The MNT Provider includes articles on topics such as billing, coding and coverage, CMS updates and releases, practice and business management, health care reform, Medicare, Medicaid and private insurance reimbursement, and is free to Academy members. Click the image here to access even more MNT Provider newsletters.
Are you an RDN who performs medical nutrition therapy? Are you responsible for billing in a facility where RDNs use medical nutrition therapy? The Academy seeks to empower dietetics professionals — including billing personnel — to expand coverage and receive competitive reimbursement for quality nutrition services.
See this great INFO SHEET for more.
Celebrating a Centennial Anniversary is always special, and the Academy (AND) did it well at the October 2017 FNCE meeting in Chicago. Donna Martin, Academy president showed us how far we’ve come since the beginning of our organization as indicated by the photos. I want to challenge each of you, ArAND member or student, to express a centennial-size appreciation to the Academy during our ArAND Fundraising effort by donating dollars according to where you stand in your career path.
I recommend each RDN or NDTR donate $1 for each year you have been a RDN or NDTR. For example, I became a RD in 1976 so I will donate $42. For students or interns I recommend you donate $1 for your year of study. If you are a sophomore, donate $2. And if you are a senior, donate $4. For dietetic interns, donate $5. Of course, we appreciate and will accept any donation in any amount you can make!
For those attending the ArAND AME meeting you can donate in person. If you are unable to attend this year, here is the link where you can donate by credit card. If you prefer, mail a check to: ArAND, PO Box 55234, Little Rock, AR 72215, and indicate in the note section that it is for the Foundation Anniversary Challenge. (Check is to be made out to ArAND.)
Why does it matter? All the monies collected will be donated to the Academy of Nutrition and Dietetics Foundation as a kick start for the Second Century. The Foundation provides for scholarships, awards, research, public education, international resources & opportunities and Second Century.
To read more about Why It Matters, click on the https://eatrightfoundation.org/why-it-matters/.
Ruth Johnston, MS, RD, LD, FAND
ArAND Fundraising Chair
Check out the Farm to School fliers and learn how you can get involved.
By: Jennifer Shelton
Healthcare reimbursement has recently made a 180 degree change. If you haven’t heard of terms such as MACRA, CPC+, Value Based Care, or Pay for Performance, then you must make it a priority to watch the news and perform some internet research. If you have heard of these terms, keep reading as there may be a few new key points worth knowing. The main focus of this article is to discuss a fairly new role for Registered Dietitians in an outpatient setting, specifically Family Practice and Pediatrics, called a care coordinator.
I’m speaking from experience when I reference most of the key points in this article. I had the opportunity to serve as a Care Coordinator in a Family Practice clinic a few years ago, and I am now employed as a Practice Transformation Coach for clinics functioning in a similar model that I participated in. This has all been made possible by a significant change in healthcare reimbursement trending from the “Fee for Service” world to “Pay for Performance.”
What does this mean? I know it can be confusing to many of us who aren’t used to dealing with reimbursement. The traditional way to reimburse for healthcare is fee-for- service. This means a patient receives a service by a provider and the provider bills the appropriate code to the insurance company for reimbursement. One issue with this way of billing is the quality provided to the patients isn’t measured. As healthcare costs and the rate of comorbidities continue to rise, payers had to create a model of reimbursement that ensures the patient/member is receiving the care they deserve. Therefore, providers are now required to submit quality measures to CMS on their patients and services in order to prevent a reduction in payments. There are several models and programs that are based on this concept. The models vary by payer and state.
A specific model that incentivizes practices that focus on quality and transforming the patient’s experience is known as the Patient-Centered-Medical Home (PCMH) model. This is not a new model of care, as it was invented in the late 1960s; however, it is a new model that has recently received recognition for reimbursement by many payers in Arkansas. There are a few program choices for practices in Arkansas, including The State Medicaid PCMH, Arkansas Blue Cross PCMH, and the CMS led-multi-payer Compressive Primary Care Plus (CPC+).
The PCMH model focuses on the individual patient by including their preferences and goals, utilizing a healthcare team, coordinating care with specialists, and including aspects of the community. A Care Coordinator is an integral part of the healthcare team that is often funded by these value-based care models. As a Registered Dietitian Nutritionist, you may think this isn’t the job for you; however, many of the job duties listed for Care Coordinators include common core concepts RDNs are educated and trained in. Here are some examples of duties you may find listed for a Care Coordinator: chronic disease education and management, care plans, transitions of care from the hospital to home, behavioral change counseling, etc. These job descriptions vary by provider, clinic, system, and program and can often be adapted to fit the needs of the population served. Since RDNs have the medical and counseling background, this can be an ideal position for those who enjoy working in an outpatient setting.
As far as reimbursement goes, there are a few ways to reimburse the RDN in the practice. Many clinics employee the RDN and pay a yearly salary supported by the funds received in the value-based program. The clinic can chose whether or not they will bill for the RDNS services under this model. Another option is contracting RDNs for a selected amount of time for an hourly wage or allowing the RDN to bill under their own NPI.
Like I mentioned earlier, healthcare reimbursement is changing and there are still many aspects to figure out. If you are one that enjoys providing nutrition education and assisting in managing chronic diseases of patients, or establishing rapport with patients that you see regularly on an outpatient bases, this is possibly the job for you. Would you like to provide MNT to patients with diseases that aren’t typically covered under insurance? If so, this is also a possibility under this type of reimbursement. Many of the job descriptions are written with a nurse in mind, so don’t be afraid to reach out to the clinic or employer and let them know you are interested and have many skills to bring to the table.
If you are interesting in learning more about these models of care, visit the payment tab on eatrightpro.org and see the resources below:
The Revised 2017 Scope of Practice for the RDN, and the Revised 2017 Standards of Practice (SOP) in Nutrition Care and Standards of Professional Performance (SOPP) for RDNs, are now available in the Journal as ‘Articles in Press’. The RDN documents reflect changes impacting practice such as:
CMS regulations- hospital ordering privileges and delegated orders in long-term care
Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 – discharge planning and transition of care
National efforts to address malnutrition
Learn more about the Scope and Standards of Practice at www.eatrightpro.org/scope.
The Academy is seeking outgoing, knowledgeable registered dietitian nutritionists with experience working with the news media to apply to join the Academy's Spokesperson Program. Members who have been RDNs for more than five years and have at least two years of media experience are encouraged to apply. Numerous topic areas and geographical markets are available. The application deadline is February 2, 2018.
The Academy’s Food & Nutrition Magazine® has launched an initiative to help foster community and constructive discourse among peers: The Pledge of Professional Civility. The pledge was announced during FNCE® by Academy President Donna Martin at the Member Showcase and discussed during the FNCE® session on Cyberbullying, presented by Academy President-elect Mary Russell and Past-President Connie Diekman.
Public antagonism and hostility among peers dishonors the nutrition and dietetics profession, and is a disservice to the more than 100,000 professionals who hold the RDN or NDTR credentials. Just as in work environments and professional settings, words and behaviors on social media not only reflect the competencies and conduct of individuals, but the values and credibility of the entire profession. It is crucial that strong examples of personal conduct and professional behavior be set for fellow and future practitioners.
As professionals who are active in social media and communications, you are no doubt aware of some challenges regarding a shift in the online behavioral landscape. Forums such as social media channels and listservs continue to provide positive opportunities for discussion and connection; however, antagonism and negativity also have become more prevalent.
The Pledge of Professional Civility is a voluntary, public commitment to the civil treatment of professional peers, including those with whom we may not agree on all issues. Anyone is welcome to take the pledge. As Academy leaders, we encourage all of you to review the Guiding Principles and supporting resources, take the Pledge of Professional Civility and help demonstrate positive, productive engagement among our community. You are welcome to share this information with your members.
Learn more and take the Pledge - https://foodandnutrition.org/professionalcivility/
The Community Preventive Services Task Force (CPSTF) recommends comprehensive telehealth interventions to supplement the care of adults who have chronic diseases that are affected by diet, such as cardiovascular disease and diabetes.
Telehealth interventions allow healthcare providers and patients to communicate by phone, email, web-based programs, or other electronic or digital media. Healthcare providers and patients may also interact in person, though in comprehensive telehealth interventions, most of their interactions are distance-based.
Telehealth methods were found effective for a variety of dietary outcomes and for several chronic conditions. They were effective when delivered by a diverse range of healthcare providers (including, nurses, dietitians, social workers, health educators and physicians), using several electronic media/modalities. Therefore, the CPSTF finding should be applicable to U.S. adults with diet-affected chronic conditions.
CPSTF notes that implementers should understand state policies regarding application of HIPAA to electronic communications involving patients.
See FULL report HERE!
The Research DPG is holding an exciting, educational symposium on October 21, noon to 3 pm, the Saturday FNCE starts. Anyone is welcome to attend, and they do not have be registered for FNCE, but they do have to register to participate in the symposium. We have secured 3 continuing education credits for the symposium. During the last decade, interest in and scientific information on the gut microbiome has exploded. Has that left you confused? This symposium will unravel the mystery of the many different bacteria present in our gut, the fiber sources used as fuel, and their health impact, and then demonstrate how industry is translating the scientific literature into products. Four experts from the field will dispel your confusion. Register Here!
School Meal Successes: President's Message to USDA Secretary
An August 19 op-ed column in the Augusta Chronicle by Academy President Donna S. Martin, EdS, RDN, LD, SNS, FAND, discussed the successes of school meal programs at her county's public school district. Martin wrote she was "surprised to hear Secretary of Agriculture Sonny Perdue recently dust off the antiquated excuse that 'kids won't eat healthy food' when he moved to delay the enactment of school nutrition standards. And when Perdue specifically claimed kids won't eat whole grains, I had to wonder where he's getting his information. He's certainly not talking about the schools I've visited! At our school, participation spikes to 99 percent on cheese grits day. We serve affordable, whole-grain grits that our local farmers provide. Cheese grits day is the day here in Burke County." Martin noted improvements in school meals since Congress passed the Healthy, Hunger-Free Kids Act of 2010 and called Perdue to support implementation of successful national school nutrition standards. The Academy continues to be a leader in urging Congress and the Trump administration not to roll back the standards.
Academy Urges CMS: Consider Needs of RDNs in Medicare Quality Payment Program
The Academy's comments to the Centers for Medicare and Medicaid Services' proposed rule for the 2018 Quality Payment Program Year 2 strongly encouraged CMS to offer registered dietitian nutritionists the same opportunities to earn value-based payments as physicians and other Medicare providers, given RDNs' contribution to CMS's goals of better care, smarter spending and healthier people. The Academy also urged CMS to avoid financially penalizing RDNs under new payment models due to the present lack of opportunities; and recommended CMS cover medical nutrition therapy services for additional disease states and provide incentives for physicians to utilize RDNs to increase access to evidence-based, cost-effective MNT services.
Academy Meets with Senior CMS and Medicare Officials
Academy staff members and other representatives of the Obesity Care Continuum met last week with senior officials of the Centers for Medicare and Medicaid Services, including Demetrios Kouzoukas, principal deputy administrator and director of the Center for Medicare, to urge CMS to enable Medicare beneficiaries to have access - consistent with recommendations of the United States Preventive Services Task Force - to medical nutrition therapy for obesity, risk factors for cardiovascular disease and prediabetes. The Academy strongly believes CMS has the authority to modify the current, limited coverage of MNT to include these additional disease states and conditions.
Academy Participation in New Mexico Farm Bill Hearing
Academy member Patty Keane, MS, RD, recipient of the Academy's 2017 Award for Grassroots Advocacy, participated in a listening session August 18, hosted by U.S. Rep Michelle Lujan Grisham (N.M.)., on nutrition programs included in the Farm Bill. Keane highlighted the Academy's 2018 Farm Bill recommendations and New Mexico-specific priorities for SNAP and SNAP-education as important drivers of public health. The Academy thanks Keane and other passionate advocates who support strong nutrition programs in the Farm Bill that employ Academy members and improve the nation's health.
Congress' August Recess: A Great Time for Members to Take Action
Members of Congress are in their districts until September 5, so now is a great time to make your voice heard on the Academy's important legislative priorities. Help secure your member's support to co-sponsor the congressional resolution recognizing the Academy's Centennial and the contributions of our past and present. There is still time to contact your member of Congress (or do so again); we need additional Academy members' outreach to succeed.
September 5 Webinar: Nutritional Misconceptions Travel Across the Globe - Different Cultures, Similar Observations
Different cultures have different perspectives on nutrition, but too often myth supersedes understanding. A September 5 webinar will address nutrition misconceptions observed across the globe and educational opportunities based on current evidence to correct them. The webinar offers 1 CPEU.
September and October Nutrition-Focused Physical Exam Hands-On Training
The Academy has developed an interactive, hands-on training workshop to provide registered dietitian nutritionists with skills and knowledge to perform nutrition-focused physical exam skills in the workplace and aid in the nutrition diagnosis of malnutrition. Workshops will be held September 8 in Dodgeville, Wis.; September 18 in Rock Springs, Wyo.; September 18 in Alexandria, Va.; andOctober 20 and 21 (pre-FNCE) in Chicago, Ill. Ten CPEUs for each workshop are available.
September 19 Webinar: Operationalizing Dietitian Order Writing Privileges - The Step-by-Step Process
Clinical nutrition managers can learn how to establish an order writing system in their facilities via an in-depth look at the dietitian order writing process. A September 19 webinar will provide CNMs with the tools to implement a complete program, including stakeholder analysis, executive summary and process timeline. The webinar offers 1 CPEU.
Revised: Food Allergy Management Certificate of Training Program
The Center for Lifelong Learning, with experts in food allergy management, has completed a full update of the online certificate program with a focus on food allergy management. The update includes the latest research and recommendations on preventing peanut allergies as well as additional information on managing food allergens in schools and foodservice. Members enjoy a reduced rate of $24 for each module.
New Online Certificate of Training Program: Public Health Nutrition
Develop competency and earn CPEUs online with a new program concerning the emerging and exciting area of public health nutrition. The Level 2 program consists of five modules covering the foundations of public health nutrition, developing, implementing and evaluating a plan and more. This program has been developed by the Academy's Center for Lifelong Learning and planned with the Association of State Public Health Nutritionists, Committee for Public Health/Community Nutrition and the Public Health and Community Nutrition dietetic practice group.
New Certificate of Training Program: Informatics in Nutrition
Keep up with the rapidly changing world of health care: The Academy's Center for Lifelong Learning, planned with the Nutrition Informatics Committee, the NIC Consumer Health Informatics Workgroup and the Interoperability and Standards Committee, offers this program to ensure nutrition professionals stay up-to-date with the latest methods of processing and using data in all areas of the profession. The program covers every facet of informatics, including Electronic Health Records, security and ethics, utilizing data and more. The information in this program can be successfully utilized on a daily basis.
New Certificate of Training Program: Integrative and Functional Nutrition
Develop competency and earn CPEUs online with a new program on digestive health, dietary supplements, inflammation and more. This certificate of training program was planned by the Academy's Center for Lifelong Learning and the Dietitians in Integrative and Functional Medicine dietetic practice group. Don't miss out on the opportunity to become an expert in this rapidly growing field.
Certificate of Training Program: Chronic Kidney Disease Nutrition Management
Learn about the most recent population data from USRDS and NHANES and recently revised recommendations for sodium intake and blood pressure control.
Certificate of Training Program: Vegetarian Nutrition
A growing trend offers registered dietitian nutritionists opportunities to be the go-to source for tailoring a healthy vegetarian diet. A new online certificate program prepares RDNs to excel in this specialty.
Certificate of Training Program: Supermarket Business and Industry Skills to Thrive in Retail Dietetics
Learn business basics, influence the retail environment, create return on investment, build and nurture community and business relationships and understand the roles and responsibilities of today's retail dietitian.
Online Certificate of Training Program: Culinary Nutrition
The Center for Lifelong Learning, with the Food and Culinary Professionals dietetic practice group, offers a new program to prepare registered dietitian nutritionists to excel in the fast-growing field of culinary nutrition. Topics such as planning healthy meals, food safety, preparation techniques and more are covered.
Revised Certificate of Training Program: Developing Your Role as Leader
The Center for Lifelong Learning introduces updates and a revision to the online certificate program with a focus on enhancing leadership skills for all members.
Revised Certificate of Training Program: Executive Management
The Center for Lifelong Learning introduces updates and a revision to the online certificate program with a focus on enhancing executive management skills for all members.
Certificate of Training: Adult Weight Management
This program takes place September 29 to October 1 in Phoenix, Ariz.; October 19 to 21 in Chicago, Ill.; and November 16 to 18 in Orlando, Fla.
Certificate of Training: Childhood and Adolescent Weight Management
This program takes place September 7 to 9 in Memphis, Tenn.
Level 2 Certificate of Training: Adult Weight Management
This program takes place October 19 to 21 in Chicago, Ill.
Members who are unable to attend an on-site Certificate of Training Program may wish to consider a self-study module: Adult Weight Management; Childhood and Adolescent Weight Management; Level 2 Adult Weight Management.
CDR Customer Service Survey
Please take a moment to provide feedback to the Commission on Dietetic Registration regarding the quality of service you received and improvements that could be made to better meet your needs.
Practice Papers Offer Free CPE Opportunities
Read Academy Practice Papers and complete a quiz to earn 1 free CPEU.
Free Member Handbook: Working with the Media
Whether you're new to working with the news media or an experienced veteran, the Academy's revised and expanded public relations handbook Working with the Media: A Handbook for Members of the Academy of Nutrition and Dietetics is packed with hundreds of useful and practical tips. You'll find advice on developing story ideas and pitches, preparing for and conducting interviews in print, TV and radio, responding to incoming media calls, tackling tough questions, dressing for success on TV and more.
Revised Practice Tips
The practice tips "Hospital Regulation: Ordering Privileges for the RDN" and "Implementation Steps: Ordering Privileges for the RDN," updated in July, include revised web links. The "Hospital Regulation" practice tip also includes the revised CMS State Operations Manual for various practice areas. Find specific practice areas that include hospital, critical access hospital, end-stage renal disease facilities and long-term care. Steps on how to utilize the CMS Manual are provided.
New Issue: MNT Provider
Learn how to use the Explanation of Benefits to manage claims; read about the expansion of the Centers for Medicare and Medicaid Services' Comprehensive Primary Care Plus model and opportunities for registered dietitian nutritionists; and discover new resources to assist with successful participation in MIPS, all in the new issue of the MNT Provider.
Just Released: New Edition of Pocket Guide to Pediatric Weight Management
Build healthy lifestyles from the start with this must-own guide. The Pocket Guide to Pediatric Weight Management (2nd ed.) integrates the latest evidence-based practice guidelines with the Nutrition Care Process to help practitioners create individualized nutrition care blended with practical and realistic advice.
Updated Food and Nutrition Gold Standard Is Now Available
Whether addressing nutrition questions from clients, consumers, students or others, the 5th edition of the Academy of Nutrition and Dietetics Complete Food & Nutrition Guide is the ultimate resource for communicating science-based advice and answers on a myriad of topics. More comprehensive than ever, this guide has been updated to reflect the 2015-2020 Dietary Guidelines for Americans, Academy positions and the most recent and authoritative public health guidelines.
Guide Your Clients to a Healthy Pregnancy with Updated Book
The Academy's newly published book, Expect the Best: Your Guide to Healthy Eating Before, During and After Pregnancy (2nd ed.), is a comprehensive resource for new and future parents to make the best choices throughout the entire pregnancy journey, including nutrition lifestyle habits from preconception to post-delivery.
Keep Your Clients Informed with Educational Handouts
With a colorful design, engaging format and short, clearly defined sections, these brochures are easy to read for clients who may be unfamiliar with a variety of nutrition topics. The latest brochures cover the hottest topics, such as gluten-free eating, smart snacking, added sugars, Mediterranean-style eating and more.
Get Your Clients on the Healthy Track with the Latest Tech: Now Available in 10-Packs
The accessible Bits and Bytes: A Guide to Digitally Tracking Your Food, Fitness and Healthdescribes how to get started with digital health tracking and choose the right tools to achieve personal health goals. With colorful illustrations and sample screens, this guide compares popular apps and tracking programs, explaining the features they offer. Save 50 percent when you buy more: Bits and Bytes is now available in economy packs of 10, making them easy to distribute to clients.
Easily Track and Improve Patient Outcomes with eNCPT
eNCPT is an online publication containing a comprehensive explanation of the Nutrition Care Process and standardized terminology, which allows for a consistent approach to practice, making tracking patient outcomes easier. Subscribers have access to the most up-to-date terminology, an easy-to-access web platform, multiple language translations and free access to the Electronic Health Records Toolkit. Learn how eNCPT can make a positive impact on your effectiveness.
Success Starts With eatrightPREP for the RDN Exam
Put yourself in the best position to pass the RDN exam with this comprehensive and convenient resource from the Academy. eatrightPREP goes above and beyond what any book can do, with an exam study plan including more than 900 questions, unlimited access to three full-length practice exams and performance statistics to identify your strengths and target weaknesses. eatrightPREP complies with the Commission on Dietetic Registration's 2017 Test Specifications, better preparing the student for the exam.