Healthcare Financial News

The Centers for Medicare & Medicaid Services (CMS) has announced a proposal to clarify its policies for Medicare coverage of bariatric (weight loss) surgery as a treatment for beneficiaries with type 2 diabetes.

CMS proposes to not cover bariatric surgery for patients who do not meet the definition of morbid obesity, but do have type 2 diabetes. While recent medical reports claimed that bariatric surgery may be helpful for these patients, CMS did not find convincing medical evidence that bariatric surgery improved health outcomes for non-morbidly obese individuals.  CMS seeks comments from the public about this evidence and its implications for coverage, and about which groups of patients should be covered for this surgery.

The proposed decision notes that type 2 diabetes is one of the co-morbidities CMS would consider in determining whether bariatric surgery would be covered for a Medicare beneficiary who is morbidly obese. An individual with a body-mass index of at least 35 is considered morbidly obese.

Read the proposed decision memorandum.

The cost of failing to fix our broken health care system is greater than the price tag of comprehensive health reform, according to “The Cost of Doing Nothing: Why the Cost of Failing to Fix Our Health System Is Greater than the Cost of Reform,” a new report and interactive online state guide released by the Health Policy Program at the New America Foundation.

The report found that the average cost of a family employer-sponsored health insurance plan will climb to more than $24,000, or over 45 percent of median household income, by 2016.  Under this scenario, half of American households would need to spend more than 45 percent of their income in order to secure health insurance for themselves and their families. 

The report also found that the U.S. economy lost as much at $207 billion in 2007 because of the poor health and shorter lifespan of the uninsured.

Read the report.