Employer Health Benefits

A Programmatic Approach to Leveraging Anti-Obesity Medications

Self-funded plan sponsors face a critical stewardship decision around member demand for highly effective, and costly, anti-obesity medications. To cover or not to cover? The effectiveness of the medications makes the decision more complex as it highlights the role and the responsibility of the plan to be a good steward of financial and health resources.

Responsibility. It’s a powerful word. How far does responsibility to members go when it comes to their lifestyle choices and the consequences, and costs, of those choices? Plan sponsors have been balancing this question since the beginning but the stakes have increased as pharmaceutical options have proliferated to help ameliorate random disease as well as disease brought-on by lifestyle choices. We want the best for members but must also protect plan resources. A balance must be found.

Plan sponsors want to responsibly support members on their path to healthiness and are looking for programmatic pathways to managing the cost of new anti-obesity medications while maximizing their benefit to members. However, concerns lie in simply adding expensive medications to health plans without mechanisms for ensuring their appropriate use and effective management. The question is: how do we help our members benefit from these new products responsibly without driving costs through the roof?

A Blueprint for Success

Northwind’s Weight Management Clinical Blueprint pairs industry-leading health coaching focused on lifestyle behavior change with powerful weight loss medications.  Our innovative approach to sustainable weight loss is focused on an ongoing commitment by engaged individuals to invest in themselves and their overall health with improvement in lifestyle choices and appropriate use of anti-obesity medications. 

Through collaboration with our self-funded clients and clinical partners, we build programs that incorporate offerings within the existing benefit design to increase utilization of established resources.  In alliance with physicians, nurse practitioners, and physician assistants, our program incorporates the expertise of clinically trained pharmacists to implement best practices for obesity management, ensure medication safety, navigate tolerability and dosing challenges, and optimize therapeutic outcomes. 

Our highly skilled health coaches are key in building strong connections with people and influencing lifestyle behavior change across the continuum.  They work diligently to meet people where they are, understand their challenges, and creatively build unique plans to generate forward progress.  Along with ongoing weight monitoring and goal tracking, engaged individuals are also monitored for presence and improvement of other weight-related complications. 

Ultimately, the goal for our Weight Management Clinical Blueprint is to help patients optimize the use of medications with adjustments in behavior to move to a higher state of healthiness. With clinical focus and programmatic management, we make sure the right medications are used in the right way at the right time and for the right duration. Side by side with plan sponsors and clinician partners, Northwind is committed to driving and maintaining successful weight loss that results in happier, healthier, more productive member populations. 

That is good stewardship.

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Betsy Bigler | Mar 7th, 2024
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Phillip Berry | Jan 31st, 2024
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