By 2030, 51.1 percent of American adults are projected to have obesity. This development portends both a rise in obesity associated chronic diseases, but also an enormous economic impact. Currently, obesity contributes 8.5 percent of Medicare and 11.8 percent of Medicaid costs; both programs spend an annual $61.8 billion on obesity. As of 2008, the average Medicare beneficiary with obesity utilized an additional $1,964 in services compared to a normal weight beneficiary.
On February 2, 2016, the STOP Obesity Alliance convened a roundtable of federal and state government officials, researchers, patient advocates, public health professionals, healthcare providers, payers, and other experts to discuss coverage of obesity treatment services. This meeting served as the first in a series of roundtable discussions intended to identify policy and programmatic changes in the Medicare and Medicaid programs to improve access to and implementation of obesity prevention and treatment services. The goal of this first meeting was to discuss specific opportunities for policy change by identifying coverage gaps.
CMS has made some regulatory changes to address the growing burden of this disease, first in 2006 with the inclusion of the coverage of bariatric surgery, and most recently in 2011 by adding coverage of intensive behavioral therapy for obesity for beneficiaries entitled to Parts A and B of Medicare. The revision in coverage for Medicare includes obesity screening, nutritional assessment, and behavioral therapy to promote sustained weight loss through high intensity interventions of diet and exercise.
Currently, this coverage applies to primary care physicians, nurse practitioners, clinical nurse specialists, and physician assistants. Healthcare professionals outside of primary care settings - clinical psychologists, registered dietitians, health/fitness professionals, trained health educators, and nutrition professionals - are excluded from reimbursement despite appropriate training to provide obesity counseling. Counseling that occurs outside of a primary care office is not covered, including several community-based lifestyle counseling programs.
The evidence-base for the success of these programs is growing, and CMS has already explored the role of community-based organizations in treating other chronic diseases. In 2012 the Center for Medicare and Medicaid Innovation awarded a demonstration grant to Y-USA, the national office of the YMCA, to fund the implementation of the YMCA's Diabetes Prevention Program (YDPP) across several communities. Community-based interventions, such as the YDPP, are being covered by managed care organizations. The meeting we convened this month, and the future meetings that will follow, are centered on creating similar coverage opportunities for interventions targeting obesity.
Obesity treatment is currently fragmented, inadequate, and lacks effective delivery mechanisms. Without changes in reimbursement and delivery, many patients affected by obesity will not receive the care they need. New systems of care delivery are needed that address lifestyle and behavioral changes and integrate clinical care with community systems. I look forward to updating you on the progression of these roundtable discussions.
Sincerely,
|
Alliance & Member News
| |
|  |
American College of Sports Medicine Introduces "Exercise is Medicine Solution"
To jointly address the rapid progression of chronic diseases and skyrocketing health care costs, Exercise is Medicine® (EIM), a global health initiative managed by the American College of Sports Medicine (ACSM), along with the American Council on Exercise (ACE) and the Medical Fitness Association (MFA) announced a new collaboration called the Exercise is Medicine Solution. The partnership and the EIM Solution will bring together health care systems, clinicians, fitness professionals and community resources to affect positive health outcomes and reduce health care costs. The announcement was made at the National Press Club in Washington D.C. and included a keynote by 18th U.S. Surgeon General Regina Benjamin, M.D.
The EIM Solution's multipronged approach has never been implemented in the US and will include physical activity counseling, as well as prescription and referral strategies, particularly those linking health care and community-based resources. Ultimately the goal is to achieve global targets for the reduction of inactivity, related morbidity and mortality, and health care costs. An often missing component of physician-prescribed treatment plans has been the involvement of health and fitness professionals. As part of the EIM Solution, physicians can refer their patients to qualified exercise professionals who hold the EIM Professional Credential.
Enhance Your Knowledge about Clinical Obesity Treatment at Obesity Medicine 2016 in San Francisco
CDC: Prevention Status Reports
Today, the Centers for Disease Control and Prevention (CDC) released the newest Prevention Status Reports (PSRs), which highlight the status of policies and practices designed to address 10 important public health problems. Individual reports are available for all 50 states and the District of Columbia on 10 key health topics:
- Alcohol-Related Harms
- Food Safety
- Healthcare-Associated Infections
- Heart Disease and Stroke
- HIV
- Motor Vehicle Injuries
- Nutrition, Physical Activity, and Obesity
- Prescription Drug Overdose
- Teen Pregnancy
- Tobacco Use
Each report describes the public health problem, identifies potential solutions to the problem drawn from research and expert recommendations, and reports the status of those solutions for each state and the District of Columbia, using a simple, three-level rating scale-green, yellow, or red.
The PSR website offers the following features:
- An interactive map that leads directly to individual reports for each state
- State Summary tables that outline the full set of policy and practice ratings for each state
- A National Summary that shows aggregate ratings across all states and DC for each policy or practice for 2015, along with bar charts comparing aggregate ratings for 2013 and 2015 where applicable
- A Quick Start Guide to help state health officials and other public health leaders use the PSRs to advance the use of evidence-based public health policy and practice in their state
- Answers to frequently asked questions (FAQs)
- A PSR Fact Sheet
Visit the PSR website to view the reports and related materials. To receive future updates about the PSRs, subscribe here. If you have questions or comments, contact the PSR Team at psrinfo@cdc.gov.
|
News Round-Up
|
|
|
 |
| BMI Doesn't Really Tell You Anything About Your Health
Huffington Post
By Anna Almendrala
"Based on their data, the study's researchers estimate that approximately 19.7 million Americans who think they are obese may actually be metabolically healthy. For this population, they wrote, the "obese" label is a distracting misclassification that could negatively harm their overall health. When healthcare providers prescribe weight loss for this group, they aren't just wasting patients' time and effort, they're also contributing to stigma and "high levels of anti-fat bias," according to the researchers. Overall, they estimate that about 74.9 million Americans are misclassified in some way because their BMI number doesn't match up to their true metabolic health status. "I'm sure some will defend the BMI as a relatively quick and cheap measure, but why should 'quick and cheap' win out over accurate, especially when we're talking about the health of millions of Americans?" said co-author Jeffrey Hunger, a doctoral student specializing in weight-based stigmatization at the University of California, Santa Barbara."
February 17, 2016
Medical News Today
By Yvette Brazier
"This is the first major study to use online street views to assess the exercise and dietary habits of neighborhoods.The study took 4 years to complete and involved data from nearly 6,000 people living in major cities across Europe. It looked at the nature of local neighborhoods, tallying self-reported perceptions of the environment by residents with objective measures based on Google Street View. It also involved estimates of individual health behaviors, social integration and community support. Many measures related to the local environment appear to be linked to health behavior and the risk of developing obesity, according to the study results.
Levels of physical activity, self-rated health, happiness and neighborhood preference were closely associated with residents' perception and use of their neighborhood. People living in socioeconomically deprived areas were less likely to see their area as conducive to healthy behaviors, compared with residents of wealthier areas. The researchers noted a significant variation in the presence of food outlets, outdoor recreation facilities and green spaces between the cities surveyed. Residents who reported higher levels of social integration also rated their health more highly, were less likely to be obese and consumed more fruit.
However, the same group also tended to spend more time sitting down and were less involved in physical activity that required transportation."
February 16, 2016
Obesity News Today
By Margarida Azevedo
February 19 2016
Huffington Post
By Lynn Erdman
" Women who [with obesity] during pregnancy are at a higher risk of serious health complications during pregnancy and after birth. During pregnancy, obesity is associated with gestational diabetes, high blood pressure (preeclampsia), preterm birth, and increased rates of induction of labor and infection. Undergoing an induction of labor for any reason, including a medically indicated induction, increases the risk of excessive bleeding during birth and increases the likelihood of blood transfusion, hysterectomy, problems in future pregnancies, and cesarean birth. During the last 50 years, the rate of obesity has more than doubled worldwide. The World Health Organization reports that there are 300 million women who are categorized as obese. While the United States is making progress in recognizing and addressing obesity, much more work needs to be done to educate women so that they better understand the health risks of obesity in pregnancy."
February 22, 2016
The Hill
By David Seres
"A study published earlier this month in the International Journal of Obesity has found that our common wisdom about the relationship between obesity and the risk for cardiovascular disease is possibly overstated. The U.S. Equal Employment Opportunity Commission (EEOC) has been considering rules that would, in effect, allow health insurers to charge obese people more for coverage if they fail to lose weight. This recent study strengthens the argument against the obesity penalty. But whether the risks of obesity are, or are not, overstated is the least of the issues raised by the EEOC considering allowing weight to determine insurance rates. Penalizing the obese for a medical condition and charging them more for medical coverage is contrary to two of the prime tenants of the Affordable Care Act (ACA): The coverage of preexisting conditions and access to all. But more than being contrary to ACA core values, it is contrary to American values by institutionalizing prejudice and blaming the victim."
February 22, 2016
Health Affairs Blog
" In 2012, the Congressional Budget Office (CBO) released an in-depth study of the health and budgetary effects of raising the excise tax on cigarettes. We commented on this study in our blog about the complex economics of disease prevention and longevity. CBO has since turned its attention to obesity and recently released a list of issues needing resolution in order for CBO to estimate the effects of federal policies impacting obesity.
In this Health Affairs Blog post, we summarize research we have done, under a grant from the Robert Wood Johnson Foundation (RWJF), on the value of reductions in cigarette smoking and obesity. Among our findings, as explained in more detail below, was how dramatically the returns to prevention could be impacted by changes in the cost and effectiveness of treatment for the conditions being prevented."
|
|
