Promoting Healthy Weight Management

Obesity is a major driver of poor health outcomes and health care costs in the United States.¹ It is associated with chronic conditions such as type 2 diabetes, heart disease, asthma, and certain cancers, as well as increased risk of pregnancy complications and premature mortality.² Rates are particularly high among individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP): roughly 25 percent of children and 40 percent of adult Medicaid beneficiaries have obesity.^1,³

Although 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 For adults, the USPSTF has issued a grade B recommendation that adults with a BMI of 30 kg/m² or higher receive intensive, multicomponent behavioral interventions.⁵ States may cover these recommended behavioral interventions—such as intensive lifestyle and weight-management programs—as well as related obesity services, including nutritional counseling, pharmacotherapy, behavioral health services, and other clinically appropriate treatments and supports.

Promoting Healthy Weight Management in Medicaid and CHIP Managed Care

As the dominant delivery system for Medicaid and CHIP,⁶ managed care offers states a key opportunity to advance healthy weight management through managed care plan (MCP) contracts, oversight, accountability mechanisms, and quality improvement (QI) activities. To support these efforts, Centers for Medicare & Medicaid Services (CMS) developed companion technical assistance resources focused on promoting healthy weight management through improved nutrition and physical activity among Medicaid and CHIP populations and strengthening measurement and monitoring efforts.

State Strategies to Improve Healthy Weight Management in Medicaid and CHIP Managed Care. This brief outlines strategies states can use to support improved nutrition, physical activity, and obesity prevention through Medicaid and CHIP managed care, including examples of state implementation approaches.
Measuring and Monitoring Progress in Healthy Weight Management in Medicaid and CHIP Managed Care. This resource provides an example measure slate that states and MCPs can use to design, implement, and evaluate healthy weight management strategies across the care continuum, including screening, service delivery, and outcomes.

CMS will also host a webinar highlighting how states can partner with their MCPs to improve nutrition- and physical activity-related outcomes. The webinar will feature national data and clinical guidelines, and highlight its importance to the Make America Healthy Again (MAHA) strategy. It will also showcase state examples of strategies and quality measures used to improve outcomes, including barriers encountered, approaches to address challenges, and the successes achieved through QI initiatives.

Webinar: Promoting Healthy Weight Management in Medicaid and CHIP Managed Care (September 17, 2026). Register here!

Addressing Childhood Obesity in Medicaid and CHIP

To help states and their QI partners serve children with obesity, CMS hosted a webinar to highlight opportunities for state Medicaid and CHIP programs to strengthen prevention and treatment efforts.

The webinar features 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 also showcases 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 (slides, video, transcript) (January 2026)

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 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 MCPs 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.