Changes in Healthcare Spending Attributable to Obesity: Payer- and Service-Specific Estimates

Abstract

Background: National efforts to control US healthcare spending are potentially undermined by changes in patient characteristics, and in particular increases in rates of obesity. The objective of this study was to provide current estimates of the effect of obesity on healthcare spending overall, by service line and by payer using the NIH classifications for BMI. Methods: We used a quasi-experimental design and analyzed the data using generalized linear models and two-part models to estimate obesity-attributable spending. Data was drawn from the 2006 and 2016 Medical Expenditures Panel Survey. We identified individuals in the different BMI classes based on self-reported height and weight. Results: Total medical costs attributable to obesity rose to $126 billion per year by 2016, although the marginal cost of obesity declined for all obesity classes. The overall spending increase was due to an increase in obesity prevalence and a population shift to higher obesity classes. Obesity related spending between 2006 and 2016 was relatively constant due to decreases in inpatient spending, which were only partially offset by increases in outpatient spending. Conclusions: Obesity related spending between 2006 and 2016 was relatively constant due to decreases in inpatient spending, which were only partially offset by increases in outpatient spending. Obesity class 2 and 3 were the main factor driving spending increases, suggesting that persons over BMI of 35 should be the focus for controlling spending.