Obesity Surgery

, Volume 30, Issue 1, pp 374–377 | Cite as

Impact of Statewide Essential Health Benefits on Utilization of Bariatric Surgery

  • Karan R. ChhabraEmail author
  • Zhaohui Fan
  • Grace F. Chao
  • Justin B. Dimick
  • Dana A. Telem
Brief Communication



In response to concerns about inadequate insurance coverage, bariatric surgery was included in the Affordable Care Act’s essential health benefits program—requiring individual and small-group insurance plans in 23 states to cover bariatric surgery. We evaluated the impact of this policy on bariatric surgery utilization.


Multiple-group interrupted time series analyses of IBM MarketScan commercial claims data from 2009 to 2016.


Bariatric surgery utilization increased in all states after ACA implementation, but this increase was no greater in states with a bariatric surgery essential health benefit.


Our findings suggest that the essential health benefits program may have been too narrow in scope to meaningfully increase bariatric surgery utilization at the population level.


Health policy Health insurance Essential health benefits Bariatric surgery Utilization 



The authors acknowledge the Institute for Healthcare Policy & Innovation Data and Methods Hub for analytic support on an earlier version of this manuscript.


Dr. Chhabra receives funding from the University of Michigan Institute for Healthcare Policy and Innovation Clinician Scholars Program, Agency for Healthcare Research and Quality grant T32HS000053, and the National Institutes of Health’s Division of Loan Repayment. Dr. Chao receives funding from the Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System; this work does not represent the views of the US government nor the Veterans Affairs. Dr. Dimick receives grant funding from the NIH, AHRQ, and BlueCross BlueShield of Michigan Foundation. Dr. Telem receives funding from AHRQ K08 HS025778-01A1.

Compliance with Ethical Standards

Conflict of Interest

Dr. Dimick is a cofounder of ArborMetrix, Inc., a company that makes software for profiling hospital quality and efficiency, which had no role in the work herein. Dr. Telem receives consulting fees from Medtronic. All other authors declare that they have no conflict of interest.

Ethical Approval Statement

For this type of study, formal consent is not required.

Informed Consent Statement

Does not apply.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.National Clinician Scholars Program at the Institute for Healthcare Policy and InnovationUniversity of MichiganAnn ArborUSA
  2. 2.Center for Healthcare Outcomes and PolicyUniversity of MichiganAnn ArborUSA
  3. 3.Department of SurgeryBrigham and Women’s HospitalBostonUSA
  4. 4.Department of SurgeryYale School of MedicineNew HavenUSA
  5. 5.Department of SurgeryUniversity of MichiganAnn ArborUSA

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