Health Plans and Bariatric Quality

This article appears in the February 2012 issue of HealthLeaders magazine.

Health plans have often changed their stance on covering bariatric surgery. During the peak of bariatric surgery in 2004, it was covered by most plans under a general category. But health plans soon began to require waiting periods for patients considering undergoing a weight-loss procedure.

Now that bariatric surgery is generally regarded as among the best solution to obesity, many plans are covering the surgery again. Plans are also dropping the pre-surgical weight loss and exercise requirements that they previously called for. None of these health plan requirements had any effect on quality outcomes, say David Provost, MD, founder of Provost Bariatrics in Denton, TX.

"Immediate pre-surgery routines, such as high-protein low-carb diets, decrease liver size and make operations easier and safer, but six-month wait plans mandated by insurers produced no evidence to support they’ll be effective of the outcome or predict success or failure for a weight-loss operation," he says.

This article appears in the February 2012 issue of HealthLeaders magazine.