Description: 

The percentage of members 3–17 years of age who had an outpatient visit with a PCP or OB/GYN and who had evidence of the following during the measurement year.

BMI percentile documentation*.

Counseling for nutrition.

Counseling for physical activity.

Because BMI norms for youth vary with age and gender, this measure evaluates whether BMI percentile is assessed rather than an absolute BMI value.


Denominator: 

Product lines
Commercial, Medicaid (report each product line separately).
Ages
3–17 years as of December 31 of the measurement year. Report two age stratifications and a total for each of the three indicators:
3–11 years.
12–17 years.
Total.
The total is the sum of the age stratifications.
Continuous enrollment
The measurement year.
Allowable gap
No more than one gap in continuous enrollment of up to 45 days during the measurement year. To determine continuous enrollment for a Medicaid beneficiary for whom enrollment is verified monthly, the member may not have more than a
1-month gap in coverage (i.e., a member whose coverage lapses for 2 months [60 days] is not considered continuously enrolled).


Anchor date
December 31 of the measurement year.
Benefit
Medical.
Event/diagnosis
An outpatient visit (Outpatient Value Set) with a PCP or an OB/GYN during the measurement year.



Numerator: 

BMI Percentile

BMI percentile (BMI Percentile Value Set) during the measurement year.

Counseling for Nutrition

Counseling for nutrition (Nutrition Counseling Value Set) during the measurement year.

Counseling for Physical Activity

Counseling for physical activity (Physical Activity Counseling Value Set) during the measurement year.


Exclusions (optional):

Members who have a diagnosis of pregnancy (Pregnancy Value Set) during the measurement year. The denominator for all rates must be the same. An organization that excludes these members must do so for all rates.