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Bariatric Surgery Value-Based Program Helps Members with Weight Loss

Published Date: May 23, 2022

Horizon and the New York Bariatric Group have developed an innovative Bariatric Surgery Value-Based Program that makes weight-loss surgery more convenient and successful for Horizon members. The program covers the cost of bariatric surgery performed in the practice’s bariatric ambulatory surgery center and includes a customized mobile app, called VHPGO™, that helps patients maintain their weight loss after surgery. It’s the first value-based program for bariatric surgery in New Jersey.

The New York Bariatric Group is one of the largest bariatric surgery practices in the United States, with offices in New Jersey, New York, Connecticut, Arkansas and Oklahoma. It has 30 surgeons who have performed more than 30,000 bariatric surgeries, and a surgery center that is solely dedicated to bariatric surgery. As part of the value-based program, patients can get a sleeve gastrectomy and return home the same day. Shawn Garber, MD, is the founder of the practice.

“This is the way medicine is going in the future. Patients want to get out of the hospital quicker and it saves money. And we know it can be done safely,” Dr. Garber said.

The value-based package not only includes the cost of the surgery and any facility fees, if applicable, but it also covers the cost of follow-up care and support services through the VHPGO app for up to two years after surgery.

“One of the hurdles with long-term, follow-up care for patients is the rise in out-of-pocket costs they have to pay,” Dr. Garber said. “By having a package that is all-inclusive up front with no other out-of-pocket costs, you’ll increase compliance and get more value for the dollars spent and better results. You’ll improve comorbidities like diabetes, high blood pressure and sleep apnea.”

Follow-Up Care is Key to Weight-Loss Success

“Horizon is forward thinking to include the VHPGO app and other support services into the bundle,” explains Dr. Garber. “A key part in the success of bariatric surgery is that patients follow up with nutrition. Since we developed the platform, our compliance rates have grown by 78 percent and outcomes have improved more than two times.”

The HIPAA-compliant VHPGO app, which Dr. Garber helped develop, provides patients with nutrition, fitness and lifestyle modification support. It offers many services at no cost to members such as:

  • Recorded one-on-one sessions with a nutritionist every month
  • Food diaries
  • Goal tracking
  • Lifestyle and behavioral modification classes and support groups
  • Remote weigh-ins
  • Fitness classes and training sessions
  • A library of meal plans, recipes and cooking demonstrations
  • Appointment scheduling with nutritionists and fitness trainers

The VHPGO platform allows providers to monitor their patients’ behaviors and results. If a patient gains weight, doctors can reach out to the patient and check in, or if a patient loses weight, doctors can send an encouraging message acknowledging the achievement.

“So based on a lot of different variables, we always know how all of our patients are doing,” Dr. Garber said. “We can keep them engaged in the platform, and we keep them engaged in the practice.”

The Long-Term Benefits of Value-Based Programs

Dr. Garber explains that Horizon was the only insurance company capable of developing a value-based bundle for bariatric surgery. He collaborated with Cathy Sherman-Ostrow, Manager of Provider Partnerships, Contracting, and New Models at Horizon, to develop the program.

“It’s important to work with providers like New York Bariatric Group to optimize performance goals of Episodes of Care like bariatric surgery,” Sherman-Ostrow said. “It improves population health and the patient experience with demonstrated cost reductions. NY Bariatric Group also included the well-being aspect. In a clinically organized manner, they have developed an end-to-end intervention to help people lose weight and give them the tools to keep the weight off, plus reduce/eliminate co-morbidities.”

“Horizon is on the forefront of value-based packages. It’s amazing what they’re doing,” Dr. Garber said.

“We are the voice of the member and it’s important to consider their longitudinal needs. We are trying to get the most mileage from a quality and cost standpoint,” Sherman-Ostrow said.

The VHPGO app is a registered trademark™ of Virtual Health Partners®. Virtual Health Partners is independent from, and not affiliated with Horizon Blue Cross Blue Shield of New Jersey.