2022 Atlanta Board of Trustees Meeting

1/22

Obesity Treatment: Finding Effective Coverage and Payment Models for Employer Adoption A proposal for a NEHI roundtable and white paper on the future of obesity treatment NEHI is seeking sponsors for a 7-month project on obesity treatment projected for completion by Fall 2022. The project will respond to three ongoing developments:  the increasing health and cost burden imposed by obesity, now more acute due to COVID-19  the growing toolbox of obesity treatment and weight management interventions now available to health care providers and actively marketed for coverage by health care payers, and  related and unresolved issues regarding the health care system’s ability to measure and reward long-term effectiveness of obesity treatment as a pre-requisite for supporting obesity treatment at greater scale. The goal of the project is to outline pathways to improved obesity management outcomes through effective provider payment models. The project will focus on how provider payment can incentivize appropriate uptake of obesity treatment modalities such as digital chronic disease management, anti- obesity medications, and weight loss surgery. The project will focus initially on provider payment models suitable for adoption by employer-purchasers of employee health benefits. Recommendations will be incorporated into a white paper that will be actively disseminated by NEHI and made available to project supporters, NEHI member organizations, and other interested parties. Background Obesity has been steadily rising in the U.S. since the 1970s, and as many as half of all U.S. adults may have obesity by the year 2030. 1 Obesity is associated with many health risks, including type 2 diabetes and cardiovascular diseases, and obesity has long been viewed as a significant root cause of health care utilization and spending. 2–5 The COVID-19 pandemic has exacerbated the obesity crisis. Persons with obesity have been more likely to suffer severe illness from COVID-19 and require more intensive medical treatment. 6–8 Meanwhile many Americans have experienced significant weight gain during the pandemic. 9,10 Obesity now looms even larger as a driver of poor health and medical spending in the post-pandemic period. At the same time clinical evidence has strengthened to support broader use of established treatment modalities (such as weight loss surgery), while new care models, new tools, and a new generation of anti-obesity medications (AOMs) have emerged. By most measures, we have arrived at a new era of significantly expanded options for active treatment of obesity. Surgery has been shown to achieve weight loss that results in superior glycemic control and reduction of cardiovascular risks 11 , reduces the need for weight-inducing medications such as insulin among some patients with obesity and diabetes 12 , and leads to improvement in quality of life 13 . New, FDA-approved anti-obesity medications (AOMs) achieve clinically significant levels of weight loss that reduce risks of

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