Employee retention for subscribers with and without an obesity diagnosis in self-insured employer health plans: A claims-based analysis.

Abstract

Obesity rates in the United States have continued to grow, impacting health care costs and utilization among employer-based commercial insurance coverage. Many employers are now considering offering weight management programs and coverage of obesity treatments. Employers want to better understand the potential value of their investment dollars, given the delayed realization of health benefits from weight loss. To provide insights into the duration of employment for employees with obesity, this study aimed to observe whether there was a difference in employee retention based on diagnosis of obesity. A retrospective, observational descriptive study was conducted using an administrative claims database with over 50 million commercial lives. The study analyzed medical claims and enrollment data from 2014 to 2023 for self-insured employers. Individuals were categorized into obesity and nonobesity cohorts based on diagnosis codes. Retention rates were assessed using a Kaplan-Meier estimator, with statistical significance evaluated via a log-rank test. Among self-insured employer subscribers (employees who subscribe to their employer's insurance), subscribers with obesity had higher retention rates than those without (49% vs 26% at 5 years; 30% vs 14% at 10 years; <i>P</i> < 0.0001). This pattern was consistent across age bands and gender, with the highest retention observed in subscribers aged 30-49 years and subscribers who were male. Industry-specific analysis showed that subscribers with obesity in manufacturing, financial/insurance/real estate, and service/public administration had the highest retention, whereas the lowest retention was observed in retail. Subscribers with obesity-related comorbidities had a retention rate up to 10 percentage points higher at year 5 and 5 percentage points higher at year 10 compared with the overall obesity diagnosis cohort. Additionally, those with dependents diagnosed with obesity also showed higher retention compared with those with dependents who were not diagnosed with obesity (<i>P</i> < 0.0001). The study found a higher employee retention in subscribers who had a diagnosis for obesity compared with those who did not. This information could help employers estimate the potential long-term costs and benefits regarding weight management programs and coverage of obesity treatments.