At the beginning of 2015, UnitedHealth announced that vaginal hysterectomies would not require prior approval. As of April 2015, it will require prior authorization for most types of hysterectomies. Outpatient vaginal hysterectomy is exempt from this approval. The push is fueled by an FDA investigation of high power morcellators. These morcellators can spread malignant tissue such as uterine sarcoma, a dangerous form of cancer.
The company was already showing favor for vaginal surgery after the American Journal of Obstetrics & Gynecology article citing the benefits of the minimally invasive option. Besides the costs which are nearly 50% lower, vaginal surgery usually doesn’t require a hospital stay and results in more positive outcomes for the patient.
Despite evidence showing the healthcare benefits of vaginal surgery, laproscopic hysterectomy has been the procedure of choice for decades. This is primarily due to the heavy marketing of technological tools to surgeons and the limited training for residents in vaginal procedures.
Understandably, doctors and associations like the American College of Obstetricians and Gynecologists are not happy with insurance companies driving decisions between physicians and patients and vaginal surgery is not always an option for all patients. Those with abnormal anatomy due to prior surgeries or a uterus that is too large would probably be better suited to open abdominal surgery.
After considering the recent studies and published reports showing the benefits of vaginal hysterectomy for patients, it is difficult to deny that it is a procedure that helps save more than just money. With the approximately 500,000 hysterectomies performed per year the idea of providing the option vaginal surgery could result in a real shift to support evidence-based medicine overall.
Marina Medical has always supported minimally invasive gynecological surgery and we continue to work with surgeons to develop instrumentation with this mission in mind. We recently released a line of instruments designed with Dr. Rosanne Kho including anatomically curved clamps, retractors, and an ergonomic morcellation knife handle. Download our flyer for complete details.