Dear Friends and Colleagues,
The last few weeks have been exciting and fruitful times for ASMBS.
1. OBESITY WEEK-END & OBESITYWEEK LA
I want to thank everyone who attended our Obesity Week-End 2015 in Las Vegas, June 25-27. This was our most successful interim annual meeting to date with over 550 attendees. For the future, this meeting will be devoted to practical, clinically-oriented courses in an intimate setting allowing for easy interaction between attendees and faculty. In addition to Live Surgery, Revisional and Sleeve Courses, Obesity Week-End saw inaugural courses for Intra-Gastric Balloon, Gastroparesis, MBSAQIP Reviewers and Incorporating Medical Management.
Missed Obesity Week-End 2015? Don’t worry. Come to ObesityWeek 2015 in Los Angeles! All of the aforementioned courses (Live Surgery, Revisional, Sleeve, Intra-Gastric Balloon, Gastroparesis, MBSAQIP Reviewer and Medical Management Courses) will be offered again at ObesityWeek 2015 in Los Angeles November 2-7 in more depth and there is more including courses on bariatric anesthesia, bariatric team training, endoscopy, plastic surgery, quality improvement, access, GERD, Latin-American Session on Innovation, Asian Session on Low BMI and more! Our ASMBS courses and poll reaffirm our members’ interest and expertise in medical management and endoscopy, two future areas of growth for all us. Thanks to Aurora Pryor and Michel Gagner (Program Cmte Chairs) and our outstanding ASMBS staff for ObesityWeek and Week-End planning and execution.
2. BMI 30-35 FOR DM
We continue to make gains in access. As reported last month, the Washington State Health Technology Assessment found evidence to support bariatric surgery for BMI 30-35 in Diabetics. On July 14, 2015, in Los Angeles, CA, at the offices of the California Endowment, the California Technology Evaluation Forum unanimously endorsed laparoscopic Roux-en-y Gastric Bypass for BMI 30-35 in Diabetics with Drs. Bruce Wolfe, Brian Smith and myself providing supporting testimony. In addition, Blue Cross Technology Evaluation Center has also previously endorsed bariatric surgery for diabetics with BMI 30-35, http://www.bcbs.com/blueresources/tec/vols/27/27_02.pdf. To capitalize on these landmark decisions and on all the burgeoning evidence in this area, I am instituting a Low BMI (Bariatric and Metabolic Implementation) Taskforce to be chaired by ASMBS Secretary-Treasurer Stacy Brethauer. Dr. Brethauer will be an outstanding leader for this important initiative based upon Cleveland Clinic’s visionary insurance coverage for its employees with BMI 30-35 and Diabetes and his prior leadership on the Revisional Surgery Task Force and the Clinical Issues Committee. Dr. Brethauer’s co-chairs will be Drs. Shanu Kothari and John Scott. If you are interested in serving on this taskforce, please contact us at firstname.lastname@example.org.
3. Colorado Essential Health Benefit Win
Our Access Committee’s campaign to secure bariatric surgery coverage in all 50 states, Leave No State Behind, can now claim its first victory! In late June, Colorado’s Division of Insurance selected the Kaiser State Employee Plan as its Essential Health Benefit Benchmark Plan, which includes bariatric surgery. This is the first of what we hope will be 27 states changing from not providing bariatric surgery to now providing bariatric surgery in their benchmark plan. Thanks to Drs. Wayne English, Brandon Williams, and John Scott for their service on the Access to Care to Committee and Covidien’s special effort in one of their home states.
4. Choosing Wisely
ASMBS has joined over 70 other medical specialties in providing recommendations for bariatric surgery with the intention of facilitating wise decisions about the most appropriate care based on a patients’ individual situation. This effort was lead by Dr. Shanu Kothari, Chair of the Clinical Issues Committee.
5. CMS DRG
In the CMS-1632, CMS FY2016 Inpatient Prospective Payment System (IPPS) Proposed Rule, there is a proposed reduction in MS-DRG 619 of 11.1%. This DRG is a small component of over-all bariatric surgery and ASMBS through commentary from Dr. Matt Brengman and myself strongly refutes the proposed reduction. ASMBS is concerned that CMS certified facilities will be unable provide comprehensive resources if reimbursement is reduced. We asked that CMS consider an increase of 1.1% for MS-DRG 619 in keeping with Hospital Inpatient Quality Reporting Program (IQR) and meaningful electronic health record users (MEHR) incentives. For hospitals not participating in IQR or MEHR, we ask that MS-DRG 619 be kept neutral. We are also requesting an opportunity to meet with CMS to further discuss bariatric surgery in hopes of an ongoing dialogue.
6. Bariatric Surgery Numbers
I saved the best for last for last. I am proud to report that our overall bariatric surgery numbers have increased from 179,000 to 193,000 this year. I appreciate Dr. Jaime Ponce’s leadership of the ASMBS Numbers Taskforce, which provides rigor in estimation of bariatric surgery through multiple data sources. ASMBS will continue its efforts to increase insurance coverage and physician/patient referral and education so patients in need can have the care they need and deserve.
With very best wishes,
John M. Morton, MD