Patients who successfully lose weight typically regain much of that weight after 1 year and nearly all of it by 5 years (7). Moreover, obesity rates were higher among veterans who obtained care partially (28%) or exclusively (31%) in Veterans Affairs Medical Centers (VAMCs) than veterans who did not use VA services (24%).ĭespite widespread dissemination of evidence-based weight management recommendations, only 20% of people trying to lose weight adhere to guidelines on dietary intake and physical activity (6). Veterans have a higher rate of overweight and obesity than the general population (5). Excess weight is also costly, resulting in an estimated $75 to $93 billion in annual medical care expenditures (4). Obesity is associated with chronic, debilitating illnesses (2) and was the second leading cause of preventable deaths in the United States in 2005 (3). Obesity is a major health and health care problem more than one-third of Americans are currently obese and another approximately one-third are overweight (1). These results suggest that VA should not assume that copayment reductions for selective preventive services will motivate patient change and achieve intended system-level outcomes. We saw an unexpected larger increase in demand among veterans who receive all VA care for free. Analysis of number of clinic visits adjusted for patient and clinic factors also found that exempt and nonexempt veterans had similar numbers of repeat clinic visits. This finding was confirmed in adjusted analyses. All models were adjusted for patient and clinic factors.Īmong newly exempt patients, the clinic-standardized rate of new use increased by 2.2% after the copayment was eliminated but increased 12% among already exempt veterans. We used 2 outcomes before and after copayment elimination: 1) the ratio of number of clinic visits by new users with the mean number of MOVE! clinic visits by all users, and 2) the number of clinic visits by each new user in the 6 months after their first visit. We examined clinic use via mixed-effects models for patients who were already exempt from copayment and patients who were newly exempt from copayment. We examined clinic use by 44,411 new patients seen in a Veterans Affairs (VA) MOVE! weight management clinic before the copayment elimination and clinic use by 64,398 new patients seen in the year after copayment elimination.

Our objective was to examine whether copayment elimination increased use of a weight loss clinic by veterans. Overweight and obesity are public health issues in the United States, and veterans have a higher rate of overweight and obesity than the general population. Demand for Weight Loss Counseling After Copayment Elimination. Suggested citation for this article: Maciejewski ML, Yancy WS Jr, Olsen M, Weidenbacher HJ, Abbott D, Weinberger M, et al. Weidenbacher, PhD David Abbott, MS, MCS Morris Weinberger, PhD Santanu Datta, PhD Leila C. Yancy Jr, MD, MPH Maren Olsen, PhD Hollis J.

Va copay rates 2012