title: The impact of a managed care obesity intervention on clinical outcomes and costs: a prospective observational study.
abstract: OBJECTIVE
  To evaluate the impact of a managed care obesity intervention that requires enrollment in an intensive medical weight management program, a commercial weight loss program, or a commercial pedometer-based walking program to maintain enhanced benefits.
  
  
  METHODS
  Prospective observational study involving 1,138 adults with BMI ≥ 32 kg m(-2) with one or more comorbidities or BMI ≥ 35 kg m(-2) enrolled in a commercial, independent practice association-model health maintenance organization. Body mass index, blood pressure, lipids, HbA1c or fasting glucose, and per-member per-month costs were assessed 1 year before and 1 year after program implementation.
  
  
  RESULTS
  Program uptake (90%) and 1 year adherence (79%) were excellent. Enrollees in all three programs exhibited improved clinical outcomes and reduced rates of increase in direct medical costs compared to members who did not enroll in any program.
  
  
  CONCLUSIONS
  A managed care obesity intervention that offered financial incentives for participation and a variety of programs was associated with excellent program uptake and adherence, improvements in cardiovascular risk factors, and a lower rate of increase in direct medical costs over 1 year.
authors.affiliation: Department of Internal Medicine, University of Michigan, Michigan, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Rothberg
authors.forename: Laura N
authors.initials: LN
authors.lastname: McEwen
authors.forename: Tom
authors.initials: T
authors.lastname: Fraser
authors.forename: Charles F
authors.initials: CF
authors.lastname: Burant
authors.forename: William H
authors.initials: WH
authors.lastname: Herman
mesh_terms: D000328:Adult; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D061217:Weight Reduction Programs / Q000191:economics