the last 5 years or so."
And it's weighing heavily
on those who feel caught
between competing interests.
"Because the population is
getting so large, and reim-
bursements have dwindled
down to nothing," says Ms.
Waters, "there's a push with
investors to slide that person
in, to say, 'It'll be OK.'"
At Ms. Waters's facility, the
BMI limit is now 50, which,
among our respondents, is not
especially unusual. One in 5
have set the same limit, and
others say they'll go even high-
er under certain circumstances. That's concerning, says Ms. Waters. "Our
anesthesia providers would like to decrease our limit to 30, 35, or 40 max,
but we meet a lot of resistance from those who want the money to be gen-
erated."
Who decides?
Rather than set hard-and-fast limits, slightly more than 40% of our
respondents say they make decisions on a case-by-case basis. Some
also use sliding, incremental criteria. "Our absolute cutoff is 50," says
Cindy Beauvais, RN, BSN, MBA, CAPA, clinical director of the
(Savannah) Georgia Eye Institute Surgery Center. "(But) patients with
a BMI of 40 to 49 are reviewed by the anesthesiologist for appropriate-
ness to have surgery in an ambulatory setting."
5 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 6
• UPPING THE ANTE Nearly half of our respondents say they've had to raise their BMI or weight limits
in recent years.
