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National rates for Bariatric Surgery on the Rise,

 

By: Elizabeth Smith, President

     ESA Medical Resources

As the national rate of obesity steadily has increased across all age groups, so has Americas willingness to turn to an effective surgical intervention to address severe obesity.

From 1996-2002 the use of bariatric surgery has increased seven-fold nationally, and its use has more than tripled among youth. More than 80 percent of individuals in all age groups who underwent the procedure were female.

These findings, from researchers at the University of Michigan, also reveal that in 2002 alone hospitals charged more than $2 billion for bariatric surgery, with private insurers picking up more than 80 percent of the charges.

Results from the study, which also examined the most common medical conditions among youth who undergo bariatric surgery, were reported in the January issue of Archives of Surgery.

Bariatric surgery, which includes procedures such as gastric bypass, gastric banding and biliopancreatic diversion, aims to change the gastrointestinal tract to restrict the amount of food a person is able to consume.

The procedure is recommended only for individuals with severe obesity, or for those who are obese and suffering from other medical complications of obesity such as diabetes.

The increase is having a noticeable impact on health insurance. In 2002 hospitals charged more than $2 billion for these procedures, with more than 80 percent billed to private insurers. On average, each hospital stay in 2002 for bariatric surgery led to about $29,000 in charges.

Private payers are shouldering an increased share of the costs for bariatric surgery, and this trend is most likely a result of increased coverage among private payers for this procedure, which has a track record of success compared to other therapies for obesity. The surgery appears to be an increasingly attractive option for private insurance plans and employers who face growing health care costs associated with obesity.

In February 2006 the Centers for Medicare & Medicaid Services (CMS) announced it will establish a national coverage policy for bariatric surgery to help reduce the significant health risks, including death and disability, associated with obesity.  This new policy applies to all Medicare recipients including those over 65 and Medicare disabled who are morbidly obese (body mass index or BMI of 35 or greater) with any obesity related condition or disease and have been previously unsuccessful with the medical treatment of obesity.  Medicare’s coverage for Bariatric surgery will also increase the revenues for physician and hospitals performing Bariatric surgery.  The demand for Bariatric Surgery will increase the need for Bariatric trained surgeons and support staff.  

 

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