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The Alliance convened a workgroup of large public and private employers, and union trusts over four months to identify and act upon opportunities for improvement in their health and wellness offerings to improve care for their workforce of people living with obesity.
The Alliance included clinical research as a model, including Prevention and Screening, Behavior Therapy, Pharmacotherapy, Surgery, and Weight Maintenance.
The Alliance shared other publicly available clinical pathways and provided information to educate members should they decide to develop treatment pathways for patients with obesity.
With our partners at Midwest Business Group on Health, an Obesity Management Toolkit was created, full of employer-focused resources from addressing obesity through employee benefits to business cases and economics.

Access the Obesity Management Toolkit

Obesity Workgroup — Washington Health Alliance

Obesity Workgroup — Employer Profiles

1

Employer #1

Industry
Public Sector Benefit Trust
Covered Lives (WA)
30,000+
Coverage
HMO & PPO

Challenges

We coordinate benefits for 270 employer groups state-wide. While enrollment skews toward one carrier, the lower-enrollment plan has a higher percentage of enrollees with obesity. Getting useful claims data has been difficult — obesity coding rates are generally low, and we can only pull one diagnosis at a time, making comorbidity analysis difficult. We also currently lack coverage for any weight loss medications.

2

Employer #2

Industry
Public
Covered Lives (WA)
15,000
Coverage
HMO & PPO

Challenges

Claims data from one of our plans is less transparent and may be inflating patient counts when a member has multiple diagnoses. Current lifestyle programs need review for condition-specific and culturally competent options — a focus group reported perceived obesity bias and lack of cultural representation from one vendor. Members have requested more weight management coverage, and we've seen escalating costs for GLP-1 prescriptions used off-label without a diabetes diagnosis.

3

Employer #3

Industry
Public
Covered Lives (WA)
30,000+
Coverage
HMO & PPO

Key Data Points

0.058%
of enrolled members had a principal diagnosis of overweight or obesity — despite far higher related diagnoses
14%
have related diagnoses of dyslipidemia, type 2 diabetes, hypertension, or metabolic syndrome
27%
of PPO members receiving Ozempic had no diabetes diagnosis — Ozempic ranks 7th in drug spend with a 118% cost trend over 12 months
4

Employer #4

Industry
Public Union Trust
Covered Lives (WA)
22,000
Coverage
HMO & PPO

Challenges

54%
of the population have a chronic condition with a comorbidity of obesity — yet engagement in available programs remains low

Coverage of pharmacotherapy is currently restricted to diabetes management, but members have requested weight management coverage as well. We also recognize the need to extend coverage to minors.

Overweight and Obesity – Labels & Language

According to the Centers for Disease Control and Prevention (CDC), overweight and obesity are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. We are using the CDC’s recommendations for the use of people-first language. For example, “adults with obesity” and “individuals who are overweight or have obesity” are used rather than “obese adults” and “individuals who are overweight or are obese”. For more information on people-first language for obesity, click here.