Facing more than $100 million in annual costs linked to obesity, the Medicaid program in one of the country’s most overweight states is turning to a familiar name to help residents slim down.
Up to 75,000 West Virginians will soon be eligible for free weight loss courses through Weight Watchers, thanks to an effort by the state Medicaid program and the health benefits group UniCare, the largest provider of Medicaid coverage in the state.
Medicaid clients of Unicare who obtain a physician’s referral and score within specific ranges on the fat-measuring body mass index will be eligible to take up to 16 weeks of courses for free from Weight Watchers. The group is famous for its regular meetings and system of assigning points to different foods.
Advocates of the program — including the state’s first lady, Gayle Manchin — hope the partnership will improve the health of residents in the state and serve as a model for other states that face a similar problem. West Virginia has the third-highest percentage of obese residents in the country, behind Mississippi and Tennessee.
“It’s not just a West Virginia problem, it’s a national problem,” said John Monahan, president of state sponsored programs for Indiana-based Wellpoint Inc., of which UniCare is a subsidiary.
Program may expand
If the program is successful in West Virginia, Wellpoint will look at rolling out similar programs in the 14 states where it provides benefits, Monahan said. Those states are California, Colorado Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin.
Last year, Tennessee’s Medicaid agency, known as TennCare, completed a pilot program for 1,400 Medicaid recipients who paid nominal fees to participate in Weight Watchers. Over a six-month period, they lost a combined total of more than 8,000 pounds, according to TennCare spokeswoman Marilyn Wilson.
“We feel confident that this could really delay the onset of diabetes, heart disease and even stroke,” she said.
If such programs can work on a large scale, it could be a boon not only to the health of residents, but to fiscal stability. Medicaid programs are available to low-income residents, who are also more likely to be overweight and obese than higher income residents.
In West Virginia, Medicaid — at more than $2.1 billion — is the largest single item in the state budget. And in fiscal year 2002, the most recent year for which data is available, the state estimates that it spent nearly $140 million on medical and pharmacy costs related to obesity.
“It’s like smoking was years ago,” Monahan said, referring to growing prevention efforts. “I think all states are going to have to start addressing this.”
Dr. Mary Vernon said states have a vested interest in encouraging weight loss, but isn’t sure West Virginia is going about it the right way.
“The statistics would show people that really need help need a more individual and supervised program under a doctor’s care,” said Vernon, president of the American Society of Bariatric Physicians, an association of physicians who specialize in obesity and weight loss.
“It's not about immediate cost containment”
The potential impact of the program also is a relative drop in the bucket considering that about two-thirds of adult West Virginians are overweight or obese and UniCare covers only about 75,000 of the estimated 300,000 to 370,000 residents covered by Medicaid.
It’s not clear how much money the state might save from having healthier residents, but state Medicaid spokeswoman Shannon Riley says: “It’s not about immediate cost containment. The Medicaid program will see savings down the line, but this is about slowing the growth of lifestyle-induced diseases and disabilities.”