Stemming the tide of obesity: Good for patients and good for payers
To support office visit consults, physicians need resources such as organized, structured programs that incorporate coaching, education and one-on-one support for their patients who need to lose weight. Obesity is a chronic condition that requires ongoing monitoring and care.
By addressing obesity with consistent counseling, eating plans and ongoing monitoring, physicians can go beyond treating symptoms and help patients achieve a healthy weight, potentially avoid chronic illnesses and live longer lives. With physician oversight, the patient’s medical condition is evaluated and monitored as the weight is lost; any medications that may need to be adjusted as weight loss occurs will be managed by the doctor.
When patients, physicians and employers organize weight management around these principles, they achieve positive results that benefit everyone. To illustrate, Wausau, Wisconsin-based Aspirus Heart and Vascular implemented a pilot weight loss protocol with 50 employees and family members, and the resulting weight loss and improvement in metabolic markers was so significant that the self-insured health system decided to offer it to their entire employee base of 6,500 people.
In a study presented at Obesity Week 2016, Aspirus followed 306 employees who had successfully completed the same medically developed weight loss protocol and analyzed claims costs for these employees from 2013 to 2015. Results from the study, Effect of the Ideal Protein Weight Loss Protocol on Employee Healthcare Costs, indicated an average of $916.97 (18% reduction) decrease in overall average costs. Females had the greatest decrease from 2013 to 2015 averaging -$974.71 (17%) from 2013. Comparing 2013 to 2015, males reduced their claims by -$472.88 (19% reduction).
These finding indicate that employers can potentially save between $500 and $1000 annually per employee on medical claims. With 70% of the U.S. population of 325 million overweight or obese, multiply those numbers accordingly—these efforts could conceivably be saving the insurance industry more than $2 billion a year in claims related to the health complications of excess weight.
What stakeholders can do to promote weight loss
· Employers should team with physicians and health systems to offer patient-centered, structured weight loss and weight maintenance protocols to their employees. Additionally, payers and employers should develop more focused, local resources to address obesity including hiring trained specialist and dieticians trained in safe, scientifically based weight-management techniques, including low carbohydrate, ketogenic diets.
· To support the permanent behavioral change needed to maintain weight loss, a focus on long-term lifestyle change, education, and support must be taken throughout the journey. Initial experience shows that the ROI on savings from obesity-related costs more than pays for the cost to implement the wellness initiative.
· Employers and payers should incentivize healthy weight by paying for obesity care and treatment, including in some cases, anti-obesity medications and bariatric surgery. These costs can be shared—and should be—by the employee so they have “skin in the game,” but subsidies from employers and insurers will be an added incentive to undertake the challenge of long term weight management.
· Employers should foster a healthy work environment, including healthy choices in the employee cafeteria and onsite vending machines. Educating employees about avoiding sugar and excess carbohydrates is also helpful.
With collaboration and initiative, physicians and payers can support patients as we together, reverse the tide of obesity and realize the benefits of better health and lower healthcare costs.
Timothy N. Logemann, MD, FACC, ABOM, is a board-certified internist and cardiologist at Wausau, Wisconsin-based Aspirus Heart and Vascular. He is certified by the American Board of Obesity Medicine and is a member of the Ideal Protein Cardiology Advisory Board.