Few Medicare Providers Offer Intensive Behavioral Therapy for Obesity

Just 1% of primary care providers who cared for Medicare beneficiaries provided intensive behavioral therapy (IBT) for obesity at any time between 2013 and 2019, according to a study published online in PLOS One.

“Although IBT utilization in the Medicare population across the United States has been steadily increasing over the years since the implementation of the Centers for Medicare and Medicaid Services (CMS) procedure codes, it is still a highly underutilized benefit among the Medicare population who qualify for the service,” wrote corresponding author Zhehui Luo, PhD, of Michigan State University, East Lansing, Michigan, and study coauthors. “Approximately 28.5% of Medicare beneficiaries are estimated to meet criteria for obesity, suggesting there are about 10 to 11 million fee-for-service beneficiaries that meet the criteria to receive IBT services per year.”

The study investigated IBT procedure codes among 537,754 primary care providers with more than 10 patients insured by Medicare for the years 2013 through 2019. Individual IBT for obesity has been covered by Medicare since 2011 and group IBT since 2015.

Only 1.2% of the primary care providers included in the analysis provided IBT services in any year during the 7-year period, according to the study. Among them, 246 were considered always users (with IBT claims for more than 10 beneficiaries every year), 1358 were considered early adopters (with some IBT claims in 2013 or 2014 but not always in the other years), and 4563 were considered late adopters (with no IBT claims in 2013 and 2014 but at least one claim in another year).

Providers who delivered IBT were more likely to be men, internal medicine providers, and located in the South or Northeast. They also saw more patients covered by Medicare, the study found, and had a higher proportion of patients with hyperlipidemia.

“Further investigation is needed to mitigate barriers to the uptake of IBT services among primary care providers,” researchers wrote.

Reference

Ozoor M, Gritz M, Dolor RJ, Holtrop JS, Luo Z. Primary care provider uptake of intensive behavioral therapy for obesity in Medicare patients, 2013-2019. PLoS One. 2023;18(3):e0266217. doi:10.1371/journal.pone.0266217