AHA Praises New Medicare Benefit for Obesity Therapy

CEO Nancy Brown says the move "will help our nation take on one of its most significant public health problems."

American Heart Association CEO Nancy Brown on Nov. 30 thanked the federal agency thjat funds Medicare and Medicaid services nationwide for announcing Medicare will cover behavioral therapy for obesity.

"The announcement by the Centers for Medicare & Medicaid Services that Medicare will now cover intensive behavioral therapy for obesity will help our nation take on one of its most significant public health problems. It will also move us one step closer to achieving our shared goal of preventing one million heart attacks and strokes as outlined in the recently announced 'Million Hearts' initiative in which the American Heart Association is a proud and committed partner," Brown said in the statement posted at AHA'swebsite.

CMS announced the added coverage for preventive services on Nov. 29, saying they add to Medicare's existing portfolio of preventive services available without cost sharing under the Affordable Care Act. "Obesity is a challenge faced by Americans of all ages, and prevention is crucial for the management and elimination of obesity in our country," said CMS Administrator Dr. Donald M. Berwick. "It's important for Medicare patients to enjoy access to appropriate screening and preventive services."

Screening for obesity and counseling for eligible beneficiaries by primary care providers in settings such as physicians' offices are covered under the new benefit. A beneficiary who screens positive for obesity with a body mass index greater than or equal to 30 kg/m2 could receive one face-to-face counseling visit each week for one month and one face-to-face counseling visit every other week for an additional five months. The beneficiary may receive one face-to-face counseling visit every month for an additional six months (for a total of 12 months of counseling) if he or she has achieved a weight reduction of at least 6.6 pounds (3 kilograms) during the first six months of counseling. "This decision is an important step in aligning Medicare's portfolio of preventive services with evidence and addressing risk factors for disease," said Dr. Patrick Conway, M.D., MSc, CMS' chief medical officer and director of the agency's Office of Clinical Standards and Quality. "We at CMS are carefully and systematically reviewing the best available medical evidence to identify those preventive services that can keep Medicare beneficiaries as healthy as possible for as long as possible."

"More than 72 million Americans, or 34 percent of all adults, are obese. It affects approximately one-quarter to one-third of all adults age 65 and older," Brown said. "Unfortunately, the number of obese Medicare beneficiaries has grown in recent years and will likely increase. The obese not only suffer from cardiovascular disease, cancer and diabetes, they also live shorter lives. In addition, if the rate of obesity continues to rise, healthcare costs attributable to this condition could be as high as $861 billion to $957 billion by 2030. But we can begin to change this dire forecast with prevention and treatment. Medicare preventive services that screen for obesity, provide counseling, and include both nutrition and physical activity interventions can effectively help adult beneficiaries lose weight and live healthier lives. Recent research also indicates that physician visits, counseling, and online support can help individuals drop five percent of their body weight and maintain that lower weight.

"This new Medicare benefit will go a long way to help stamp out obesity, one of this nation's greatest health challenges, and the American Heart Association commends the Centers for Medicare & Medicaid Services for taking this important step to fight this epidemic."

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