Save $14,000 Per Qualifying Employee!

Conclusion

Bariatricians can implement an evidence based primary care medical model with a comprehensive approach to obesity management resulting in a reduction in weight, BMI and fat mass in obese patients while preserving lean mass. The degree of reduction attained significantly lowers the risk of developing obesity related disorders, as well as improving conditions such as Type 2 Diabetes, Hypertension, and Ischemic Heart Disease. Potential Return on Investment (ROI) is also significant because these patients are among the 10% that cause 70% of the healthcare expenses.

ROI Calculations:

Potential Cost Avoidance Calculation based on BMI reduction, and reduction of risk factors for Type 2 Diabetes and Heart Disease.

 Employer savings

Sources:    1. American College of Occupational and Environmental Medicine, 2. American Diabetes Association, 3. American Heart Association


Challenges

CPT codes have not caught up with USPSTF recommendations. CPT codes exist for ‘Screening’ and ‘Counseling’ for Obesity, but the reimbursement is sporadic. CPT codes for ‘Treatment’ of Obesity apply to surgical treatment only, and do not apply for Bariatrician’s care.

Employee/Patient privacy concerns of employers, even for self-funded employers, who own their claims data, need to be respected. Corporate health benefit policies need to cover comprehensive care that the high risk employees need.

The Employers and Wellness Program vendors view Bariatrician services as redundant to the existing programs already in place. Bariatricians should be considered as strategic partners to leverage the screening results from ‘Corporate Wellness’ programs, and generate ROI by addressing the needs of the highest risk employees and by managing conditions that drive high costs.

CorporateResults-Challenges


Future

Directly measure savings and ROI from clinical interventions by analyzing year over year claims data from for the same cohort of patients. Similar to the ACO model used by CMS, offer Bariatricians incentives based on clinical outcomes and shared healthcare savings.

Employers, including federal and state governments, and self funded employers in the private sector should fund prospective studies and or initiate a pilot program for their employees to determine the ROI from a comprehensive, Bariatrician led program.


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Call us to discuss how we can bring about savings at no additional cost to you.
Director – CWE
847-881-6099
CWE@healncure.com

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