Bariatric surgery program gets national designation, Medicare coverage

September 20, 2006, ST. LOUIS - Bariatric surgery - weight loss surgery - can change lives. Several people at the Washington University Weight Management Program had to put that change on hold when Medicare announced in March that it would only cover bariatric surgery performed at medical centers designated as Centers of Excellence by the American Society for Bariatric Surgery (ASBS).

Washington University and Barnes-Jewish Hospital were in the process of applying for the designation, but hadn''t yet had a review of their application or a site visit.

On Sept. 13, Washington University bariatric surgery program at Barnes-Jewish Hospital received the designation as an ASBS bariatric surgery Center of Excellence. The patients who had been waiting for Medicare coverage were able to schedule their surgery.

The number of bariatric surgeries in the U.S. more than quadrupled between 1998 and 2002, with about 120,000 procedures performed in 2005. Faced with clinical evidence that the most experienced and best-run bariatric surgery programs have by far the lowest rates of complications, the ASBS Centers of Excellence program was created to recognize bariatric surgery centers that perform well and help surgeons and hospitals continue to improve the quality and safety of care provided.

Mortality rates for bariatric surgery at those Centers of Excellence average less than one percent with complication rates at about six percent. Medicare currently covers bariatric surgeries performed only at these designated centers.

"We have worked to provide our bariatric surgery patients with the highest quality care and we''re pleased to be recognized for that work," said Chris Eagon, MD, surgical director of the Washington University bariatric surgery program at Barnes-Jewish.

To earn a Center of Excellence designation, the Washington University/Barnes-Jewish program, and the bariatric surgeons, Dr. Eagon and Valerie Halpin, MD, both board certified, underwent rigorous review, followed by a site visit during which all aspects of the program''s surgical processes were closely examined and data on health outcomes was collected. Washington University/Barnes-Jewish and other centers receiving the bariatric surgery Center of Excellence designation agree to continue to share information on clinical pathways, protocols and outcome data.

Surgical Review Corporation (SRC), an organization that evaluates surgical quality, formulates and establishes the rigorous standards with which Centers of Excellence must comply, thoroughly inspects and evaluates each candidate, and upon review recommends approval of designation for those physicians and facilities whose practices and outcomes meet the stringent guidelines set forth.

"This certification recognizes the commitment Barnes-Jewish Hospital to giving all patients exceptional care," said Colleen Becker, RN, Barnes-Jewish director of surgical services.

Becker also heads Barnes-Jewish''s bariatric care team. The team, one of the first of its kind in the U.S., addresses the care of all obese patients at Barnes-Jewish Hospital, suggesting modifications in hospital design, working with vendors to develop equipment and training staff to care for obese patients safely and compassionately.

Washington University Bariatric Surgery Program at Barnes Jewish Hospital: The program provides expert surgical therapy in conjunction with dietary consultation, behavioral consultation and patient support groups.

The Bariatric Surgery Program offers the LAP-BAND® procedure or the open and laparoscopic gastric bypass surgery as alternatives for patients who meet certain criteria. More information is available on the surgery web site for both types of surgery - click on the following procedure names: LAP-BAND® and gastric bypass surgery.

For appropriate patients, surgery is highly effective for producing long-term weight loss. This treatment option is for patients who are severely overweight with a body mass index of 35 or greater and a medical complication of obesity, or a body mass index of 40 or greater without other medical complications.

Patients who decide to pursue bariatric surgery undergo a careful pre-surgical evaluation to ensure the patient is an appropriate candidate for the procedure. Support group meetings are provided both before and after surgery to help patients achieve the best possible results.

In addition to surgical treatment of obesity, the Washington University Weight Management Program offers a comprehensive approach to weight loss and management, including nutrition counseling, behavior modification and support groups.