Improving Access to Obesity Care
Today, more than 93 million U.S. adults are living with obesity. Many do not consider obesity as a disease or that there are health professionals who can help them with weight-loss and maintenance. Having access to obesity care can lead to a more successful weight management journey, but many Americans lack insurance coverage to help them pay for these healthcare options. We believe that everyone should have access to obesity care that is not limited by a person’s weight or economic status.
This month, we were excited to participate in the 5th Annual National Obesity Care Week (NOCW), a national obesity awareness campaign. The STOP Obesity Alliance is a founding partner of NOCW, along with the Obesity Action Coalition (OAC), the American Society for Metabolic and Bariatric Surgery (ASMBS), and the Obesity Medicine Association (OMA). During the week of September 15-22, more than 50 organizations joined as Champions of NOCW, and we are pleased to report that 13 of those organizations are members of the STOP Obesity Alliance. In addition, during the week, over 1,000 people pledged their support for access to care without barriers for persons with overweight and obesity.
It is essential that people affected by obesity have access to appropriate levels of care, regardless of where they enter the healthcare system. Much of our research focuses on identifying barriers to effective obesity care and strategies to help persons with overweight and obesity receive appropriate treatment.
National Obesity Care Week offered an opportunity to take stock of our collective efforts to improve obesity care. Efforts during the week also focused on garnering support for the Treat and Reduce Obesity Act (TROA) in Congress. TROA will provide Medicare beneficiaries and their healthcare providers with meaningful tools to reduce obesity by improving access to weight-loss counseling and new prescription medications for chronic weight management. While the legislation is focused on improving access to obesity treatments for Medicare beneficiaries, it is important to remember that private and employer-based insurance plans often base their coverage to match Medicare coverage. Therefore, this legislation is important to all Americans.
NOCW – now in its sixth year – has helped increase awareness of the need for obesity care. Our efforts reached more people this year, with thousands of pledge takers, participation from 55 countries, 50 million media impressions, and more than 15,000 social media interactions. As summarized below, the efforts of the STOP Obesity Alliance have focused on improving the care of people with obesity.
Assessing insurance coverage for obesity care
Last year, we published a state-by-state analysis of state employee health plan and Medicaid coverage for obesity prevention and treatment over a ten year period. We found that state coverage for three recommended types of obesity treatment – nutritional counseling, medications, and bariatric surgery – generally improved over the last decade but improvement was piecemeal and inconsistent across states. We developed an interactive map to support dissemination of these findings and enable state-to-state comparisons of coverage for obesity care. State summary documents provide coverage specifics for Medicaid and state employee health plans offered during the 2016-2017 plan year, such as coverage criteria and potential barriers to accessing evidence-based obesity care.
Developing a standard of care for adult obesity
Because insurance coverage for obesity care varies greatly across insurance plans, we convened a group of experts to develop a practical, tangible, measurable and simple standard of care for the treatment of adult obesity. The product of our efforts was a Proposed Standard of Care for All Providers and Payers, published in the July 2019 issue of Obesity. No comparable standard addresses the spectrum of care that persons with obesity may need to address their disease.
Designing an ideal obesity care benefit
We have now begun drafting and seeking input from experts and stakeholders on what constitutes an ideal obesity care benefit. Our recommended benefit design will be broadly consistent with current evidence-based treatment guidelines and informed, in part, by current obesity benefit offerings across plan types and payers.