Tools and recommendations to promote obesity-related policies to strengthen health systems and improve health outcomes
Proposed Standard of Obesity Care
During 2018, the STOP Obesity Alliance convened a series of roundtable meetings with relevant stakeholders to deliberate about who should provide obesity care, where obesity care should be delivered and what care should be provided by whom. It was our goal to develop a standard of care to enable the patient to move within the continuum of care, as well as to provide assurance that patients have access to appropriate levels of care, regardless of where they enter the healthcare system. The product of our meetings was a practical, tangible, measurable and simple standard of care for the treatment of adult obesity, published in the July 2019 issue of Obesity. No comparable standard addresses the spectrum of care that persons with obesity need to address their disease.
State-by-State Analysis of Obesity Coverage
Since 2010, the STOP Obesity Alliance has conducted an annual state-by-state analysis of Medicaid coverage for obesity prevention and treatment. The research deals with three main areas of concern: coverage for bariatric surgery, pharmaceutical therapy, and counseling. Because obesity treatment varies person to person, patients require access to a wide range of treatments for effective management. Adequate coverage of broad services will ensure that anyone with obesity has access to individualized care.
Medicaid Coverage for Obesity Treatment Services
State Employee Coverage for Obesity Treatment Services
Survey of Obesity & Health-Status Mandates by state for Private Insurance (2010)
GWU researchers, including legal researchers, analyzed state insurance codes to determine whether states’ eligibility and rate adjustment determinations were, or could be, based upon obesity or health status factors, as well as any mandates for obesity-related treatments. One of the most interesting research findings is that states’ coverage and mandate decisions appear to lack any evidence base, both across the states and within a state. This is particularly noteworthy given that there are well-recognized federal sources states may utilize when making these decisions, namely the U.S. Preventive Services Task Force(USPSTF) and the National Heart Lung and Blood Institute of the National Institutes of Health (NIH). Both of these organizations issue evidence-based guidance regarding prevention, screening, and treatment of obesity yet these guidelines appear not to have been considered by most states.
Changing the Dialogue: Obesity Drug Outcome Measures Project
In 2011 and 2012, STOP convened several roundtables with stakeholders, including FDA, to transform the process used to evaluate pharmacotherapy and developed a consensus report that explored challenges in the development and approval of obesity drugs.
Community Benefit and Obesity Programming: Guidance and Opportunities for Nonprofit Hospitals
In 2013, STOP reflected on the challenges and opportunities for nonprofit hospitals to address obesity through community benefit activities. Nonprofit hospitals can use the insights offered in the paper to inform their decisions around obesity programming. The paper offers guidance on issues such as how to select community partners, how to determine the scope of an intervention, and which obesity-specific factors to take into account when developing programs. Findings included in the paper included a lack of proven community-based programs that directly address obesity in adults; a need to reduce stigma; and the value of effective partnerships.
Comprehensive Obesity Benefit
The present landscape of obesity care coverage is piecemeal, and providers frequently cite inconsistent and/or inadequate reimbursement for obesity-related services as barriers to delivering appropriate care. The STOP Obesity Alliance has outlined what we consider to be the core components of an obesity benefit package that are essential for effective and evidence-based treatment of obesity.