Obesity Management in 2024: A Look at the CINEMA Program’s Growth and Impact

Ian Neeland, MD, recently chaired an Institute for Value-Based Medicine^® event hosted by The American Journal of Managed Care® (AJMC^®) and University Hospitals in Cleveland, Ohio. Neeland serves as director of cardiovascular prevention and codirector of the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA) at the University Hospitals Harrington Heart & Vascular Institute, as well as associate professor of medicine at Case Western Reserve University School of Medicine.

AJMC sat down with Neeland at the event to discuss the CINEMA team at University Hospitals, which focuses on patient care and outcomes and has led to significant growth in patient visits and referrals, as well as the challenges in obesity management in 2024 amidst the ongoing semaglutide shortage affecting both patients with diabetes and obesity.

During his opening presentation, Neeland referenced major successes of the CINEMA program in 2023 and 2024. In 2023, the program saw a 57% increase in new patient visits, a 28% increase in established patient visits, and a 24% increase in total referrals. The team has also expanded, adding an advanced practice provider, a second nurse navigator and dietitian, and a fifth physician to the program.

This transcript has been lightly edited for clarity.

Transcript

Can you explain what working on the CINEMA team is like for the providers at University Hospitals?

Working on the CINEMA team is really a joy. It's one of the greatest things that I've done in my career and one of the things that really is impactful for both patients and providers, I think, in our health system. We have a great team, it's a very diverse team with lots of different expertise, and we really work well together and complement each other. We're all focused on patient care, excellence, and outcomes for patients, and making people healthier and living better and happier.

What factors have contributed to the program’s remarkable growth in new and established patient visits and referrals?

I think that our outcomes speak volumes, and patient testimonials and their journey in our program is really what puts us forth and really makes us unique. So, when a patient is so successful with improving their health, improving their risk factors, and lowering their risk for heart disease, that really is the word of mouth that goes around both for doctors and for patients, and people are interested.

I also think that all the research that we do and all the community engagement that we do really goes far and wide across Cleveland and beyond, and really helps to engage people, get them excited about the program, and helps drive our growth. And certainly our leadership for our health care institution, they're behind us 100%, and their support and their assistance with our program growth really has spurred us to grow year over year. And we continue to add people to our team and continue to reach out to more and more patients across the Cleveland area.

Can you elaborate on what those community engagement efforts are?

We have both marketing to patients across the Cleveland area to show them what we do, why we do it, and the value that we bring. We also have lots of educational opportunities both for patients and providers, [such as] weekly meetings and educational events [and] monthly speaker series. So, we really try to engage and reach out to the community, let them know what we do and why we do it, and people really respond well.

What are the biggest challenges in obesity management in 2024, and how is the CINEMA program combatting them?

I think that people who are living with obesity want to be treated; they want to feel better and reduce their risk for heart disease and diabetes. It's just there's so many people that are living with obesity—up to 40% of people in the United States—we just don't have enough providers [or] enough resources for these folks. It's just a supply and demand issue, predominantly, and also an issue of education. Not as many people are educated on how to address obesity, manage obesity, how to work with patients to do that. We don't get education like that, really, in our training. So, the CINEMA program really tries to address those issues, narrow those gaps, and really try to make sure that we meet patients where they are and provide them the resources and tools that they can be successful in their treatment.