When Bariatric Surgery is Easier to Obtain, Everybody Wins

In the past, morbidly obese patients faced insurmountable obstacles to fix their health.  Private Insurance companies were allowed to drop them from coverage without warning.  Government-funded insurances would only pay under very defined circumstances and only at a "Center of Excellence," CMS's definition of a Medicare and Medicaid covered hospital.  The expense of travel to and from these regional hospitals, post-surgical care, and the costs of lost work income are often too much for a person to pay for out of pocket, especially if they also have to potentially pay for the surgery themselves.

A group of surgeons from Michigan looked at the long term outlooks if bariatric surgery was covered and their prognosis was pretty incredible.  They found that the costs of the surgery would be recouped by the insurance payer within 2 to 3 years because of the balance in expenses that would be created when the patient no longer had Type II Diabetes, Sleep Apnea, Heart Disease and Arrhythmias, Incontinence, and high risks of Cancer.  Not to mention the lowered costs of in home care, specialty (and expensive) bariatric medical equipment, and home modifications.  They also found that the surgery could be performed more locally, further increasing access, without detriment to the patient.  

It appears to be a no-brainer, win-win situation.  What are your opinions?

POSTED ON: February 12 2014
Posted by:Su-Lauren Wilson owner,CFO
image description