Weight-loss programs might save Medicare billions

By Jeannine Stein, Los Angeles Times / For the Booster Shots blog
4:05 p.m. CDT, September 8, 2011, Appeared in Chicago Tribune

Medicare could save billions of dollars if people who were pre-diabetic or at risk for cardiovascular disease took part in community-based weight-loss programs, a study finds.

Researchers projected cost savings for the government healthcare program if millions of people in the U.S. age 60 to 64 participated in a program that helped them lose weight and gain more healthful lifestyle habits. They based their findings on an existing YMCA diabetes prevention program that is, as of this year, at 50 facilities in 24 states. In a study of a similar program, participants lost an average 7% of their body weight and maintained that over 2.8 years. The prevalence of diabetes went down 71% among people age 60 and older.

Their projection was based on a scenario in which the program would roll out across the country and target adults age 60 to 64--those not eligible for Medicare yet--who are pre-diabetic, with a body mass index greater than 24 (considered overweight or obese), and who show risk factors for cardiovascular disease. Under the proposal, funding would come from the Centers for Disease Control and Prevention's National Diabetes Prevention Program and the Prevention and Public Health Trust Fund. Both were established by the Affordable Care Act.

The study authors estimated Medicare savings over a 10-year period as well as for a person's lifetime, and based them on two participation rates from results of a pilot study: one in which 70% of people took part, and one in which 55% of people took part.

If 70% of eligible people age 60 to 64 with a BMI of 24 or higher enrolled, the program would cost $590 million. But that would also mean a net savings of $2.3 billion to Medicare over 10 years and a net lifetime savings of $9.3 billion. At the 55% participation rate, the net savings would be $1.8 billion over 10 years and $7.3 billion over participants' lifetime.

Include overweight and obese people who also have the cardiovascular disease markers of high blood pressure and high cholesterol (even if they're not pre-diabetic) and that would add an additional $1.4 billion in savings over 10 years and an extra $5.8 billion in lifetime savings, with 70% enrollment. With 55% participation there would be a net savings of $1.2 billion over 10 years and $4.6 billion in lifetime savings.

"Diabetes is expensive to treat," says Kenneth Thorpe, a professor at Emory University, in a news release. Thorpe, lead author of the study that was released Thursday in the journal Health Affairs, added, "Most of the growth in health care spending is linked to rising rates of diabetes, cholesterol, and high blood pressure--all conditions that weight loss can help reduce. Why not shift the focus to keeping people healthy?"

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