Utilization of Nutrition Services within the Managed Care Setting

Abstract

LEARNING OUTCOME: To recognize the need for dietetic professionals to market systematic nutrition care in health maintenance organizations. The purpose of this study was to examine if and how nutrition services, such as initial screenings, individual counseling and group sessions, are utilized within the health maintenance organizations (HMOs) in the northeast region (ME, VT, NH, RI, MA, CT, NY, NJ) of the United States. A questionnaire was distributed to administrators and medical directors, thus purposefully focusing on administrative decision-makers. Of the 83 HMOs surveyed, a total of 27 questionnaires were returned and analyzed. The results indicated that 93% (n=25) of the respondents offered nutrition services. Of those offering nutrition services, 87% reported that dietitians/nutritionists provided the services; 90% of these HMOs required that nutrition staff have RD credentials. Of those offering nutrition services, 92% reported incorporating nutrition services into their basic coverage plan. Only 13% reported that nutrition screening was a standard procedure for all subscribers. Results from this study indicate that HMOs offer nutrition services to their subscribers, but most do not have a standard nutrition screening procedure. Thus, in general no systematic procedure is in place to identify subscribers who could be at nutritional risk. The findings provide insight into the utilization of nutrition services within the HMOs surveyed. Continued aggressive attempts by dietetic professionals are needed to educate physicians and administrators of HMOs to understand the benefits of timely nutrition screening/assessment and intervention and its potential in reducing health care costs.