What if we knew a proven way to reduce healthcare costs and increase productivity in a large percentage of the American population? Shouldn't every healthcare provider, employer and insurance company jump on the bandwagon to ensure as many people as possible take advantage?
In a recent study, Cost Comparison of RYGB Laparoscopic Surgery Cohort and a Matched Cohort in a Commercially Insured Population, Stanford University researchers compared the future healthcare costs of 823 patients suffering from obesity who underwent a laparoscopic weight loss procedure called Roux-en-Y gastric bypass (RYGB) in 2008 with 786 patients with obesity who did not have bariatric surgery.
Dramatic healthcare savings
The research team delved deep into the Truven Health Analytics Commercial Claims Database, mining healthcare claims information from approximately 15 million people. Some of the compelling findings include:
• Immediate savings in healthcare spending per patient in each of the four years the patients were tracked. Compared to the trend in healthcare spending in the matched cohort, costs fell in the surgical group by 12%, 28%, 37% and 35% in years one to four post-surgery.
• Cost savings were more dramatic in patients with diabetes. The first year after the procedure, there was a 23% drop in costs, with the subsequent three years showing reductions of 49%, 61% and 69%.
• Workplace productivity improved. This study also analyzed the evidence regarding the benefits of obesity surgery relating to workplace productivity, an important metric that not only points to an improved quality of life for the obesity surgery patients but also to the bottom line benefits of patients' employers by reducing absenteeism.
Tackling the barriers to adoption
There are still barriers to more widespread adoption of this surgery, even though it is a reliable tool for treating obesity and reducing the cost of treatment for obesity related comorbidities. These include:
• The stigma still attached to the disease of obesity. Obesity is considered a disease by the American Medical Association and affects millions of people across the country. Data from the CDC (Centers for Disease Control and Prevention) show that from 2011 to 2012, 78.6 million adults were considered obese or overweight, many of whom suffer from debilitating co-morbid conditions like type 2 diabetes, cardiovascular disease, and hypertension. Despite studies which show the ineffectiveness of dieting and medical management for obesity, obesity is often viewed as a life style choice or character flaw.
• Some primary care physicians are hesitant to recommend weight-loss surgery. Primary care physicians are at the front line of patient care. These physicians, who are often patients' most trusted, lifelong advisors, are often reluctant to refer for bariatric surgery. It's vital that they have access to the latest data and guidelines for treating obesity.
• Not all insurance plans cover bariatric procedures. The majority of states do not cover the surgery under the Accountable Care Act, even though research has shown a minimal impact on premiums. Some employers who do offer bariatric surgery as part of their medical insurance package have expressed surprise that employees do not take advantage of bariatric surgery more often.
This study clearly indicates how the health benefits of weight loss surgery translate into real, demonstrable economic benefits. The hope is that this type of data will help to improve access to bariatric surgery for patients everywhere who struggle with obesity.