Investigators at University of Maryland Report Findings in Bariatric Surgery (Insurance Coverage of Pediatric Bariatric Surgery: a Cross-sectional Analysis of the Usa): Surgery – Bariatric Surgery

2021 NOV 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity Daily News -- Fresh data on Surgery - Bariatric Surgery are presented in a new report. According to news reporting out of Baltimore, Maryland, by NewsRx editors, research stated, “Pediatric bariatric surgery is increasingly recognized as a safe and effective option for the management of obesity and obesity-related conditions. However, insurance coverage is a key barrier to accessing these procedures.”

Our news journalists obtained a quote from the research from the University of Maryland, “Criteria are variable and often not evidence-based. In an effort to characterize common patterns in insurance coverage, we report coverage criteria for adolescents relative to adults. We surveyed medical policies of the 50 highest market share health insurance providers in the USA. Private insurer coverage criteria included age, Tanner staging, skeletal maturity, body mass index, procedures covered, medical weight management requirements, co-morbidities, and multidisciplinary team criteria. These were then compared to the American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines. Two thirds (n = 33, 66%) of companies provided inclusion criteria for adolescents. All policies covered RYGB (n = 33), most covered sleeve gastrectomy (n = 32, 97.0%). Obstructive sleep apnea (OSA) (n = 32, 97%), hypertension (HTN) (n = 27, 81.8%), and gastroesophageal reflux disease (GERD) (n = 11, 33.3%) were the three most commonly cited co-morbidities used as inclusion criteria. Tanner staging or skeletal maturity were most commonly used (n = 10, 30.3%). Similarly, twenty (60.6%) insurers required medical weight management programs. Multi-disciplinary teams were required by 81.8% of adolescent policies (n = 27) as described by the ASMBS. Seventeen (51.5%) policies defined providers for these teams, and 10 (30.3%) provided other defined criteria. Contrary to ASMBS guidelines, companies commonly require Tanner staging and/or skeletal maturity criteria as well as participation in medical weight management programs.”

According to the news editors, the research concluded: “Also, multi-disciplinary team are frequently required but not well defined.”

This research has been peer-reviewed.

For more information on this research see: Insurance Coverage of Pediatric Bariatric Surgery: a Cross-sectional Analysis of the Usa. Obesity Surgery, 2021. Obesity Surgery can be contacted at: Springer, One New York Plaza, Suite 4600, New York, Ny, United States. (Springer - www.springer.com; Obesity Surgery - http://www.springerlink.com/content/0960-8923/)

Our news journalists report that additional information may be obtained by contacting Yvonne M. Rasko, University of Maryland, Dept. of Surgery, Division of Plastic Surgery, Med Ctr, 22 S Greene St, Baltimore, MD 21201, United States. Additional authors for this research include Brooks J. Knighton, Cynthia T. Yusuf, Michael Ha, Ledibabari M. Ngaage, Selim Gebran, Natalia Kubicki and Mark D. Kligman.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1007/s11695-021-05744-9. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

(Our reports deliver fact-based news of research and discoveries from around the world.)