Could New Obesity Guidelines Hike Insurance Rates?

Jul 10, 2012

The U.S. Preventive Services Task Force recently (end of June, 2012) issued revised guidelines for treating obesity. They recommend that doctors (1) screen all patients for obesity (defined as a body mass index of 30 or higher) and (2) refer obese patients for comprehensive behavioral “interventions” to help them lose the weight.That means some insurers could be asked to cover multiple group or individual behavioral counseling or weight management sessions for overweight patients. But could it mean your insurance rates go up? No one’s certain yet, because the recommendations have just come out and there’s lots of planning and implementation to be done.

Under the 2010 health-care law, new health plans and those whose benefits change enough to lose their grandfathered status must provide services recommended by the Preventive Services Task Force at no cost to members. For the 70 percent of employers that already offer weight management programs, that may mean just supplementing what they already offer, says Russell Robbins, a senior clinical consultant at Mercer, a human resources consulting firm.

But some employers are concerned they may be on the hook for ongoing treatment as employees make repeated attempts to lose weight. – from “New Guidelines on Obesity Treatment Herald Changes in Coverage,” July 10, 2012, by Michelle Andrews, Kaiser Health News

The cost of insurance aside, here are a few facts about obesity in Rhode Island and why stepping up efforts to address it seem increasingly urgent.

In 2004, Providence County carried the state’s highest percentage of obese adults at 20.8%. Every other county weighed in below 20%.

In 2009, more than 20% of adults are obese in every Rhode Island county. In Providence County, it’s 27%.

By 2010, RI was the second fattest state in New England, behind Maine.

The data comes from the US Centers for Disease Control and Prevention. You can slice and dice the data by state, county, and year, and find some alarming trends.

The bottom line? Spending on obesity-related health care–including on chronic diseases like diabetes–is staggering: $147 billion in 2008. The cost in terms of quality of life for overweight patients is harder to quantify.

I’ll keep watching for news and reactions. Got some insights? Let me know!