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Mississippi to Pay for Bariatric Surgery to Combat Obesity

Mary K. Caffrey
The policy change is aimed at curbing the state's obesity rate as well as comorbidities such as diabetes
Mississippi, long one of the fattest and poorest states, wants to use Medicaid funds to cover bariatric surgery, according to a notice on the agency’s website. The policy change was first reported by Modern Healthcare.

The state has been among the holdouts in covering bariatric surgery for Medicaid recipients, due to safety and cost concerns. But that thinking has changed as Mississippi grapples with rising obesity and the complications that come with it, including diabetes.

According to a letter from David J. Dzielak, PhD, executive director of the state’s Medicaid office, Mississippi’s obesity rate is 35%, ranking it third in the nation. CDC data show that 13% of its residents had diabetes in 2013, the most recent year that data are available. Dzielak’s letter, which appears with the application to cover bariatric surgery starting February 1, 2016, cites other comorbidities Mississippi hopes to address, such as high blood pressure and heart disease.

Studies published in the past 2 years show that bariatric surgery not only helps patients experience rapid weight loss, but in some instances the procedure also reverses type 2 diabetes. However, the key to successful weight loss for the long term involves counseling, better diet and behavioral change, and the Mississippi application does call for counseling.

While Mississippi has not yet expanded Medicaid to those earning up to 138% of the poverty line under the Affordable Care Act, it has seen more enrollment due to increased awareness of existing criteria, and the knowledge that people are required to have health insurance if they are able to obtain it.

The state’s application shows it will pay $25,673 for each case, which includes all follow-up. Cost estimates are based on surgery for beneficiaries with a body mass index of at least 40, or with a body mass index of 35 and at least one comorbidity.

 
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