How the USPSTF Is Helping the Treatment of Obesity
The United States Preventive Services Task Force
(USPSTF) has been in the news recently because of
its controversial recommendations on mammograms and
prostate screening for cancer. As the name
indicates, the task force focuses on preventive
care. And the Affordable Care Act (ACA) has given
the task force the "sole
authority to determine which preventive
procedures must be paid for by insurers." Indeed,
this is why insurers are now required to cover
certain aspects of obesity treatment.
The ACA was put in place in September of 2010. The act put teeth in the preventive guidelines that were already established by the USPSTF. The USPSTF grades preventive measures, giving grades of A, B, C, D or I. For those preventive measures given a grade of A or B, the ACA requires that insurers reimburse healthcare providers for performing the services without requesting any copay or coinsurance. The idea being that certain preventive services will reduce healthcare costs in the long run.
Since obesity is such a big health problem, the task force graded counseling for diet and exercise as B. So, by virtue of the ACA directive, obesity counseling must be covered by insurers. This was good news for both the provider and the patient. The provider could get paid for his or her efforts, and the obese patient could avoid, perhaps, some of the comorbidities associated with obesity at a lower costs.
However, as stated above, the USPSTF has made controversial rulings on mammograms and prostate screening. And these rulings have caused some to believe that while the task force should be able to look at empirical evidence regarding health, the task force should not be involved in insurer payment. It is felt that "what insurance should pay for ought to be the job of a separate entity that could weigh "broader public health and social impacts."
Limiting the USPSTF's ability to influence insurers might not be a bad idea, but it could put a crimp in the nascent obesity payment activity now in place. And that could be a problem for obese patients and weight loss providers.
The ACA was put in place in September of 2010. The act put teeth in the preventive guidelines that were already established by the USPSTF. The USPSTF grades preventive measures, giving grades of A, B, C, D or I. For those preventive measures given a grade of A or B, the ACA requires that insurers reimburse healthcare providers for performing the services without requesting any copay or coinsurance. The idea being that certain preventive services will reduce healthcare costs in the long run.
Since obesity is such a big health problem, the task force graded counseling for diet and exercise as B. So, by virtue of the ACA directive, obesity counseling must be covered by insurers. This was good news for both the provider and the patient. The provider could get paid for his or her efforts, and the obese patient could avoid, perhaps, some of the comorbidities associated with obesity at a lower costs.
However, as stated above, the USPSTF has made controversial rulings on mammograms and prostate screening. And these rulings have caused some to believe that while the task force should be able to look at empirical evidence regarding health, the task force should not be involved in insurer payment. It is felt that "what insurance should pay for ought to be the job of a separate entity that could weigh "broader public health and social impacts."
Limiting the USPSTF's ability to influence insurers might not be a bad idea, but it could put a crimp in the nascent obesity payment activity now in place. And that could be a problem for obese patients and weight loss providers.
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posted by Information Uncover at
10:20 AM
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