MARY ELLEN SCHNEIDER
Nearly a million children would gain health insurance coverage for weight-management counseling under an obesity prevention initiative spearheaded by former President Bill Clinton.
As part of the initiative, a group of health insurers and employers have agreed to pay for at least four follow-up visits to a child's primary care physician and four visits with a registered dietitian for children aged 3-18 years whose body mass index is in the 85th percentile or above for their age.
Participating insurers include Aetna Inc., Blue Cross and Blue Shield of
North Carolina, Blue Cross Blue Shield of Massachusetts, and WellPoint Inc.
Additionally, PepsiCo. Inc., Houston Independent School District, Owens
Corning, and Paychex Inc. have agreed to offer these benefits to employees.
President Clinton announced the agreement at a press conference in New York.
The initiative is the latest obesity prevention effort from the Alliance for
a Healthier Generation, an organization launched jointly in 2005 by the
William J. Clinton Foundation and the American Heart Association.
“This landmark agreement will allow children and their families to have
access to important preventive medical services in most regions of the
country,” said Dr. Tim J. Gardner, AHA president. “Looking forward, the
initiative represents a tremendous opportunity to bring the best science
available for the prevention and treatment of childhood obesity to those who
are in greatest need.”
Research has shown that overweight and obese children have up to an 80%
chance of being overweight and obese as adults, putting them at higher risk
for conditions such as diabetes, heart disease, stroke, and even certain
types of cancer, Dr. Gardner said.
As part of the agreement reached with insurers and employers, nearly a
million children are expected to gain access to new obesity prevention and
treatment benefits during the first year of the initiative. But the
long-term goal is to reach 6.2 million children—about a quarter of all
overweight and obese children in the United States—within 3 years as more
insurers and employers agree to participate.
The first year of the initiative also will be used as a research
opportunity, with insurers collecting health outcomes information and cost
data to help determine the cost-effectiveness of certain approaches and
identify best practices. “We need to know what really works here,” President
Clinton said.
This new initiative takes the important step of removing the barriers that
limit insurance payment for obesity prevention in the primary care setting,
said Dr. David T. Tayloe Jr., president of the American Academy of
Pediatrics, adding that it can be difficult for physicians to bill insurers
for obesity counseling, and there has been a lot of confusion about what is
covered.
Obesity can be successfully treated in the office, but physicians can't do
it by themselves, Dr. Tayloe said. For example, physicians in his rural
North Carolina practice work with registered dietitians and partner with
community organizations like the YMCA to give obese patients and their
families a comprehensive program of nutrition and fitness advice, and health
assessments.