Recent medical news supports the reasoning behind the innovative Wellness Incentive Program offered by Teachers Health Trust (THT), the 42-year-old, self-funded, nonprofit health insurance plan for educators in Clark County, Nevada. The program enables plan members to have bariatric surgery for an out-of-pocket co-pay of $5,000 that can then be fully reimbursed over the following five-year period if target body mass index (BMI) reductions are maintained.
Researchers reported earlier this summer at the annual meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS) that patients who underwent a sleeve gastrectomy or gastric bypass surgery lost approximately five times more weight after two years than people who used the anti-obesity GLP-1 prescription drugs Wegovy and Zepbound. The findings show bariatric surgery is associated with “superior sustained, long term weight loss” compared to GLP-1s among patients eligible for both options.
“This procedure was the best thing I have ever done for my health,” said Dean Goldhammer, who lost more than 86 pounds and attained 97% of his weight loss goal. “The benefit was not only weight loss, but the surgery also reduced my hypertension and made my joints feel better. The medications I was taking prior to surgery and weight loss have now been decreased or eliminated. I am much more active. I play pickleball almost daily and I walk every day… the gastric sleeve was a miracle in my life.”
“We are committed to helping our members to achieve sustainable weight loss and a healthy lifestyle in the long-term,” said Tom Zumtobel, CEO of Teachers Health Trust. “Based on medical outcomes we have seen, which this latest research supports, bariatric surgery enables patients to lose weight and keep it off more effectively than GLP-1 drugs. As a result, Teachers Health Trust incentivizes our members to get the procedure if they need it and then to maintain a healthy lifestyle to ultimately recoup their full co-pay.”
Specifically, the THT Wellness Incentive Program allows members to get gastric sleeve or gastric bypass surgery for a $5,000 co-pay, and then, recoup $1,000 annually over the next five years, by achieving a 5-point BMI reduction in the first year and two additional points each year thereafter for a total of a 9-point BMI reduction after five years. Alternatively, patients who meet program criteria including surgical office visits, primary care physician appointments, visits with a certified dietician, and support group meetings are also eligible to recoup their co-pay.
Since its debut in 2023, 56 THT members have taken advantage of the THT Wellness Incentive Program with the utilization rate doubling from the first year to the second. With the publicity of the new medical research, THT is hopeful that even more members will take advantage of the program in 2025.
About Teachers Health Trust
In October 1983, the Clark County School District (CCSD) and Clark County Education Association (CCEA) collaborated to establish the Teachers Health Trust (THT) as the health plan for its educators. It is a self-funded, nonprofit health insurance plan available to all CCSD (and other partner charter schools) educators and their dependents in Clark County, Nevada. For more information visit: www.ththealth.org.
