The U.S. Preventive Services Task Force has recommended health plans screen adults age 18 and older for obesity and offer “intensive, multicomponent behavioral interventions” for people with a body mass index (BMI) of 30 or greater. In 2005, the Task Force made a similar recommendation for children and adolescents.
Under the health reform law, non-grandfathered employer health plans are required to cover preventive services at no out-of-pocket cost to the enrollee. The services include any preventive care with a rating of “A” or “B” from the U.S. Preventive Services Task Force. The new obesity screening guideline gets a “B” from the Task Force. Consequently, non-grandfathered plans will be subject to the new coverage mandate as of the first day of the plan year that begins on or after July 1, 2013 (i.e., January 1, 2014 for a calendar year plan).
According to the fact sheet released by the Task Force, a successful weight management program for people with BMI of 30 or higher should:
- Include 12 to 26 sessions in the first year;
- Include group and/or individual sessions;
- Help people make healthy eating choices;
- Include physical activity recommendations;
- Address issues that make it difficult to change behaviors;
- Help people monitor their own behaviors; and
- Help people develop strategies to maintain healthy eating and physical activity behaviors.
Plans should see costs increase, in some cases substantially, as roughly 30% of health plan members are obese. Significantly, the Task Force did not endorse weight loss medications or weight loss surgeries.