Telemedicine and primary care obesity management in rural areas – innovative approach for older adults?
Published Date:Jan 05 2017
Source:BMC Geriatr. 17.
Pubmed Central ID:PMC5216556
Funding:R01 HS021681/HS/AHRQ HHS/United States
U01 HL122904/HL/NHLBI NIH HHS/United States
U54 EB015408/EB/NIBIB NIH HHS/United States
UL1 TR001086/TR/NCATS NIH HHS/United States
U48 DP005018/DP/NCCDPHP CDC HHS/United States
K23 AG051681/AG/NIA NIH HHS/United States
U01 EB012470/EB/NIBIB NIH HHS/United States
The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity.
We describe the challenges in the implementation and delivery into real-world settings. The challenges in rural settings that have the fastest growing elderly population, high obesity rates, but also workforce shortages and lack of specialized services are emphasized. The use of Telemedicine has successfully been implemented in other specialties and could be a useful modality in delivering much needed intensive behavioral therapy, particularly in distant, under-resourced environments. This review outlines some of the challenges with the current benefit and proposed solutions in overcoming rural primary care barriers to implementation, including changes in staffing models.
Recommendations to extend the benefit’s coverage to be more inclusive of non-physician team members is needed but also for improvement in reimbursement for telemedicine services for older adults with obesity.
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