“Program Fees are Unethical!”
By Colleen M. Cook
Well, now we have your attention, don’t we? That was just one of the comments BSCI received in our nationwide survey on bariatric program fees.
Who’s charging them, how much, and what are they being used for?
Great questions all; and the responses have been quite insightful.
We were not surprised to find that a whopping 34% of the programs are indeed collecting an out of pocket patient program fee with an additional 8% considering implementing one. And many expressed very strong opinions about the need for, absence of, or collection of bariatric program fees.
Of the 168 respondents to date, 54% were representing hospital-based programs and 24% were from surgeon’s offices. 25% were Bariatric Program Managers, 17% RNs, 6% RDs, and 21% Bariatric Support Group Leaders, and nearly 15% were bariatric patients. (Some wearing multiple hats, as you might imagine)
Over 40% reported that program fees are being collected by surgeon’s offices, compared to the 27% collected by hospitals. Program fees range from $100 to upwards of $1500 with the majority of the programs charging between $200 - $500.
Respondents reported that program fees provide revenue to fund a variety of programs and services not covered by insurance. According to our survey, 18% of the funds are being used for Support Groups, 13% for an RD visit or dietary consultation. Nearly 16% of the funds are being used for patient educational materials and 8% for websites (which, in my estimation have been designed primarily as marketing tools, not to educate, serve, and support post-op patients).
We were quite surprised that some even reported that their program fees are used to cover such things as the cost of their “info” or marketing sessions, the surgeon’s cell phone, protein supplements, and even follow up appointments.
It was however, a pleasant surprise to find that some are utilizing the funds to provide patient conferences and events, fitness center membership, personal trainers, and support group materials.
While we would love to share just BSCI’s views on the subject, (BSCI’s viewpoint and impact) the real value of this survey and subsequent article is to share many views for consideration. You may read the actual survey responses here or please read on for a candid review of the pros and cons expressed in our survey:
The Pros:
“Appropriate for patients who come from other practices.”
“Our program was giving away a lot of services so we now charge a program fee”
“It is essential to pay for non- clinical services”
“People are more committed if they have to pay for something.”
“We charge a pre-op nursing education fee.”
“I am an RD and we receive no reimbursement for my time.”
“Program fees allow us to provide long-term educational and support programs”
The Cons:
“Connecticut law does not allow it”
“Indigent population cannot afford to pay”
“Too difficult to collect”
“Medicare patient have limited resources”
“Our group is to help people, not make money!”
“Will we lose people from our program if we charge?”
“We charge cash so a program fee is redundant and unfair.”
Related Articles
BSCI’s Position Statement on Bariatric Program Fees
Bariatric Program Fee Survey Article
The Grass Roots Support Group Movement
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