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99% of eligible patients don't get bariatric surgery. Here's what you can do about it.

January 12, 2018

    Hospital planners and marketers face a significant challenge in growing bariatric surgery volumes: Prospective patients tend to underestimate their obesity, and very few of those eligible choose weight loss surgery as a solution. In fact, information presented at the 2017 Obesity Week conference suggested less than 1% of eligible patients get weight loss surgery.

    To tap into bariatric surgery growth, planners and marketers need to mitigate the barriers that prevent patients from seeking surgery. Read on for three common barriers to surgery, and how you can overcome them.

    Barrier 1: Providers fail to reinforce surgery as a weight loss option


    There's a growing recognition that weight loss surgery can be beneficial: Julia Belluz of Vox recently called it "medicine's best and most underused tool" to combat obesity. Even still, bariatric surgery enjoys less of a presence in consumers' mind than diet, exercise, or weight loss supplements. This is due in part to a failure of clinicians to present weight loss surgery as a viable option: Surveys show that, of individuals who meet the criteria for bariatric surgery and have recently interacted recently with the health care system, only 12% were told they were eligible for the surgery by a doctor.

    Counter-measure: Ensure your practitioners understand patient eligibility criteria and are prepared to present surgery as an option, if appropriate. Developing an easy-to-use decision aid may help the conversation.

    Barrier 2: Patients perceive surgery as dangerous

    A third of patients believe bariatric surgery is unsafe, and 37% of Americans surveyed believe weight loss surgery is more dangerous than living with their current weight.

    Counter-measures: Use marketing to link untreated obesity to the associated comorbidities that can accompany it, such as joint pain and diabetes, to more concretely illustrate the risks of avoiding treatment. In these messages, assure prospects on the safety of the procedure by highlighting the low rate of 30-day serious complications (between 0.25% and 1.25%) for the most popular bariatric surgeries: gastric banding, sleeve gastrectomies, and gastric bypass.


    Or, like Valley Health in Virginia, consider facilitating in-person educational seminars to support prospective patients' weight loss goals, educating attendees on surgical options as they move toward the procedure.

    Barrier 3: The high cost of surgery dissuades interested patients

    Our consumer surveys have revealed that cost is the most important factor dictating a consumer's decision to seek surgical services (it's a stronger decision driver than travel time or following a referral). Of patients who have considered bariatric surgery but do not follow through, 40% said the main reason for not receiving surgery was the cost—likely due to a national shift toward high-deductible health plans and the fact that some states mandate only limited coverage for bariatric surgery.

    Counter-measure: If patients in your market are especially price-sensitive, consider offering financial counseling or payment plans. Also, consider offering direct-to-consumer bundles to attract shoppers based on cost. Bon Secours Mary Immaculate Hospital, for example, offers a direct-to-consumer bariatric surgery bundle that includes pre-op, surgery, inpatient stay, and one to two post-op visits. The bundle works to attract out-of-market patients and grows the share of wallet in the bariatric surgery episode. These bundles can be crafted to a variety of purchasers—including consumers and medical tourists, but also to regional employers and health plans.


    Criteria Informs Which Services to Prioritize for Shoppable Procedures




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