HMO plans to start subsidizing weight-loss programs
WILLIAMSBURG, Va./CHICAGO - Health insurers, spurred on by employers grappling with billions of dollars in costs due to obese employees, are increasingly subsidizing programs such as Weight Watchers and providing other incentives for people to shed pounds.
Aetna Inc. Thursday said it would test a program that pays for weight-loss counseling and other fat-fighting measures.
Other health maintenance organizations, including Cigna Corp. and WellPoint Health Networks Inc. have recently added discounts on nutrition programs, health club memberships and offered other incentives.
In Aetna�s program, patients who enroll will receive discounts on weight-loss programs as well as pedometers to encourage walking, company officials said at an obesity conference in Williamsburg, Virginia sponsored by Time magazine and ABC News.
The programs are desperate attempts to deal with expanding waistlines. An estimated 30 percent of Americans are considered obese and weight problems cost employers roughly $12 billion annually, according to the National Business Group on Health, an employers� group.
Obesity raises the risk of heart disease, some cancers and other health problems, and adds billions of dollars to health-care costs.
�The insurance industry has been very reluctant to touch issues of weight management simply because the failure rate is so high,� Aetna Chief Medical Officer William Popik said.
HMOs hope to save money
Aetna�s pilot program starting next January likely will aim to enroll about 500,000 beneficiaries, Popik said. If successful, the company will expand it further.
HMOs hope to save money by staving off the need for expensive blood pressure drugs and other medications and reducing the need for doctor visits for obesity-related problems, Popik said in an interview. He said he could not yet estimate the savings.
�It�s something that appeals to employers,� who pay for most of health care in the U.S.,� said Matthew Borsch, an analyst for Goldman Sachs. �The benefit to the health insurance company is somewhat questionable, because the benefits will likely be over time. The odds you�ll have that enrollee many years out� is slim.
Thirty percent of Aetna�s costs are incurred by the sickest 1 percent of members, Popik said. That lopsided financing is typical of other health insurance risk pools, experts said.
Many obese people suffer from diabetes, heart disease, joint problems and other ailments related to being overweight, all of which are extremely costly conditions.
People enrolled in Aetna�s weight-management program will be put in touch with a nurse to coordinate counseling and other services. Each patient�s own physician also can become involved.
Eventually, Aetna and other insurers may offer discounts on premiums for healthier people as an incentive for people to keep their weight down and adopt a healthy lifestyle, Popik said. As employers shift more costs to employees, consumers may demand lower rates for maintaining a healthy lifestyle.
�We haven�t thought about doing that yet ... but I see that coming,� Popik said.