Sunday, July 6, 2008

Insurance for Bariatric Surgical Complications

In 2006, the American Society for Metabolic and Bariatric Surgery (ASMBS) estimated that less than 1% of persons needing bariatric surgery actually get the surgery. Part of the reason for this is the cost of the surgery.

Some estimates put bariatric surgery at around $25000.00 on average. Getting insurance companies to pay for the surgery often proves difficult. And even if a prospective patient is able to pay out-of-pocket for the basic surgery, associated medical care complications can drive the cost up.

Surgery related medical care complications can can cause the cost of the surgery to rise to more than double the original cost. So even for a potential patient who can pay for the basic bariatric surgery, the possible additional cost to treat medical care complications can discourage the potential patient from getting the surgery.

However, the financial services company, BLIS, recently introduced an insurance policy for bariatric surgical patients that covers the cost of medical care complications. The name of the BLIS product is BLISCare.

BLIS does have a set of standards that must be satisfied by the bariatric surgical provider. Standards for a provider include having been inducted into a bariatric Center of Excellence Program (COE), such as the one initiated by the ASMBS.

In any case, we believe that this policy could encourage some to get the surgery who would not otherwise do so, since this policy serves as protection against the cost of possible complications. Therefore, the policy could increase the market for bariatric surgery.

This kind of policy underscores the fact that bariatric centers should establish, maintain, and enforce high standards for the surgery. These centers should position themselves to enter a COE program or maintain their standing in the program. This should be part of any surgical weight loss center's strategic plan.


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