Best practices to elevate your standard of care for improved patient outcomes

Tier 1 medications on our formulary have a $0 copay for Medicare Advantage members, including when medications are filled through home delivery or a preferred retail pharmacy with up to a 100-day supply.

Switching your patient to a Tier 1 medication can reduce financial barriers and improve medication adherence. You may also want to consider combination products in Tier 1 to reduce pill burden. For your convenience, here are the Tier 1 medications for the Medication Adherence Star Rating measures:

<Back>

By initiating conversations about weight management, you can empower your patients to improve their overall health and reduce their risk of chronic conditions.

Best practices for initiating conversations with patients
Discussing weight can be a sensitive topic for patients.

• Ask for permission before discussing weight-related topics
• Use open-ended questions like: Would you be open to discussing how your current weight might be impacting your overall health?
• Focus on health benefits of weight management rather than weight loss alone
• Frame conversations around health risks rather than appearance

Connecting patients to behavioral health providers
Mental and emotional well-being are fundamental to successful weight management. Consider:

• Referring patients to in-network behavioral health providers for comprehensive support
• Directing patients to virtual care options available through their member account on regence.com
• Addressing underlying emotional factors that may contribute to weight challenges

Addressing health disparities in weight management
Certain populations—such as racial and ethnic minorities, low-income communities and individuals with disabilities—are disproportionately affected by obesity and related health conditions. To address these disparities:

• Address language barriers by providing multilingual resources
• Consider cultural food preferences when discussing nutrition

Social determinants of health (SDoH), such as food insecurity and lack of access to safe physical activity spaces, can also impact weight management. You can help address these factors by connecting patients with local resources, such as food banks or nutrition assistance programs, and recommending safe and accessible physical activity spaces in the patient's home and community.

Measuring BMI
Measuring your patients’ body mass index (BMI) regularly may help you identify who may benefit from weight loss information and counseling.

• Measure BMI regularly to identify patients who may benefit from weight management support
• Utilize EMR alerts for automatic BMI calculations when available
• Use proper coding practices:
  • Include obesity diagnosis codes (ICD-10 E666.1-E666.3, E666.8, or E66.9)
  • Add corresponding BMI Z codes for comprehensive documentation

Resources
Find helpful resources in English and Spanish to share with your patients by searching for the Maintaining a Healthy Weight category in our Quality Improvement Toolkit.

Our Health Equity Toolkit includes resources to address health disparities and advance health equity.

<Back>

As daylight hours shorten, days get gloomier and temperatures drop, many people experience what's commonly called the "winter blues." But for about 5% of people in the U.S., these seasonal changes trigger seasonal affective disorder (SAD).

Proactively screening patients this time of year is essential for identifying individuals at risk. Early detection through routine exams enables timely intervention, which can improve patient outcomes by facilitating prompt access to effective treatments.

Key signs and symptoms to screen for SAD
Symptoms of SAD often mirror those of depression, but their cause is linked to seasonal changes. Doctors should be alert for the following symptoms, particularly at this time of year:

• Persistent feelings of sadness or hopelessness
• Loss of interest in activities they usually enjoy
• Feeling sluggish or fatigued
• Being restless or agitated
• Changes in sleep patterns, often oversleeping
• Difficulty concentrating
• Changes in appetite, particularly craving carbohydrates or overeating
• Social withdrawal

Screening can fit your schedule
Consider these steps when seeing patients during regular exams:

• Ask about mental health issues during the physical exam. Proactively inquire about mood, sleep, appetite and energy levels.
• Check for symptoms of depression. Ask patients about their thoughts, feelings and behavior patterns.
• Use validated screening tools. The Seasonal Pattern Assessment Questionnaire and the Patient Health Questionnaire 9 (PHQ-9) are recommended for quick depression assessment.
• Offer evidence-based treatments. SAD can be treated using traditional forms of care, such as therapy and antidepressant medication. Patients may also benefit from light therapy, vitamin D supplements and lifestyle changes.

Toolkits and resources on our provider website

• Behavioral Health Toolkit: The PHQ-9 is available in the Depression section of the toolkit, which includes support for treating many types of behavioral health conditions.
• Quality Improvement Toolkit: Share patient education materials from Healthwise’s Knowledgebase, which has helpful information about SAD (available in English and Spanish)

• Health Equity Toolkit: Racial and ethnic groups, the LGBTQIA+ community, people with lower socioeconomic status, and other underrepresented and underserved groups experience disparities in behavioral health diagnosis, access to care and treatment. This toolkit includes resources to address these behavioral health care disparities, as well as continuing medical education (CME) opportunities.

<Back>