Dive Brief:
- Routine policy exclusions for obesity care continue to fail to address it in the same way that related medical conditions like diabetes or heart disease are now managed, according to a panel at the recent Patient-Centered Diabetes Care conference.
- Proponents for obesity care argue that refusing to treat it medically with medications or bariatric surgery costs insurers more in the long run.
- Panelists suggested the ongoing transition to a value-based healthcare system should help drive coverage for obesity care because it will be accepted as cost-effective and having proven outcomes.
Dive Insight:
The panelists suggested the stigma around obesity is still a major factor in leaving 93% of obese individuals with unmet medical needs. They also said physician training must improve to help guide better care.
Ted Kyle, founder of the obesity care advocacy group ConscienHealth, argued the consequences of not covering obesity treatment could be more costly than providing access to care.
"Whether or not healthcare plans cover care for obesity, we are paying for obesity," Kyle told the American Journal of Managed Care. "Our 'sick care' system does a great job of paying for the result."
The panelists noted things are moving in the direction of increased reimbursement for obesity care, considering that now, Medicare covers bariatric surgery and the U.S. Preventive Services Task Force has required health plans to cover intensive behavioral counseling for patients with obesity and at least one other cardiovascular risk factor.