Health Professionals' perceptions of insurance coverage for weight loss services

Objective To examine health professionals' (HPs) perceptions of top challenges and solutions in obesity care, and whether these perceptions differ by patient-panel income level. Methods A 2014 national cross-sectional survey of HPs in nutrition, nursing, behavioural or mental health, exercise and pharmacy was analysed. The dependent variables were identification of insurance coverage for their services as a top (1) challenge or (2) solution for obesity care. The independent variable was self-reported income distribution of HPs' patient panels, which was dichotomized as 'lower-income' if 'mostly low income' or 'higher-income' if 'mostly not low income/evenly split between low-income and not low-income'. Multivariate logistic regression with survey weights was used. Results Among 450 HPs, mean age was 44.9 years; 86% were women; 44% had lower-income panels. Overall, 25% of HPs endorsed insurance coverage as a current challenge, and 58% viewed improved coverage as a solution. HPs with lower and higher-income patient panels were similarly likely to identify coverage as a challenge (28% vs. 20%, p = 0.33) and benefits expansion as a solution (47% vs. 64%, p = 0.08). Conclusions Most HPs perceive insurance coverage for their services to benefit patient weight loss. While the Affordable Care Act expands obesity counselling coverage to many lower-income patients, legislation increasing access to benefits for all patients regardless of insurance type may be beneficial.