02 Sep Low Uptake of Medicare Obesity Counseling Benefit
MedicalResearch.com Interview with:
John A. Batsis, MD, FACP, AGSF
Associate Professor of Medicine and The Dartmouth Institute
Geisel School of Medicine at Dartmouth
Section of General Internal Medicine – 3M
Dartmouth-Hitchcock Medical Center
MedicalResearch.com: What is the background for this study?
Response: In 2011, the Centers for Medicare and Medicaid implemented a regulatory coverage benefit to cover 22 brief, targeted 15-minute counseling visits by clinicians over the course of a 12-month period for Medicare beneficiaries with a body mass index exceeding 30kg/m2. This was an important policy determination in tackling the obesity epidemic in the United States. An emphasis on the importance of counseling, or intensive behavioral therapy, in a primary care setting set the foundation for this benefit.
Yet, it was unclear how and if this benefit (which would be free of charge without a copay or deductible for beneficiaries) was being implemented in clinical care. We therefore identified fee-for-service Medicare claims for the years 2012 and 2013 to determine whether the G0477 code (Medicare Obesity benefit code) was billed. We additionally explored the rate of uptake of the Medicare benefit in relation to the prevalence of obesity using the 2012 Behavior Risk Factor Surveillance System data.
MedicalResearch.com: What are the main findings?
Response: Our main findings suggested that the number of beneficiaries increased in successive years from 27,338 (0.10%) to 46,821 (0.17%). The beneficiary rates using the benefit decreased with increasing age. Importantly, our exploratory analysis suggested that the proportion of beneficiaries using the Medicare benefit that were in fact eligible increased only slightly from 0.35% to 0.60%.
MedicalResearch.com: What should readers take away from your report?
Response: There are a few main take-home points.
First, the utilization of the benefit is extremely low and varied depending on how the provider billed the encounter.
Second, the rate of Medicare beneficiaries with obesity eligible for this benefit is markedly low. This suggests that while some marginal improvements in its use was observed, we have considerable work to improve its use in primary care.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Additional provider training and improving healthcare systems to provide this benefit are critically needed. Appropriate use of electronic medical records may facilitate capturing work done within the practice. In addition, identifying whether other healthcare providers can be integrated in the management of obesity may reduce the stressors for primary care clinicians who may have little formal training and have little time to deliver this benefit in busy practices.
MedicalResearch.com: Is there anything else you would like to add?
Response: Further clinical trials are needed to improve awareness of the epidemic of Geriatric Obesity to clinicians.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Obesity (Silver Spring). 2016 Sep;24(9):1983-8. doi: 10.1002/oby.21578. Epub 2016 Jul 28.
Uptake of the centers for medicare and medicaid obesity benefit: 2012-2013.
Batsis JA1,2,3, Bynum JP2,3.
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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Last Updated on September 2, 2016 by Marie Benz MD FAAD