PITTSBURGH and HARRISBURG, Pa., Aug. 13 /PRNewswire/ -- HealthAmerica and HealthAssurance have launched the area’s first comprehensive program to coordinate care and help assure quality in bariatric surgery services. The health plans have taken the lead in establishing criteria for medical sites to qualify as a center of excellence, based on the level of care they provide for patients and the clinical outcomes and expertise of the surgical team.
HealthAmerica and HealthAssurance have developed the Bariatric Surgery Centers of Excellence program in response to mounting concerns about patient safety related to some of the well-publicized complications and deaths associated with this procedure across the country. As a weight-loss treatment, bariatric surgery is growing in popularity. With the increased interest in the surgery has come an increase in the number of facilities offering the service, some without the level of experience and standards of care established by the American Society for Bariatric Surgery.
“Like all major medical operations, bariatric surgery is risky,” said Josh Bennett, M.D., HealthAmerica’s vice president for quality and cost management. “By establishing the Centers of Excellence designation and assuring that facilities meet those criteria, we can help our members make a more informed decision about this treatment option and increase the chances for a successful outcome.”
Bennett added that the Centers of Excellence program does not mean that HealthAmerica and HealthAssurance will approve more bariatric surgeries.
“We will continue to follow our criteria for approval, precertifying patients for whom the surgery is medically necessary,” he said. “The approved Centers of Excellence have agreed to our criteria for patient selection.”
Among the criteria centers must meet for the HealthAmerica and HealthAssurance Bariatric Surgery Centers of Excellence program are:
* Comprehensive patient consent form. * In-house consultative services for patients. * Documented clinical pathway for post-op care. * Multidisciplinary team that includes nutrition, psychiatric, social worker and dedicated nursing staff, as well as a patient educator, all of whom are receiving continuing medical education in the field of bariatrics. * Availability of organized and supervised patient support groups. * Minimum of four gastric bypass procedures per week or 200 per year. * Documented outcomes measures, including average length of stay, morbidity and mortality rates, infection rates, and readmission rates. * Comprehensive post-discharge, follow-up program.
To date, the centers listed on Attachment 1 have earned the Centers of Excellence designation.
Note to Editors: Please see related media material: * Attachment 1: Centers of Excellence * Attachment 2: A Heavy Toll: The Costs of Obesity About HealthAmerica and HealthAssurance
HealthAmerica Pennsylvania, Inc., has a 29-year record in managed care. HealthAmerica, HealthAssurance Pennsylvania, Inc., and affiliate companies cover over 715,000 members in Pennsylvania and Ohio through HMO, POS, PPO, Medicaid, and Medicare+Choice plans. In addition, HealthAmerica earned an “Excellent” Accreditation for its HMO plan and HealthAssurance earned an “Excellent” Accreditation for the HealthAssurance POS by the National Committee for Quality Assurance, an independent, non-profit organization dedicated to measuring the quality of America’s health care. With corporate offices in Pittsburgh and Harrisburg, Pennsylvania, HealthAmerica and HealthAssurance provide managed health care products and services to over 10,000 employers in Pennsylvania and Ohio. HealthAmerica and its affiliates employ over 1,500 people in Pennsylvania. For more information, visit HealthAmerica’s Web site at http://www.healthamerica.cvty.com/ .
Attachment 1 HealthAmerica and HealthAssurance Bariatric Surgery Centers of Excellence Western Pennsylvania West Penn Bariatric Surgery Center 4727 Friendship Avenue Suite 140 Pittsburgh, PA 15224 412-235-5900 412-235-5901 fax Pittsburgh Bariatric, PC of Heritage Valley Health System 301 Ohio River Blvd. Suite 200 Sewickley, PA 15143 412-741-8862 412-741-7707 Bariatric Surgery Program at UPMC Horizon 110 N. Main Street Greenville, PA 16125 724-589-6349 724-589-6321 fax The Center for Comprehensive Weight Loss at St. Elizabeth Health Center 1044 Belmont Avenue Youngstown, OH 44501 330-480-2866 866-803-8729 Magee-Womens Hospital of UPMC Health System Surgical Weight Loss Center Suite 5500 300 Halket Street Pittsburgh,PA 15213 412-641-1000 412-641-1328 fax Central Pennsylvania Surgical Weight Loss Program of Milton S. Hershey Medical Center Department of Surgery H070 500 University Drive P.O. Box 850 Hershey, PA 17033-0850 717-531-6321 717-531-3649 fax Central PA Surgery Weight Loss Clinic at Pinnacle Health Hospital 875 South Arlington Avenue Harrisburg, PA 17109 717-652-1107 717-652-1142 Attachment 2 State Obesity Related % of Total Medical Expenditure Spending CA $7.68 billion 5.5% NY 6.08 5.5 TX 5.34 6.1 PA 4.14 6.2 FL 3.99 5.1 IL 3.44 6.1 OH 3.30 6.1 MI 2.93 6.5 NJ 2.34 5.5 NC 2.14 6.0
Source: Finkelstein, EA, Fiebelkorn, IC, Wang, G. State-level estimates of annual medical expenditures attributable to obesity. Obesity Research 2004; 12 (1):18-24.
HealthAmerica and HealthAssurance
CONTACT: Kendall Marcocci, Director of Communications of HealthAmericaand HealthAssurance, +1-717-540-6746, or kmarcocci@cvty.com
Web site: http://www.healthamerica.cvty.com/
