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Multidisciplinary Approach to Obesity Management: A Case Report
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Insurer and employer views on pediatric obesity treatment: a qualitative study

S E Hampl1, A M Davis, M L Sampilo

  • 1Department of General Pediatrics, Children's Mercy Hospitals and Clinics/University of MO-Kansas City School of Medicine, Kansas City, Missouri, USA. shampl@cmh.edu

Obesity (Silver Spring, Md.)
|May 29, 2013
PubMed

Insights

Insurers and employers rarely cover pediatric weight management programs due to cost concerns. Addressing themes like program effectiveness and employee benefits is crucial for future coverage of these vital multidisciplinary treatments.

Area of Science:

  • Pediatric Health
  • Health Services Research
  • Obesity Management

Background:

  • Group-based, multidisciplinary pediatric weight management programs (Stage 3) show growing evidence of effectiveness.
  • Limited insurance coverage and employer benefits hinder program accessibility and sustainability.

Purpose of the Study:

  • To investigate the perspectives of insurers and large employers regarding coverage for group-based pediatric weight management programs.
  • To identify key factors influencing decisions on benefit coverage for these interventions.

Main Methods:

  • A qualitative research design was employed.
  • Structured interviews were conducted with key stakeholders, including insurers and large employers.

Main Results:

  • Six major themes emerged from the interviews: cost considerations, perceived program effectiveness, corporate social responsibility, secondary benefits for parents (employees), existing coverage options, and the process for determining new benefits.
  • Cost and program effectiveness were significant factors influencing coverage decisions.

Conclusions:

  • Future strategies to obtain insurance payment for pediatric weight management programs must strategically address the identified themes.
  • Engaging insurers and employers with data on cost-effectiveness and broader benefits is essential for expanding program access.
Abstract

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