Mississippi, which often leads the nation in its obesity rate, is proposing to pay for Medicaid beneficiaries' bariatric surgeries, according to state officials.
For years, the state declined to cover the procedures, citing safety, efficacy and cost concerns. In 2013, it was singled out by the advocacy organization, Strategies to Overcome and Prevent (STOP) Obesity Alliance, as being one of just four states that actively excluded coverage for the surgery.
However, Mississippi health officials have become even more worried about the rise of co-morbidities tied to obesity in the state, including heart disease and diabetes.
“We are pursuing all clinical options to reduce the co-morbidities associated with obesity,” said David Dzielak, the state's Medicaid director. “Reducing the incidence of obesity may reduce the occurrence of these co-morbidities and lead to better health outcomes for our beneficiaries, as well as reduced cost."
The state has submitted an amendment to its Medicaid coverage that requires CMS approval. It anticipates it will start covering bariatric surgeries Feb. 1. The average cost of the surgery runs between $20,000 and $25,000.
Mississippi ranks first in the nation for cardiovascular disease-related deaths, with a rate of 250 deaths per 1,000 residents annually, according to federal data. The state also ranks second nationwide for overall diabetes prevalence, with over 276,000 adult Mississippians, or 12.5% of the adult population, living with type 2 diabetes.
Four out of every 1,000 Mississippi deaths were related to diabetes in 2012, accounting for 1,039 total deaths, according to state data.
As of 2013, 47 states covered bariatric surgery, with the holdouts being Mississippi, Montana, New Mexico and Ohio, according to the STOP Obesity Alliance.
The new surgical coverage is expected to increase state and federal Medicaid expenditures by more than $14 million annually.
Therese Hanna, executive director at the Center for Mississippi Health Policy, said she was glad to see the state use the tools at its disposal to address the state's health problems.
Providers who have been concerned for years about the state's obesity epidemic also say the coverage is a positive step forward.
“Lower-income individuals can barely afford the medications needed to control the co-morbidities associated with obesity,” said Dr. Erin Cummins, who directs the bariatric surgery department at Central Mississippi Medical Center in Jackson. “If we can get to the root of the problem, we can get these people off the medications, which will save the state a ton of money.”
Still, some experts say behavior modification, including dietary changes, are a major contributor to success after bariatric procedures. And public health officials are fighting a battle that, until recently, they thought they were winning. For the past several years, experts thought the nation's alarming, decades-long rise in obesity had leveled off. But the Centers for Disease Control and Prevention recently reported that the obesity rate climbed to nearly 38% of adults in 2013 and 2014, up from 32% from a decade earlier.