EMORY (US) — Investing in weight loss programs to prevent diabetes or heart disease could save the U.S. government as much as $15 billion in Medicare spending.
A new study published in the journal Health Affairs proposes enrolling overweight and obese adults between the ages of 60 and 64 with prediabetes before they enter the Medicare program at age 65.
Prediabetes is a silent condition that occurs when blood glucose levels are higher than normal. Often triggered by weight gain, if left unchecked, the majority of patients will develop diabetes.
The proposal comes at a time when Congress is looking to reduce Medicare spending and lower the federal deficit. Current approaches don’t address the rising rates and prevention of chronic disease and obesity.
“The majority of health care spending is due to increasing rates of weight-related health issues like diabetes, cholesterol, and high blood pressure so by the time many people become Medicare eligible, they are already battling these health issues,” says Kenneth Thorpe, professor of health policy and management at Emory University.
“By focusing on weight loss and prevention, we could not only improve our country’s bottom line, we could make a huge impact in the fight against chronic disease.”
The proposal is modeled on a program developed by the U.S. Centers for Disease Control and Prevention (CDC), the YMCA of the USA, and the private insurance company UnitedHealth Group.
Under the program, conducted in partnership with the YMCA, a trained lifestyle coach helps overweight people at risk for diabetes learn about healthier food and create a fitness plan to increase physical activity. Studies of this program and others like it have found that participants age 60 and older lose weight and reduce the risk of developing diabetes by up to 71 percent.
To size up the impact of the proposal, Thorpe and Zhou Yang, assistant professor of public health, first studied a scenario that would enroll people in a weight loss program age 60-64 showing signs of prediabetes.
The authors estimated that the 16-week program would cost the federal government $590 million and proposed two sources of funding: the CDC’s National Diabetes Prevention Program and the Prevention and Public Health Trust Fund.
The investment would eventually save Medicare an estimated $2.3 billion over the next 10 years or $9.3 billion in net lifetime savings, the amount saved from the time of enrollment until the death of participants, which, according to the author, is an average of 13 years.
Next, the team expanded the program to include overweight people who had high blood pressure or high cholesterol. These people may have prediabetes but also face a high chance of suffering from heart disease in the future. Using this scenario, the researchers estimated that Medicare would eventually save $1.4 billion in 10 years and accrue $5.8 billion in net lifetime savings, assuming a 70 percent participation rate.
Thorpe and Yang also ran an analysis in which they included both groups—those in the pre-diabetic category and those with high blood pressure or high cholesterol. In this case, they estimated Medicare savings of up to $3.7 billion over the next 10 years and up to $15.1 billion over participants’ lifetimes.
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