Aetna’s Exercise in Obesity Treatment

    The heaviest participants will be contacted at least 29 times a year, primarily by phone, with nutritionists, weight-loss counselors and nurses at the other end of the line, Aetna spokeswoman Susan Millerick says. Those who only need to lose a few pounds will hear from Aetna about half as often.

    Participants will also be provided pedometers and discounts to community weight-loss programs. The pilot initiative is being marketed to 35,000 employees working at Aetna and building materials manufacturer Owens Corning, Millerick says. In the first eight weeks, 400 people have expressed interest.

    "I look at obesity as causing so many other problems in our health care costs," says Jane Hopkins, Aetna’s director of benefits. "If we can get people to manage that weight and be physically active, we are going to see decreases in medical costs."

Uncovering other conditions
    Hopkins acknowledges that self-insured companies like Aetna face inherent risks when they aggressively treat obesity.

    A recent Congressional Budget Office report looking at the potential cost-effectiveness of disease management highlighted that dilemma. Most current studies don’t include the financial hit of unearthing other, heretofore unknown, medical conditions, the report’s authors wrote.

    Still, Hopkins would prefer identifying employees’ obesity-related health problems sooner rather than later. "If we happen to stumble across the fact that they have diabetes and hypertension, that’s a good thing. If we don’t find that, then they will have the stroke or heart attack and they will be more expensive down the line."

Return on investment
    It’s too soon to speculate about the pilot program’s potential return on investment, Millerick says. Aetna officials plan to track both the program’s costs and clinical outcomes. But the real-life benefits of disease management are not necessarily limited to medical savings, she says.

    Aetna’s congestive heart failure program, for example, has a strong medical return on investment, with $3 in health costs saved for every $1 invested in the disease management program, Millerick says. On the other hand, the asthma program breaks even, with $1 saved in health costs for every $1 invested. But savvy employers understand the added value of boosted productivity, she says.

    "You have (asthmatic) children who are feeling better, so parents are at work," Millerick says. "You have employees who are breathing better, who are at work. You will in fact have that employee in that chair that day."