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CHI Issue Brief Examines New Strategy in Obesity Battle

How are you doing on your New Year’s resolutions? Ten days into 2013 may be a little early. But for those of us who resolved to improve our health, such as eating cauliflower instead of cookies or getting on our bikes instead of getting in our cars, we already know whether we’re making progress.

There may be many reasons why we don’t meet our New Year’s goals: too little time, lack of friend or family support, lack of awareness about programs or resources, and the expense.

For some obese Coloradans who have resolved to lose weight in 2013, the Affordable Care Act (ACA) provides relief for a few of these potential obstacles.

Of the roughly 610,000 obese Coloradans with health insurance, many may now be eligible to sign up for treatment programs without cost-sharing or co-pays. An ACA provision, often referred to as the “Preventive Mandate,” requires most private insurance companies and Medicare to cover the costs of screening and treatment for obese patients (and other evidence-based prevention services) without patient cost-sharing.

In a newly-released issue brief, Obesity Treatment: A New Strategy to Address a Growing Problem, CHI looks at the policy and how it engages the health system – insurance companies, health care providers, employers and educators – in addressing obesity.

CHI sought input from a wide range of experts who view the requirement as a positive step in the battle against obesity, but also point out a number of challenges in its implementation. Obesity is unique, requiring multiple treatment options and a patient who is ready to make a personal commitment. Today’s health system and payment models aren’t necessarily structured to provide effective interventions. The new guidelines cover only those who are already obese rather than those who are overweight and could be prevented from crossing the line into obesity. And Colorado may not have enough qualified providers to deliver or coordinate multi-component behavioral interventions.

Coverage mandates raise important cost considerations. Obesity is linked to many preventable diseases such as heart disease and diabetes. It is also expensive. Obesity-related medical issues cost an estimated $1.6 billion in Colorado in 2009, with almost half spent by Medicare and Medicaid. Obese individuals rack up $1,429 more each year in medical costs than those of normal weight. Only time will tell whether the initial higher costs to provide the coverage will result in healthier patients at lower weights – and lower overall costs – down the road.

Addressing obesity is not easy. Many factors influence obesity, including genetics, personal behaviors and motivation. But leaders across Colorado recognize that obesity is more than a personal issue. It’s a community issue that impacts the state’s workforce, its productivity and the general health of all, especially children. Public health agencies, private foundations and not-for-profit organizations are working together to reduce obesity in communities. And the ACA provides another avenue for individuals ready to make 2013 the year they tackle their obesity.