Table 1.

Practice management challenges & proposed recommendations for coverage for medicare obesity benefit in rural areas

	Current state	Barrier	Recommendation
Personnel	Physician, Associate Provider, Clinical Nurse Specialist	Decreased supply of PCPs creating a gap in service coverage	Allowing other healthcare providers or peer-health coaching to deliver service
		Lack of Specialized Services Available	Permit allied health providers in delivering service from larger, specialized centers
Frequency of Visits	22 visits provided by above personnel	Creation of an access issue in practices already overworked and overwhelmed	Maintain visit numbers
			Delegate visits to allied health providers to off-set visits
Clinical Site	Face-to-face or Telemedicine-based office setting	Transportation issues create a barrier to providing health care services	Advocate for Telemedicine in rural areas
		Individuals must resident and receive care in designated service areas	Eliminate requirement of service area
		Home-based care is not covered	Permit home-based care
Reimbursement	G0477 Code - $27/visit	Reduced reimbursement to providers	Increase reimbursements or transition to value-based care model

PCP primary care provider