Insurance coverage and incentives for weight loss among adults with metabolic syndrome.
OBJECTIVE
To describe how insured adults with metabolic syndrome respond to various options for insurance coverage and financial incentives for weight management.


METHODS
Insured adults meeting the criteria for the metabolic syndrome were randomly identified through automated medical records and invited to participate in a telephone-based survey of the acceptability of various weight management programs-with different financial incentives and insurance coverage options-in a health maintenance organization. Multivariable logistic regression models were used to test the relationship between participant characteristics and the odds of being motivated by incentives.


RESULTS
One hundred and fifty-three adults with the metabolic syndrome completed the survey (i.e., 79% of telephone contacts). A hypothetical increase in insurance coverage from 10 to 100% led to a threefold increase among women and a sevenfold increase among men in the proportion reporting they were "very interested" in enrolling in a weight management program within the next 30 days. Most participants (76% of women and 57% of men) supported a health plan-sponsored financial incentive program tied to weight loss, and 41% believed such a program would motivate them to lose weight. The mean financial incentive proposed for a 15-pound weight loss was $591 (median: $125).


CONCLUSIONS
Although weight loss is an effective treatment for metabolic syndrome, standard health insurance rarely covers intensive behavioral treatment. The results of this study suggest that providing full insurance coverage and financial incentives for weight management increases the interest in participating in obesity treatment programs. Further research should determine how full coverage and incentives affect participation rates, long-term body weight changes, and costs.
Arterburn
David
D
Group Health Center for Health Studies, Seattle, Washington, USA. arterburn.d@ghc.org
Westbrook
Emily O
EO
Wiese
Cheryl J
CJ
Ludman
Evette J
EJ
Grossman
David C
DC
Fishman
Paul A
PA
Finkelstein
Eric A
EA
Jeffery
Robert W
RW
Drewnowski
Adam
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000191:economics / Q000503:physiopathology / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D015431:Weight Loss