News Release: Faculty Experts
Sep. 8, 2011
Study Shows Prevention Programs Could Offer Up to $15 Billion in Medicare Savings
ATLANTA – A study published in the September 8 issue of Health Affairs says the U.S. government could save up to $15 billion over the lifetimes of a group of baby boomers by investing in weight loss programs to help prevent diabetes or heart disease.
The research, led by Kenneth E. Thorpe, PhD, professor of health policy and management at Emory's Rollins School of Public Health, proposes expanding proven, community-based weight loss programs and enrolling overweight and obese adults between the ages of 60 and 64 with prediabetes before they enter the Medicare program at age 65.
Prediabetes is a silent condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. It is often triggered by weight gain and if left unchecked, the majority of these people will go on to develop diabetes, an incurable disease that requires expensive treatment.
The proposal offered in the study comes at a time when members of Congress are looking for ways to reduce Medicare spending and lower the federal deficit. Thorpe says many of the government’s current approaches do not address the rising rates and prevention of chronic disease and obesity.
“The majority of health care spending is due to increasing rates of weight-related health issues like diabetes, cholesterol and high blood pressure so by the time many people become Medicare eligible, they are already battling these health issues,” says Thorpe, who also serves as executive director of the Partnership To Fight Chronic Disease. “By focusing on weight loss and prevention, we could not only improve our country’s bottom line, we could make a huge impact in the fight against chronic disease.”
Thorpe and his colleague Zhou Yang, PhD, MPH, assistant professor, Emory’s Rollins School of Public Health, modeled the proposal on a program developed by the U.S. Centers for Disease Control and Prevention (CDC), the YMCA of the USA, and— most recently—the private insurance company UnitedHealth Group.
Under the program, conducted in partnership with YMCAs across the country, a trained lifestyle coach helps overweight people at risk for diabetes learn about healthier food and create a fitness plan to increase physical activity. Studies of this program and others like it have found that participants age 60 and older lose weight and reduce the risk of developing diabetes by up to 71 percent.
To size up the impact of the proposal, Thorpe and Yang first studied a scenario that would enroll people in a weight loss program age 60-64 showing signs of prediabetes.
The authors estimated that the 16-week program would cost the federal government $590 million and proposed two sources of funding: the CDC’s National Diabetes Prevention Program and the Prevention and Public Health Trust Fund.
This investment would eventually save Medicare an estimated $2.3 billion over the next ten years or $9.3 billion in net lifetime savings, the amount saved from the time of enrollment until the death of participants, which, according to the author, is an average of 13 years.
Next, the team expanded the program to include overweight people who had high blood pressure or high cholesterol. These people may have prediabetes but also face a high chance of suffering from heart disease in the future. Using this scenario, the researchers estimated that Medicare would eventually save $1.4 billion in ten years and accrue $5.8 billion in net lifetime savings, assuming a 70 percent participation rate.
Thorpe and Yang also ran an analysis in which they included both groups—those in the prediabetic category and those with high blood pressure or high cholesterol. In this case, they estimated Medicare savings of up to $3.7 billion over the next ten years and up to $15.1 billion over participants’ lifetimes.
Thorpe will present information about the study at a Health Affairs briefing today in Washington D.C. For audio and video footage from the briefing, please visit: http://healthaffairs.org/events.php.