December 21, 2011
Obesity Counseling by Primary Care Providers: Wise Move by Medicare or Not So?
A few facts are crystal clear:
- Myriad adults would improve their health status and potential longevity by losing a few pounds. Five percent seems to be the magic number to reap health benfits.
- Two thirds of adult Americans are overweight or obese, including many Medicare beneficiaries.
- Losing weight, even a few pounds, and keeping those pounds off is tough work which requires tenacity.
- Primary care providers (PCPs), including general and family practice physicians, nurse practitioners, physicians assistants and others; aren’t known for addressing or spending the time it takes with clients to counsel them on weight control. (In all fairness, they haven’t been allotted the time until now.)
- Susan Yanovski, MD, in her 11/24/11 New England Journal of Medicine editorial Obesity Treatment in Primary Care – Are We There Yet? (abstract), stated: “less than 50% of PCPs report consistently providing weight-control advice to adults and less than 25% report regularly referring people to other providers who may help them with weight control.”
- It’s well known that PCPs receive a minimumof nutritional science in training and it’s highly unlikely that many have obtained the skills known to be effective in weight management counseling from studies on long term weight management.
Yet despite these facts, on November 29th, Medicare (Centers for Medicare and Medicaid Services) announced in their Decision on Intensive Behavioral Counseling for Obesity that it will start to cover obesity counseling services when provided by PCPs (as defined by CMS).