Managed Care - October 2008 - (Page 24) Insurer’s Obesity Program In N.C. Reduces Medical Cost Blue Cross & Blue Shield of North Carolina addresses social factor as way to managed population health get them back in better shape than worse,” says Bradley. “Most payers are starting to focus on some of this. Even Medicare is starting to focus on some of this. We’re all doing it a little bit differently.” on Bradley, MD, the chief medical offiOf course, being a single-state plan means takcer at Blue Cross & Blue Shield of North ing on the health problems of North Carolina. The Carolina, says that health plan officials state has the 17th highest rate of adult obesity in the understand that they must venture into nation, according to a report issued by the health areas once the purview of public policy. advocacy organization Trust for America’s Health. “When you look at the possible interventions It has the fifth highest number of overweight we can do to impact health and medical expense, a youngsters. BCBSNC officials say that memlot of the things have been tried or are already bers who are overweight cost the company 18 implemented,” says Bradley. “I think you’ve percent more than normal weight members got to move to the next level. I think most in medical claims and expenses. Obese memhealth plans are doing something.” bers cost 32 percent more. Which means that most health plans must “You see an epidemic, you feel like somethen argue why the something they’re doing thing needs to be done about it,” says Bradley. is significantly different and better then the This sentiment is not unusual among medsomething everyone else is doing. Bradley ical directors, and even health plan CEOs see says that what sets his company’s anti-obesity “We happen to this as a viable undertaking. Charlie Baker, the “healthy lifestyle choices” program apart is its be not-for-profit, chief executive officer at Harvard Pilgrim comprehensiveness, how much the plan but we’re not a tracks outcomes and expenditures, and the charity,” says Don Health Care, says this approach to public health problems by insurers is a trend. recognition that this is a long-term project. Bradley MD, BCBSNC officials estimate that thanks to That last, the idea that the insurer wants to about why his Blues plan closely the healthy lifestyle choices program the ininfluence lifestyles over 20 or more years, tracks the outsurer saved about $450,000 on roughly 1,200 bumps into the historic hesitancy on man- comes in its antiparticipants over two years. Medical expenses aged care’s part to try to influence member obesity program. for the group were about a third less than behavior over the long haul. what the plan would have expected, given medical cost and utilization trends for commercial memSingle-state plan bership as a whole. Bradley says the plan saves about Bradley answers that in part by pointing to $200 per participant per year. Premiums were not BCBSNC’s position. “Yes, there is always some included in the equation. churn, but we’re a single-state plan,” says Bradley. “Premiums aren’t necessarily a good indicator of “Without a doubt we’re the largest carrier. We genthe health costs someone is incurring, particularly uinely believe that though we may lose people, by in an employer group setting,” says Bradley. and large we get them back.” The jaded among us used to discussing health Even if they’re no longer covered by an employer. care in billions of dollars might not find this all that Like many insurers, BCBSNC offers a Medicare noteworthy. But for a nose-to-the-grindstone medAdvantage plan, through a subsidiary. “We’d rather By Frank Diamond Managing Editor D 24 MANAGED CARE / OCTOBER 2008
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.