Demand for weight loss counseling after copayment elimination

Area of Science:

• Public Health
• Health Services Research
• Veterans Health Administration

Background:

• Overweight and obesity are significant public health concerns in the U.S.
• Veterans exhibit higher rates of overweight and obesity compared to the general population.
• The Veterans Affairs (VA) MOVE! program offers weight management services.

Purpose of the Study:

• To evaluate the impact of copayment elimination on veteran utilization of a weight loss clinic.
• To determine if financial incentives influence engagement with weight management services among veterans.

Main Methods:

• Analysis of clinic use data for 44,411 new patients before and 64,398 new patients after copayment elimination.
• Mixed-effects models were used to compare clinic use between newly exempt and already exempt veterans.
• Outcomes included the ratio of new users to all users and repeat visits within six months, adjusted for patient and clinic factors.

Main Results:

• A 2.2% increase in new patient use was observed among newly exempt veterans after copayment elimination.
• A 12% increase in use was observed among veterans already exempt from copayments.
• No significant difference in repeat visits was found between exempt and non-exempt veterans.

Conclusions:

• Copayment reductions for selective preventive services may not be a sufficient motivator for increased patient engagement.
• An unexpected rise in demand was noted among veterans receiving all VA care at no cost.
• The VA should reconsider assumptions about copayment reductions driving intended system-level outcomes for preventive services.