Addressing Childhood Obesity

Childhood obesity is one of the most common childhood chronic conditions, affecting more than 1 in 5 children in the United States, and more than 1 in 4 children in Medicaid.^1,2 It is associated with preventable chronic diseases in childhood, such as type 2 diabetes, hypertension, asthma, depression, and anxiety, as well as higher health care expenditures. Children with obesity are also more likely to have obesity as adults, increasing their lifetime risk of chronic disease, higher health expenditures, and poor health outcomes.³

Although childhood obesity is a complex disease with many contributing factors, there are numerous ways to support children and families in achieving a healthy weight and establishing lifelong healthy habits. For children enrolled in Medicaid, the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit covers all medically necessary services, which can include obesity-related prevention and treatment services, such as the United States Preventive Services Taskforce (USPSTF) grade B recommendation that “clinicians provide or refer children and adolescents 6 years or older with a high body mass index (BMI) (≥95th percentile for age and sex) to comprehensive, intensive behavioral intervention.”⁴

Addressing Childhood Obesity in Medicaid and CHIP

To help states and their quality improvement (QI) partners serve children with obesity, the Centers for Medicare & Medicaid Services (CMS) is hosting a webinar to highlight opportunities for state Medicaid and CHIP programs to strengthen prevention and treatment efforts.

The webinar will feature the latest data and clinical guidelines, presented by CMS and the Centers for Disease Control and Prevention’s (CDC’s) Division of Nutrition, Physical Activity, and Obesity. It will also showcase examples of how states are providing services to address childhood obesity in Medicaid and CHIP, including the barriers encountered, strategies used to overcome challenges, and the success achieved through QI initiatives.

Webinar: Addressing Childhood Obesity in Medicaid and CHIP
January 28, 2026,12-1pm ET
To register for this webinar, click here.

Efforts to Improve Access to Obesity Services

Many states are taking steps to increase awareness and use of obesity-related services among individuals enrolled in Medicaid and Children Health Insurance Program (CHIP). The following examples highlight a range of innovative strategies states are using to promote healthy eating, active living, and obesity prevention and treatment:

Missouri Medicaid (MO HealthNet) used a State Plan Amendment (SPA) to expand coverage for CDC-recognized Family Healthy Weight Programs (FHWPs), which are comprehensive, evidence-based, family-centered interventions that help children and their families adopt healthier eating and physical activity habits. The SPA aligns Medicaid coverage with national clinical recommendations by supporting structured nutrition education, behavior-change counseling, and physical activity components designed to improve health outcomes for children.
South Dakota Medicaid’s Well-Child Services Billing and Policy Manual explicitly covers USPSTF grade A and B preventive services, including recommendations for high BMI in children and adolescents. The manual specifies that children and adolescents aged 6 years and older with a BMI at or above the 95th percentile should be provided—or referred—to comprehensive, intensive behavioral interventions. By embedding this requirement directly in its billing guidance, South Dakota ensures providers can bill for these evidence-based obesity interventions and that Medicaid-enrolled youth have access to nationally recommended care.
Louisiana Medicaid’s (Healthy Louisiana) managed care contracts require all managed care organizations (MCOs) to submit annual Diabetes and Obesity Reports sharing data on obesity and diabetes among enrollees. Each MCO must also develop an annual Obesity and Diabetes Action Plan (see Appendix D) outlining goals and strategies to reduce obesity rates and related costs. By tying obesity data and performance reporting directly to Medicaid managed care contracts, Louisiana has created a model for accountability and data-driven policy—linking health outcomes with program spending and motivating MCOs to invest in prevention.
Massachusetts has implemented Healthy Weight Clinics (HWCs), an evidence-based, family-centered model of pediatric weight management that provides structured nutrition counseling, behavior-change support, and regular follow-up within primary care settings, including Federally Qualified Health Centers (FQHCs). Obesity screening and counseling components delivered through HWCs are covered by Massachusetts Medicaid (MassHealth) under the EPSDT benefit, enabling primary care practices serving Medicaid-enrolled children to integrate evidence-based weight management services into routine care.

Additionally, several states are collaborating with their managed care plans (MCP) to implement performance improvement projects (PIPs) focused on BMI screening and referrals for healthy weight management and physical activity counseling. For example, a West Virginia Medicaid MCP conducted a PIP aimed at increasing performance on the Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC-CH) Child Core Set measure. The MCP deployed multiple strategies, including member education and outreach, member incentives for completing a well-child visit, and provider-level care gap reports. Following these efforts, the MCP’s performance on the WCC-CH measure increased from 78 percent to 91 percent.

To explore other states conducting BMI-related PIPs, see EQR Table 6 under EQR Reporting on CMS’s EQR Reporting page.