New Advocacy Tool Kit
Helps ASMBS State Chapters and Members Improve Patient Access

Published in July 2014 Issue             

The ASMBS is calling on members and state chapters to join the fight for greater patient access to metabolic and bariatric surgery, and is providing downloadable tools to
help them do that.

Ninh, Nguyen, MD

“No one can afford to sit this one out,” said Ninh T. Nguyen, MD, president of the ASMBS “Bariatric and metabolic surgery is significantly underutilized and everyone, from individuals to organizations, has a responsibility to help tear down the barriers to treatment.”

On its new website, the ASMBS has a section dedicated to advocacy where it provides information and tools that can help members and groups make the case for access to private and public insurers, employers and the state health exchanges created under the Affordable Care Act (ACA).

The site features a state health exchange coverage map that shows more than half the country does not cover bariatric surgery or weight loss programs.

According to the ASMBS, the specific exclusion of obesity treatment in the ACA state health exchanges is unusual and in conflict with the ACA’s own stated statute that state health exchanges may not exclude treatment on the basis of a health condition. In addition, many private health insurers, employers and state health plans maintain exclusions on obesity treatment.

John Morton, MD

“There needs to be equitable treatment for the millions of people affected by obesity. It should not matter in which state you happen to live in or which insurer you happen to have. There needs to be one America where treatment for obesity is available to all,” said John Morton, MD, MPH, ASMBS President-Elect.

Dr. Morton explained though obesity is the number one public health issue facing America and bariatric surgery has been proven to be one of the most effective treatments for it, coverage just wont’ happen on its own.

“The data is on our side, but unfortunately if insurers or policy makers won’t look at it on their own, we have to bring it them and we are, and we will,” said Dr.Nguyen. “I encourage all ASMBS members and state chapters to take advantage of the tools the society has created and make a difference in their communities. Our patients are counting on us.”

ASMBS offers contact lists of key policymakers in various states, presentations on obesity, metabolic and bariatric surgery and the dangers of insufficient coverage of obesity treatments. It also offers guides on how to meeting with policymakers, important messages to communicate, fact sheets and letters of request for obesity treatment coverage for individual state health exchanges. There are also descriptions of what other states and individuals have done to improve access in their areas so others may learn from their efforts.

Advocacy resources include papers by Drs. John Baker, Robin Blackstone, Scott Shikora and attorney Gary J. Viscio on reimbursement, policy and insurance and copies of presentations on the resolution of co-morbidities after bariatric surgery, cost effectiveness and tips about to communicate with medical directors.

The website also contains ASMBS guidelines and recommendations, position and consensus statements, background on the ACA, research and systematic reviews, and insurance frequently asked questions, among many other tools you can use.

“Groundbreaking studies and major medical groups support metabolic and bariatric surgery, major guidelines urge doctors to refer patients for surgery and there is greater acceptance of obesity as a disease. There is more of a climate to seriously address obesity with proven treatments like surgery, and less of a climate for policies and medical decisions based on discrimination, bias and anecdotal information or experience. This is good for metabolic and bariatric surgery and it’s good for patients. Now let’s do something about it,” Dr. Morton said.