Bariatric Study May Inform Care Guidelines for Insurers

Bariatric Study May Inform Care Guidelines for Insurers


I think one of the greatest contributions
that PCORI has made has been to establish a process for doing this type of research
and expanding across multiple domains, multiple clinical situations where we need this type
of effectiveness data. For example, in October 2018, a study was
released that was through PCORnet, looking at effectiveness of various bariatric procedures
and looking at this across, longitudinally across one, three, and five years. This is important for us because we have benefits
establishing care guidelines for bariatric surgery and we also have medical policies
on this. Historically, we’ve had to wait a long time
to get these results, previously 10 to 15 years ago, we did not cover adjustable gastric
banding, then we adopted coverage. The findings of the PCORnet-based study on
bariatric surgery are important to Blue Cross North Carolina because it helps us differentiate
and help with our members and providers to understand which procedures
may be more effective than others. For example, in the study, comparing sleeve
gastrectomy to adjustable gastric banding, the sleeve gastrectomy had much better weight
loss in three and five years and a comparable short-term 30-day complication rate.

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