Nashville, Tenn.-based Vanderbilt University Medical Center and Greenville-based University of South Carolina researchers conducted the study. They studied plans in Oklahoma, Oregon and Virginia. These states have some plans that include bariatric surgery coverage.
The researchers used data from Avalere PlanScape, which analyzed the plans with the CMS Plan Attributes and Benefits and Cost Sharing Public Use Files.
Here are five key takeaways:
1. The researchers found slightly higher insurance premiums for plans with surgery benefits. The disparity in premiums in Oregon and Oklahoma was $24.67 versus $29.33.
2. Of the 51 State Health Exchanges, only 23 of them include bariatric surgery coverage.
3. John M. Morton, MD, president of ASMBS and chief of minimally invasive surgery, Stanford (Calif.) University School of Medicine, said there is a stark geographic issue: “Many of the states expected to exclude obesity treatments can be found in the South, where the highest rates of obesity can be found.”
4. Wayne English, MD, associate professor of surgery at Vanderbilt University Medical Center, Brandon Williams, MD, Vanderbilt Medical Center and John Scott, MD, University of South Carolina co-authored the study.
5. Nonprofit ASMBS involves a global collaboration of bariatric surgeons.
“This study shows it’s not really a cost issue as to why bariatric surgery isn’t covered,” said Dr. English. “…It shouldn’t matter where you live as to whether or not you have access to bariatric surgery.”
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