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Obesity Surgery Program Yields Significant Results for Patients

Posted on: Tuesday, 10 October 2006, 12:00 CDT

CHAPEL HILL, N.C., Oct. 10 /PRNewswire/ -- Hospital readmission rates from bariatric procedures were nearly cut in half by the twelve surgeons in North Carolina that are designated as centers of excellence for bariatric (obesity) surgery by Blue Cross and Blue Shield of North Carolina (BCBSNC). Hospital readmission rates and complications within 30 days of surgery are considered an indication of the quality of surgery.

The results of the BCBSNC program will appear in the September/October issue of Surgery for Obesity and Related Diseases and are among the first nationally published peer review data showing the clinical advantages of a centers of excellence program. The article, entitled, "Centers of Excellence in Bariatric Surgery: Design, Implementation, and One Year Outcomes," highlights the following key results(i):

- Centers of excellence readmission and complication rates decreased from 7.6 percent to 4.7 percent in one year - Proportion of bariatric procedures performed by centers of excellence increased from 55 percent to 61 percent - Non-centers of excellence readmissions declined but remain 75 percent higher than the centers of excellence rates The full article can be accessed at http://soard.org/.

"The first year results of our centers of excellence pilot program have shown that the best way to improve outcomes for our members is to have gastric bypass surgery performed by surgeons who have extensive experience with this procedure and have met national standards for quality," said Dr. Don Bradley, BCBSNC executive medical director. "We know that this surgery is a proven, effective way to help morbidly obese patients lose weight and improve their overall health. When properly done by experienced surgeons, these procedures greatly improve the member's chances of leading a normal, healthy life," he concluded.

Hospital readmission rates and post-surgical complications remain a significant concern with this surgery and have led many insurers to discontinue coverage for these procedures. However, the initial results of BCBSNC bariatric centers of excellence program show that complications are significantly lower if operating surgeons meet a strict standard of care.

"This is consistent with more recent data on bariatric surgery," said Dr. Harvey Sugerman, past president of the American Society for Bariatric Surgery (ASBS) and editor-in-chief of Surgery for Obesity and Related Diseases. "Blue Cross and Blue Shield of North Carolina is to be commended for structuring a program that recognizes and rewards quality. These outcomes prove that experience counts, and this program raises the bar for surgeons who want to continue to perform bariatric surgeries."

BCBSNC was one of the first insurers in the nation to officially recognize centers of excellence for bariatric surgery, and launched the program in October of 2004. Surgeons must meet strict qualifications to be considered as a center of excellence, such as patient selection criteria, number of surgeries performed and favorable clinical outcomes. Based on the comprehensiveness and selectivity of the program, about a quarter of bariatric surgeons in the BCBSNC network are recognized as centers of excellence. These surgeons receive special recognition in the BCBSNC provider directory, require no prior plan approval for the process and receive higher reimbursements. Surgeons who are able to meet the stringent criteria continue to be added to the centers of excellence program.

Podcast on results available

A discussion on these results from the bariatric surgery centers of excellence pilot program is available at the BCBSNC Web site (at http://www.bcbsnc.com/news/press-releases/bariatric-surgery.cfm). In the podcast, or downloadable audio file, available at this link, Dr. Don Bradley, BCBSNC executive medical director, discusses the results as well as initial program concept and design.

Additional resources for more information on bariatric surgery Harvey Sugerman, MD Past president, The American Society for Bariatric Surgery (ASBS) Editor-in-chief of Surgery for Obesity and Related Diseases (239) 472-4625 hsugerman@comcast.net Morgan Downey, JD Executive Vice President NAASO, The Obesity Society (301) 563-6526 mdowney@naaso.org Walter Pories, MD, FACS Chief, Metabolic Institute and Professor of Surgery, Biochemistry, Exercise and Sport Science Brody School of Medicine East Carolina University 252-744-3290 Office 252-236-1709 Cell pories@aol.com About BCBSNC:

Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to nearly 3.4 million members, including approximately 744,000 served on behalf of other Blue Plans. For 73 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at http://www.bcbsnc.com/.

(i) Results represent data gathered from BCBSNC claims between October 2004 and October 2005.

Blue Cross and Blue Shield of North Carolina

CONTACT: Rita Simonetta or Kyle Marshall of BCBSNC, Media Line,+1-919-765-3005

Web site: http://soard.org/http://www.bcbsnc.com/news/press-releases/bariatric-surgery.cfmhttp://www.bcbsnc.com/

Source: PRNewswire

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