"University of Iowa Hospitals and Clinics meets the criteria for Wellmark's Bariatric Surgery Center of Excellence designation," said Dr. Mary Davis, vice president and medical director quality management, Wellmark Blue Cross and Blue Shield. "This designation helps bariatric surgery patients identify centers that have developed a program dedicated to reducing the variation in evaluation, treatment and outcome. This will help Wellmark members continue to have access to quality health care, while we work to control costs in order to provide the most value for each health care insurance dollar."

Through a rigorous process management methodology, which involved extensive data analysis and research, Wellmark Blue Cross and Blue Shield identified the criteria and standards for becoming a Center of Excellence based on national benchmarks, as well as input from Iowa's and South Dakota's bariatric surgeons and other Blue Cross and Blue Shield Plans.

"We are honored to receive the exclusive Wellmark distinction," said Isaac Samuel, M.D., director of the Bariatric Surgery Program. "Our multidisciplinary and team-approach to care, offers patients a comprehensive approach before, during and after surgery."

UI Hospitals and Clinics is considered the birthplace of obesity surgery. Edward Mason, M.D., of UI Hospitals and Clinics was the first to perform gastric bypass for severe obesity in 1966. Samuel was part of the team that was the first to introduce laparoscopic, or minimally invasive, gastric bypass surgery to Iowans in 2000. This new approach offers patients less post-operative pain, reduced time spent in the hospital, earlier return to work, and substantial cosmetic benefits.

With more than 260 laparoscopic gastric bypass cases over the last five years, and more than a thousand open obesity operations over the years, the hospital has achieved outcomes that match or exceed national standards. In addition, the surgical program partners with UI Weight Management to offer patients long-term follow-up from nutritionists and other disciplines to help them manage and control their weight.

Facilities meeting Wellmark's Center of Excellence criteria are focused on quality measures, provide a continuum of care that starts prior to surgery and extends throughout the member's lifetime, and are proactive in quality improvement of processes affecting the member's experience.

Selection criteria for Centers of Excellence focused on:

• Quality of post surgical follow-up care
• Ability of clients to maintain their weight loss
• Morbidity/mortality rates
• Pre- and post-surgical education for patients and plans for follow-up care
• Appropriate equipment for management of care for morbidly obese patients
• Ongoing quality management and improvement programs
• Physician and staff experience and credentials

Each of the Centers will be reviewed for compliance with Center criteria on an ongoing basis.

Morbid obesity, defined as having a Body Mass Index (BMI) greater than 40 which equates to about 80 pounds overweight for a female and 100 pounds for a male, is on the rise. Combating this ongoing trend involves eating well and exercising, with medically supervised diets being an important follow-up intervention as well. Bariatric surgery, however, should be a last resort for morbidly obese members.

Previously, Wellmark Blue Cross and Blue Shield named the following three facilities in Iowa and one in South Dakota as Bariatric Surgery Centers of Excellence:

• Grinnell Regional Medical Center, Grinnell, Iowa
• Mercy Medical Center, Mercy Capitol Campus, Des Moines, Iowa
• Sartori Memorial Hospital, Cedar Falls, Iowa
• Sioux Valley Hospital, Sioux Falls, South Dakota

More information on Wellmark's medical policy on surgery for morbid obesity can be found on the Wellmark website.

Since 1999, Wellmark has seen exponential growth in claims dollars spent for morbid obesity. In fact, per member per month costs associated with morbid obesity have tripled. And, for Wellmark members, the number of bariatric surgery admissions doubled between 2002 and 2003. With the increased demand, the number of practitioners performing the procedure has also increased as has the variability in cost and outcomes of the procedure.

Although the Bariatric Surgery Centers of Excellence have met Wellmark's criteria and standards for identification as a Center of Excellence, recognition of the Centers does not imply any guarantee of a positive outcome or endorsement by Wellmark. Not all Wellmark health plans provide benefits for bariatric surgery.

Wellmark, Inc. does business as Wellmark Blue Cross and Blue Shield of Iowa. Wellmark and its subsidiaries and affiliated companies, including Wellmark Blue Cross and Blue Shield of South Dakota and Wellmark Health Plan of Iowa, Inc., insure or pay health benefit claims for more than 1.9 million individuals. Wellmark Blue Cross and Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association.

For more information:

UI Weight Loss Services

Department of Surgery