Uptake of Obesity Intensive Behavioral Treatment Codes in Medicare Beneficiaries, 2012–2015

Excerpt

Obesity prevalence has risen to 41% among adults aged 60 and older in the USA.¹ Rising rates are predicted to have significant medical, socio-economic, and health policy implications due to cumulative multimorbidity coupled with progressive disability. In 2011, payment for intensive behavioral therapy (IBT) for obesity was approved by the Centers for Medicare and Medicaid. In 2018, US Preventive Services Task Force recommended that clinicians offer multicomponent IBT for adults of all ages with body mass index ≥ 30 kg/m², but outline the limited evidence of long-term health outcomes in older adults.² Data favor intentional weight loss to improve function and quality of life in older adults³, despite the weakening evidence for the obesity paradox. While face-to-face individual IBT and group codes (added in 2015) pay for up to 22 visits/year in primary care, there is concern about underutilization of IBT due to operational challenges.^{4, 5} Our objective was to analyze the trends in uptake of IBT during the initial 4 years of implementation. …