MANAGED CARE April 2012. ©MediMedia USA
Forget about pills and diets. Metabolic and bariatric surgery (MBS) most effectively treats obesity and the diseases and conditions that go with it. Providing a safe environment for these types of procedures has encouraged the American Society for Metabolic and Bariatric Surgery (ASMBS) to join the American College of Surgeons (ACS) in streamlining the accreditation process and developing outcomes benchmarks.
On April 1, they unified their MBS accreditation programs.
“This will bring 621 approved [surgery centers] together and we will all be using the same data registry to provide enhanced patient safety,” says Robin Blackstone, MD, president of ASMBS. “For a specialty society like ours to join with the ACS strengthens the environment for patient safety.”
Medicaid and state employee health plans cover MBS about 90 percent of the time, says Blackstone. Small employers (10–499 employees) cover it 40 percent; large employers (>20,000 employees), 75 percent.
“As the effectiveness of MBS has become more well-known, it’s been covered more,” says Blackstone. “The question has been, with obesity affecting so many people, how do you achieve a universal benefit for obesity treatment? What you want is the most effective therapy with the least complications. That gives insurers the best value.”
About 200,000 MBS procedures are performed each year in the United States, costing from $11,000 to $26,000 each, according to the ASMBS. Value does indeed matter, as Blackstone says. The two organizations will not only merge their accreditation processes, but overhaul them as well.
“This new unified program will at first be organized around accreditation based on volume, but will be updated to reflect accreditation based on outcomes,” says Blackstone. “All of our programs will be able to access the database” to improve quality
For instance, MBS program directors will be able to track the incidence and causes of readmissions, and work to ensure that systems are in place, or that changes are made, to decrease readmissions, says Blackstone.
The college and ASMBS hope to meet with a broad spectrum of insurance company officials, including medical and pharmacy directors, sometime in the next few months to get feedback on the new accreditation standards, says Blackstone.
“What we’re hoping is that all of the payers will recognize the value of this type of outcomes reporting and data registry reporting and really get behind having this one standard and supporting it,” says Blackstone.