The 2023 California Association of Health Plans conference was an innovative and collaborative experience for the California healthcare industry. Lark enjoyed the opportunity to catch up with our industry peers for enlightening conversations on the ever-evolving landscape of healthcare, specifically the emergence of weight loss medications. After three days of presentations, meetings and networking, the panel on obesity strategies was our standout perspective from the event.
Titled Obesity: Strategies & Considerations for New Treatment, this panel of experts, featured Daphne Miller, MD of LifeLong Medical Center, Ian Duncan, PHD of Santa Barbara Actuaries Inc., and Dennis Hsieh, MD, JD of Central California Alliance of Health. The panelists delved into various aspects of weight management, obesity treatment, and the challenges faced by the healthcare industry.
Three Distinct Perspectives
Dr. Duncan started the conversation by discussing an overlooked concern about the escalating cost of GLP1 medication. He presented a cross-sectional study demonstrating that although patients taking GLP-1s experienced a decrease in BMI, the overall cost of their care did not diminish all else staying equal. In fact, health plans are paying anywhere from $14,000 to $15,000 per year per patient on GLP-1s, before discounts and rebates.
He emphasized that weight reduction might not be the primary avenue to lower healthcare costs for a vast range of patients and advocated for a more targeted approach to authorizing GLP-1s based on individual BMI brackets— further highlighting that health plans should be looking to vendor partners that help with responsible treatment triaging, lifestyle modification coaching, and processes around authorization requirements.
Next up was Dr. Miller who addressed that GLP-1 treatments are not one-size-fits-all for weight loss and the need for individualized approaches to address weight challenges. She highlighted the importance of coaching and guidance to support diet and lifestyle from a community perspective, endorsing the "Food is Medicine" approach. Furthermore, Miller underscored the significance of addressing social determinants of health (SDoHs) and partnering with vendors who contribute to the betterment of the community.
One of Miller's striking points was the significant role of zip codes in predicting health outcomes. She emphasized that changing one's zip code could have the most profound impact on metabolic health. This really resonated with Lark, because we have a long history of proven clinical outcomes in HPSAs. Additionally, group medical visits or social groups, such as a vibrant Facebook community that fosters member support and collaboration, were highlighted as solutions to overcome access issues.
Lastly, Dr. Hseih was focused on measuring the efficiency of GLP-1s and how to tackle the challenges associated with behavior change. He acknowledged that while wellness challenge programs, like "Couch to 5k", are often difficult to implement successfully, behavior-change programs to address obesity-related conditions were a starting point.
In conclusion, the California Association of Health Plans further emphasized the impact that obesity medications have had on weight management, obesity treatment, and more broadly, the future of healthcare. The insights shared by the panelists served as a reminder of the complexities and nuances involved in addressing weight management and health, ultimately highlighting the need for innovative, holistic, and member-centric approaches to tackle these pressing issues.
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