VALUE-BASED OBESITY CARE IN COLOMBIA Aligning Value

MONITORING TREATMENT OUTCOMES LEADS TO PARTNERSHIP WITH MEDTRONIC

In the last nine years, Grammo has performed approximately 1,800 surgeries of this kind. Surgeon Miguel Forero Botero, also a director at Grammo, added that they carefully monitor all treatment outcomes. At 6, 12, and 24 months, they measure variables such as:

• Excess weight and BMI percentages
• Fat volume reduction
• Resolution of comorbidities (diabetes, hypertension, hyperlipidemia)
• Hospital readmissions

Grammo Clinic's efforts to measure results were the reason Sura, one of the top three insurance companies in the Colombian healthcare system, chose Grammo to implement the value-based healthcare (VBHC) model that Medtronic had implemented at other internationally renowned medical institutions.

Unlike the fee-for-service model, VBHC places the concept of “value” on center stage. The key is to measure outcomes and pay according to results obtained.

“We partner with Medtronic because we agree on this approach,” highlighted Dr. Forero Botero. “At Grammo, we believe that surgery should be the last resort for obesity. We are convinced that treating patients comprehensively is critical — holding their interest with a program using several specialists (doctors, nutritionists, psychologists) focused on retraining patients to lose weight and change habits; reserving surgery for specific cases, while providing comprehensive pre- and post-surgical support.”

SIGNIFICANT EFFECT ON COLOMBIAN HEALTH SYSTEM PREDICTED

Today, professionals at clinics like Grammo charge fees for every ambulatory or surgical service they provide. “In this case, you also need to take into account fees from surgeons, anesthesiologists, operating room, surgical instruments, medication, patient therapy during a hospital stay, and follow-up medical fees for a year after the surgery,” added Forero Botero. And these fees are paid regardless of results obtained. In the future, as patient results improve without increasing expenses, those fees could be higher.

Initial results from this alliance will become visible within approximately two years, through a rigorous outcome analysis of 50 patients undergoing bariatric surgery. In the medium term, Grammo wants to make VBHC a business model that can also be applied to the nonsurgical care of overweight or obese patients. “We want to decrease morbimortality rates and promote education among families, in order to expand our work and help control obesity,” says Guevara Perez.

According to the last National Nutritional Health Survey in Colombia, 56% of adults are overweight and 1,200,000 people are morbidly obese.¹ With this in mind, the alliance between Medtronic and Grammo promises to have significant impact on the Colombian health system and its patients.