the medical condition of a beneficiary who has been discharged from the hospital after a successful renal transplant for up to 36 months post-transplant. Chronic renal insufficiency means a reduction in renal function not severe enough to require dialysis or transplantation [Glomerular Filtration Rate (GFR) 13-50 ml/min/1.73m2].

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