State Blue Cross Blue Shield Pilot Program
To State Blue Cross Blue Shield Policy Holders: A legislative proviso has established a one year “pilot program” that offers bariatric surgery as a treatment option for morbidly obese patients insured with the SC State Health Plan who meet certain criteria. While the plan is limited to 100 people (effective for the plan year of 2011 only), we are encouraged that the state of South Carolina is moving in the direction of increasing coverage for those in need of surgery for morbid obesity and we are developing a plan to evaluate all patients who are interested in participating in this pilot project. If you are interested in being evaluated for bariatric surgery at the Medical University of South Carolina, a designated Center of Excellence, we invite you to attend the mandatory seminar on the “Facts About Weight Loss Surgery”. Registration is required. Please register for this seminar by calling 843-792-1414. Ultimately, Blue Cross Blue Shield of South Carolina will decide which of the appropriate candidates will be selected for surgery. Our multidisciplinary team is committed to providing you with excellent care and we look forward to helping you achieve your weight loss goals. If you have any questions or concerns, you may contact our office at 843-792-3046. |
| See Dr. Byrne's interview about the pilot project posted on 9/8/10 on Facebook. |
Read Dr. Byrne's Op-Ed Letter, published in the Post and Courier September 28, 2010: Bariatric surgery worthy investment There has been much consternation and misinformation recently about a recent budget proviso passed by the South Carolina Legislature to set aside $2.4 million for a pilot project to provide 100 morbidly obese state employees insured on the state health plan with weight loss (bariatric) surgery. In a recent article in The Post and Courier, state Sen. Greg Ryberg, R-Aiken, compounded this misinformation with unsubstantiated and unpublished facts about the efficacy of bariatric surgery (for example, he erroneously called it 'lap band surgery'). Several national and international studies published in peer review journals such as the Journal of the American Medical Association have shown that bariatric procedures, such as gastric bypass, sleeve gastrectomy and adjustable gastric band, are tremendously effective in achieving sustained weight loss in the morbidly obese population. These studies have shown the procedures to be cost effective because weight-related medical conditions are cured or dramatically improved after the surgery. For example, a morbidly obese patient with Type 2 diabetes costs a health care system an average of $13,000 a year for doctor visits, hospitalizations and medications. Gastric bypass cures diabetes in 86 percent of morbidly obese Type 2 diabetics. This procedure will cost a health care system $25,000 to $30,000. Therefore, within two and a half years, it will be cost-effective in diabetics. It also will cure hypertension in 90 percent of these patients, sleep apnea in 93 percent, and gastroesophageal reflux disease (GERD) in 100 percent, as well as obviate the need for joint replacement in many patients. The Center for Medicare and Medicaid Services analyzed the available data in 2004 and made the decision to cover bariatric surgery for its recipients. Kudos to the South Carolina legislators who passed the budget proviso. When the data from the 100 patients on the pilot program are analyzed in two years and show, like all the larger studies, that bariatric procedures are safe, effective and ultimately reduce health care costs, what then? Our legislators are going to have some tough decisions to make. T. Karl Byrne, M.D. |
| Read Letters to the Editor, including some written by our patients. |
