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If your obesity contributes to conditions that Anthem is already covering, like hypertension medication or sleep apnea equipment, make the argument that GLP-1 treatment could reduce those costs over time
Landman AB, Spatz ES, Cherlin EJ, Krumholz HM , Bradley EH, Curry LA
Unlike other weight loss management injections, most of which are GLP-1 receptor agonists, it has a powerful double action, as a GLP-1 and GIP receptor agonist
For beneficiaries to be eligible under the BALANCE Model, providers must attest that they meet certain clinical criteria, including qualifying for a GLP-1 for a currently covered use (such as type 2 diabetes, cardiovascular disease risk reduction, or sleep apnea) or for use to treat obesity based on similar clinical criteria as applied in the Medicare GLP-1 Bridge (Figure 3)
Owners will also need to monitor daily food, water, and urine ketone bodies
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