Blue Cross and Blue Shield of North Carolina Expands Coverage to Treat Obesity

CHAPEL HILL, N.C. – With more than half its members overweight or obese, Blue Cross and Blue Shield of North Carolina (BCBSNC) announced today that it will pay doctors to work with their patients to understand how weight impacts health. The state’s largest health insurer will cover physician office visits and diagnostic tests to treat obesity as a primary condition.
 
“Our doctors have told us they want to have conversations with their patients about how excess weight can lead to serious health problems, but that they need our support – and to be paid for their time,” said Bob Greczyn, BCBSNC president and CEO. “We’re making significant changes in how we do business. We’re going to pay for some preventive care that historically hasn’t been covered by insurance. We want to walk the walk on our obesity epidemic.”
 
More than 1.1 million North Carolinians will be eligible for the new program called Healthy Lifestyle ChoicesSM that includes new benefits and additions to preventive care programs. For employer groups and individuals enrolled in Blue Care®, Blue OptionsSM1 or Blue Advantage® and renewing on or after April 1, 2005, the program includes:
  • Coverage of four physician office visits per year and related testing for the evaluation and treatment of obesity. (Effective April 1, 2005)
  • Coverage of two FDA–approved, prescription weight–loss drugs – Meridia and Xenical – when medically necessary. (Effective October 1, 2005)
  • Credentialing and contracting with licensed registered dieticians starting in the second quarter of 2005 to include their services in the treatment of obesity effective October 1, 2005.
Additionally, BCBSNC has identified 12 doctors in seven practices across the state as demonstrating superior results in bariatric surgery. Those practices, along with the facilities where the procedures are performed, have been identified as Bariatric Surgery Centers of Excellence.
 
The Healthy Lifestyle Choices program is intended to help members achieve a healthier weight and engage in lifestyle changes that hopefully will avoid serious – and costly health problems. The North Carolina insurer examined claims data and surveyed several thousand members to report last month that many of them don’t see excess pounds as a health threat. BCBSNC sought input from doctors across the state and from national preventive health experts including William H. Dietz, MD, director of the Centers for Disease Control and Prevention’s (CDC’s) Division of Nutrition and Physical Activity.
 
“This program represents a direction that a lot more health insurers could pursue,” said Dr. Dietz. “Clearly, Blue Cross and Blue Shield of North Carolina is making a serious commitment of resources to support its members in their efforts to manage their weight.”
 
Unhealthy weight often leads to serious health problems such as high blood pressure, diabetes, heart disease and arthritis. Treating those diseases contributes to rising medical costs. Overweight and obesity accounted for $83.1 million in excess costs to BCBSNC in 2003, according to its 2004 State of Preventive Health report released last month. Obese members incur 32 percent more in claims and medical expenses than normal–weight members.
 
“Even a modest weight loss of 5 to 10 pounds and increased activity can save lives and millions of dollars in health care costs,” said Dr. Robert T. Harris, BCBSNC chief medical officer. “Making the connection between weight and health will make a difference, and we think the doctor’s office is the right place to start this discussion.”
 
The Healthy Lifestyle Choices program encourages safe and effective weight loss, improved eating habits, physical activity and stress management. The program includes sending information and resources to doctors encouraging discussions with patients about how they can achieve a healthier weight.
 
BCBSNC already makes available to its members a variety of programs promoting physical activity and weight management, including Blue PointsSM1 – an online physical activity incentive program that allows members to earn points toward prizes. Get Fit BlueSM1 offers members discounts on nutrition and fitness products and other related programs and services.
 
Members enrolled in the State Health Plan and the Federal Employee Program or BCBSNC’s Medicare Supplemental plans are not eligible for the Healthy Lifestyle Choices program.
 
 
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to approximately 3 million members, including approximately 510,000 served on behalf of other Blue Plans. The company offers its members the Blue ExtrasSM value–added programs, which provide discounts and information on a wide variety of health–related services at no additional cost. BCBSNC also offers life, dental, long–term care and disability insurance products. For over 70 years, the company has served its customers by offering access to quality health care at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health.
 
BCBSNC’s HMO and POS products have earned Excellent Accreditation from the National Committee for Quality Assurance (NCQA), an independent, not–for–profit organization dedicated to improving the quality of health care delivered to people everywhere. BCBSNC also has North Carolina–s first and only NCQA accredited PPO plan – Blue OptionsSM. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at bcbsnc.com.
 
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