Impact of Statewide Essential Health Benefits on Utilization of Bariatric Surgery

Obes Surg. 2020 Jan;30(1):374-377. doi: 10.1007/s11695-019-04092-z.

Abstract

Background: In response to concerns about inadequate insurance coverage, bariatric surgery was included in the Affordable Care Act's essential health benefits program-requiring individual and small-group insurance plans in 23 states to cover bariatric surgery. We evaluated the impact of this policy on bariatric surgery utilization.

Methods: Multiple-group interrupted time series analyses of IBM MarketScan commercial claims data from 2009 to 2016.

Results: Bariatric surgery utilization increased in all states after ACA implementation, but this increase was no greater in states with a bariatric surgery essential health benefit.

Conclusions: Our findings suggest that the essential health benefits program may have been too narrow in scope to meaningfully increase bariatric surgery utilization at the population level.

Keywords: Bariatric surgery; Essential health benefits; Health insurance; Health policy; Utilization.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bariatric Surgery / economics*
  • Bariatric Surgery / statistics & numerical data*
  • Case-Control Studies
  • Female
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Insurance Coverage / economics
  • Insurance Coverage / statistics & numerical data*
  • Insurance, Health / economics
  • Insurance, Health / statistics & numerical data
  • Male
  • Middle Aged
  • Obesity, Morbid / economics*
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Patient Protection and Affordable Care Act
  • Resource Allocation / economics
  • Resource Allocation / statistics & numerical data
  • United States / epidemiology