Forty obese government employees will get weight-reduction surgery in a $1 million experiment to see whether it keeps insurance payments down over the long run by preventing other health problems.
The first job will be choosing the 40 from more than 1,000 people on the state’s health plan who expressed interest in the surgery. The participants will be monitored for three years.
A few states require insurance companies to cover weight-reduction operations, such as those that clip the stomach to a fraction of its original size and bypass part of the intestine. This makes people feel full much more quickly, and digest less of what they eat.
The resulting weight loss can head off long-term illness related to being overweight. The operation is generally considered only for people who are “morbidly obese” — at least 100 pounds overweight.
The Louisiana Legislature refused to require coverage of the operation after insurers objected that it would cost too much. The state health plan alone would spend an estimated $25 million in its first year if it had to cover all requests immediately, Executive Director A. Kip Wall told lawmakers this summer.
“The biggest obstacle is, for lack of a better term, pent-up demand,” he said Tuesday.
Wall said the $25 million estimate was based on a quoted price of $25,000 per operation and the more than 1,000 letters his office got after sending a notice about the proposed test a year ago to the 250,000 people covered by the plan. Nationwide, prices range up to $40,000 per operation.
A $1 million contract was approved this month for LSU Health Sciences Center — the state’s major medical school — to pick, treat and follow up with 40 volunteers for the pilot study.
Participants in the experiment will have to pay no more than the usual co-payment or deductibles. The amount would depend on which group benefits plan they are in.
