Whatever area of dietetics practice you work in, this year’s House of Delegate mega issue impacts your profession. Health care systems are changing and RDs/RDNs/DTRs have the opportunity to play a key role in the new face of health care. In fact, we have already started seeing dietitians in our state benefit from some of these changes, but there are still many more opportunities yet to come.  As members of the Utah Academy of Nutrition and Dietetics, we are key players in sharing our voice about the role of RDs/RDNs/DTRs in the changing health care environment.

In the traditional health care model, RDs/RDNs/DTRs have limited reimbursement for nutrition services, primarily through physician referrals. Most food and nutrition services in hospitals are paid through Medicaid and Medicare services as part of room board fees, meaning there is typically no separate billing for food and nutrition services. Long-term care is similarly paid through Medicaid/Medicare under a broader category of services, which include food and nutrition services. Only universal coverage for outpatient MNT services is currently available for diabetes, renal disease, and up to 36 months post-renal transplant patients through Medicare Part B. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is funded through federal dollars given to state agencies and covers costs of RDs. With the passage of the Affordable Care Act, new health care models and possibilities for reimbursement are emerging.

The impetus for the Affordable Care Act was to increase the number of U.S. citizens covered by health insurance. Provisions in the law that could affect delivery and payment of nutrition services for RDs/RDNs/DTRs include: Focusing on preventive care and implementing patient-centered medical homes. A patient-centered medical home aims to manage multiple health conditions of a patient with various health care professionals working together simultaneously under the care of one physician, which can include RD services. However, it is important to note that the Affordable Care Act does not specifically designate RDs/RDNs/DTRs as providers of care, rather lists it as “a physician-led team” and thus becomes imperative for our profession to advocate the need for our services in the patient-centered home health care model. Another possible area of reimbursement through the Affordable Care Act was the creation of Community Based Health Teams, which can include dietitians working in local health departments. As the House of Delegates Leadership Team has said: “Opportunities abound but, as with all opportunities, Academy members need to seize them before other health care providers (professional and layperson) do.” I urge you to act today by sharing your voice about this mega issue with me, including your thoughts about this question: how you think we can position nutrition services as an essential component of the evolving health care delivery and payment models?

For a more-detailed read of the Mega Issue, click here.

Rickelle Richards, PhD, MPH, RDN
Utah Delegate
rickelle_richards@byu.edu