Abstract
Purpose of review
The goal of this publication is to review the strengths, weaknesses, opportunities, threats, and history to advocacy in bariatric surgery.
Recent findings
Bariatric surgery has increased in insurance coverage through recognition of the disease process and safety and efficacy of procedure.
Summary
While bariatric surgery coverage has increased, patients with obesity still have multiple barriers to care.
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References
Recently published papers of particular interest have been highlighted as: • Of importance •• Of major importance
•• Azagury D, Morton J. Bariatric surgery outcomes in US accredited vs non-accredited centers: a systematic review. J Am Coll Surg. 2016;223(3):469–77. Demonstrates value of accreditation to payers for further acceptance.
•• English WJ, DeMaria EJ, Brethauer SA, Mattar SG, Rosenthal RJ, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14(3):259–63. Shows number of cases annually still only 1% of population.
Willaimson JM, Rink JA, Hewin DH. The portrayal of bariatric surgery in the UK print media. Obes Surg. 2012;22(11):1690–4.
Gulliford MC, Charlton J, Booth HP, Fildes A, Khan O, Reddy M, et al. Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records. Value Health. 2017;20(1):85–92.
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http://www.modernhealthcare.com/article/20140215/INFO/302159935.
http://www.commonwealthfund.org/interactives-and-data/maps-and-data/state-exchange-map.
English W, Williams B, Scott J, Morton J. Covering bariatric surgery has minimal effect on insurance cost within the Affordable Care Act. Surg Obes Relat Dis. 2016;12(5):1045–50.
https://www.obesitycoverage.com/insurance-and-costs/am-i-covered/check-my-insurance.
Schneider A, Hutcheon D, Hale A, Ewing JA, Miller M, Scott JD. Postoperative outcomes in bariatric surgical patients participating in an insurance-mandated preoperative weight management program. Surg Obes Relat Dis. 2018. https://doi.org/10.1016/j.soard.2018.01.036.
• Sadhasivam S, Larson CJ, Lambert PJ, Mathiason MA, Kothari SN. Refusal, denials, and patient choice: reasons prospective patients do not undergo bariatric surgery. Surg Obes Relat Dis. 2007;3(5):531–5. Delineates patient barriers to care.
Wang YC, Pamplin J, Long MW, Ward ZJ, Gortmaker SL, Andreyeva T. Severe obesity in adults cost state Medicare programs nearly $8 billion in 2013. Health Aff (Millwood). 2015;34(11):1923–31.
Palli SR, Rizzo JA, Heidrich N. Bariatric surgery coverage: a comprehensive budget impact analysis from a payer perspective. Obes Surg. 2018. https://doi.org/10.1007/s11695-017-3085-8.
Warren JA, Ewing JA, Hale A, Blackhurst D, Bour ES, Scott JD. Cost-effectiveness of bariatric surgery: increasing the economic viability of the most effective treatment for type 2 diabetes mellitus. Am Surg. 2015; 81(8): 807–11. https://www.kff.org/health-reform/state-indicator/state-decisions-for-creating-health-insurance-exchanges-and-expanding-medicaid/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D.
http://connect.asmbs.org/february-2018-pa-employee-coverage.html.
Funk LM, Jolles SA, Greenberg CC, Schwarze ML, Safdar N, McVay MA, Whittle JC, Maciehewski ML, Voils CI. Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study. Surg Obes Relat Dis. 2016;12(4):893–901.
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ObesityPAC Annual Report: 2016-2017. https://asmbs.org/wp/uploads/2017/11/ObesityPAC-Annual-Report-2016-2017-1.pdf.
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Conflict of interest
John D Scott and John M. Morton declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical collection on Bariatric Surgery.