Top Employer Strategies for Health Equity in Obesity, Diabetes

When it comes to obesity and diabetes benefit design, employers can—and should—adopt a health equity mindset, according to a flipbook from the Northeast Business Group on Health (NEBGH).

“Obesity and diabetes disproportionately affect people of color,” the flipbook emphasized. “Racial and ethnic disparities are pronounced in both the prevalence and treatment of obesity.”

The flipbook noted that Native Americans are twice as likely as White people to have diabetes and Black Americans are 50 percent more likely to have type 2 diabetes, which is the predominant type of diabetes and is capable of going into remission, unlike type 1 diabetes. 

Care disparities are also present in diagnosis—around four in ten Hispanic or Latino individuals who have diabetes have not been diagnosed with diabetes, experts estimate.

Given these disparities, employers should view their obesity and diabetes health benefits through the lens of health equity in order to see stronger results for their employee populations.

The book recommended seven ways to design obesity and diabetes benefits with a health equity focus.

First, employers should incorporate their obesity and diabetes chronic disease prevention and management benefits into their overall diversity, equity, and inclusion strategy. This means that diversity, equity, and inclusion leaders and employee resource groups should be aware of these health benefits in order to promote them.

Employee resource groups are an excellent space for employers to receive feedback on their health benefits in order to refine them to fit the needs of minority employee populations.

Employers should assess any gaps or inequities in their diabetes and obesity chronic disease management benefits and programs by collecting and assessing data on these efforts. Data sources can include payroll data and healthcare claims. Other resources have recommended overlaying publicly available data to identify social determinants of health needs.

Second, employers should consider their employer-sponsored health plan benefits designs.

“Employee wellness programs can be helpful in preventing obesity and diabetes but are less effective in helping people already struggling with these diseases and who need more targeted interventions,” the flipbook noted.

Employers should identify and address the lack of utilization of obesity and diabetes care management tools among minority populations. 

Employers should reduce barriers such as lack of healthcare coverage for obesity and diabetes care, lack of primary care provider education on obesity care, poor provider reimbursement, lack of trust among employees in the healthcare system overall, and lack of diversity in the provider network.

NEBGH recommended five components for sufficient obesity coverage and three measures for diabetes management coverage. Employers should cover obesity preventive care services, behavioral healthcare treatments, medications, surgeries, and weight maintenance programs. They should also cover preventive care services for diabetes, as well as diabetes monitoring costs and treatment.

Third, employers should focus on patient education about these conditions, which includes identifying obesity as a disease.

Fourth, employers should ensure that there are no financial barriers for minority employee populations as they try to access obesity and diabetes chronic disease prevention and management benefits.

For example, employers might eliminate copays or deductibles for BMI screenings or obesity specialist consultations and coordinate with payers and providers to integrate lifestyle change programs into their benefits to support employees who face obesity. 

For employees at risk for or who have been diagnosed with diabetes, employers may take steps to lower the costs of insulin and glucose-lowering medications and pass prescription discounts and rebates on to them at the point of sale.

Value-based insurance design and social determinants of health support play a huge role in establishing affordability and equitable access to care, the flipbook added.

Fifth, employers should offer mental and behavioral healthcare resources for individuals struggling with diabetes and obesity care.

Sixth, it is the employer’s responsibility to not only assess their own health equity practices, but also to ensure that the diabetes and obesity care management vendors with which they partner are pursuing health equity.

NEBGH provided a list of questions that employers can use to assess whether a vendor will offer equitable care services and encouraged employers to push for diversity in provider networks.

Finally, employers should advocate for and invest in health equity efforts. This includes investing in employees’ communities, investing in healthcare diversity, and staying up-to-date on relevant legislation such as the US Treat and Reduce Obesity Act which has implications for self-insured employers specifically.

As employers seek to support diabetes and obesity chronic disease management and prevention among their employees, they cannot ignore the critical role that health equity plays in the success of these efforts, the NEBGH resource emphasized.