Health Plans Expansion of Bariatric Surgery; Transcarent launches Comprehensive Multimodal Obesity Care; the GLP-1 Gold Rush



    • Nona Tepper reports in Modern Healthcare ‘…Health insurance companies are expanding their coverage of bariatric surgery amid rising demand for pricey new weight loss drugs.’
      • The lifting of prior authorization requirements and covering bariatric surgery for more conditions is underway at Geisinger Health Plan and Blue Cross and Blue Shield carriers in Massachusetts, Michigan and Vermont.
      • However, Dr. Jim Grant, chief medical officer for Blue Cross Blue Shield of Michigan stated ‘…Our policies don’t prioritize bariatric surgery over GLP-1s. The decision between a GLP-1 and bariatric surgery is not our decision. That’s a decision made by the patient with the consultation of their physician.’
      • James Chambers, a professor at Tufts Medical Center who studies insurance coverage of GLP-1s, notes with bariatric surgery that this is ‘…an example of how a new technology is forcing the healthcare system to reevaluate existing technologies, not just in terms of the cost, but also the value.’
      • Dr. Marina Kurian, director of New York Minimally Invasive Surgery, added ‘…In two years, the costs are equivalent (to use of GLP-1s).
      • The benefit, though, is that with surgery there’s greater weight loss and greater reduction in comorbid conditions.’
      • Of course, we should not be pitting one treatment against the other – but instead think of what works best for the patient, which might even be a combination of GLP-1 drugs and surgery for some.
    • Transcarent launches the ‘…First comprehensive Weight Health care experience delivers lifestyle management, pharmaceutical, and surgical benefits on one platform to enable individualized care…’ this week.
      • The personalized, longitudinal care experience seeks to ‘…meet the needs of their specific weight health journey, informed by analytics, clinical insights, and clinical protocols.’
      • The program brings together lifestyle management, nutrition support, behavioral coaching, medication management and bariatric care, supported by partners 9amHealth and Soda Health.
      • Glen Tullman, CEO at Transcarent commented that the new offering ‘…empowers individuals through a clinically-led approach, uniting the resources they need to find the right solution for each person in every step of their transformative health journey.’
      • I am all for the whole-person, multimodal care approach, delivered on a single care platform, and most importantly, delivered with ongoing and long-lasting support.
      • All too often we see patients undertake a complex and sometimes confusing weight management journey, to achieve suboptimal outcomes.
      • Let’s advance the ball even further to achieve resolution of chronic disease burden, and through this, a reduction in total costs of care.
    • Glen Tullman writes an article as part of the World Economic Forum Annual Meeting in Davos this past week, on the obesity pandemic, why GLP-1 drugs should only be a part of the solution, and the need to embrace a high-quality, comprehensive strategy.
      • GLP-1 medications ‘…should only be part of a comprehensive and sustainable solution and not used in a silo…’ with an intent to ‘…prioritize whole-person, high-quality care.’
      • The article advises employers to consider obesity medicine specialists, clinical appropriateness of care, long-term healthy weight, and cost-efficient care, for them to deliver high-quality, longitudinal weight management solutions, toward a healthier and happier self.
      • All good – though we need to advance beyond weight loss as the metric of success, toward a reduction in chronic disease burden.
      • And further, to consider health inequities that abound across the globe, for those who are more disproportionately affected by obesity; coupled with the troubling paradox that they are also less likely to receive appropriate treatment for their disease.


    • ‘Drive through GLP-1 providers and the gold rush of companies offering telehealth weight-loss services, in Modern Healthcare.
      • rundown on who’s entered the GLP-1 telehealth market since 2022, include Mayo Clinic, Transcarent, Eli Lilly, WeightWatchers, Noom, Teledoc, Ro and Calibrate; with newer entrants Knownwell and Alfie Health.


    • quiet week for new research.



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