Acessa Health has announced that 32 state Medicaid programs have listed the Acessa procedure on their fee schedules, providing improved access to this minimally invasive, uterine sparing alternative option to hysterectomy to millions of women suffering from symptomatic fibroids. These Medicaid states join national carriers such as Aetna, Molina and Tricare as well as several Blue Cross Blue Shield plans in Illinois, Texas, Oklahoma, New Mexico, Montana, Michigan and South Carolina in covering the procedure.
Despite this substantial momentum of insurance coverage, inconsistencies in benefit administration continue across the country. Today, most state Medicaid programs are administered by large, for-profit insurance carriers. As an example of the significant inconsistency in patients’ access to care, a Medicaid patient in Texas who has her benefits administered by Cigna (Health-Spring) or United Healthcare (Community Plan) can have access to the Acessa procedure; however, women who pay for commercial insurance with Cigna or United Health will not have the procedure covered. Providers, patients and Acessa Health are actively working with commercial payers to ensure all women have access to the less invasive procedure.
“The expansion of Medicaid coverage for the Acessa procedure represents another significant step forward in terms of recognizing the medical necessity of this procedure as well as increasing the number of options women have as alternatives to hysterectomy,” said Ryan Graver, vice president of market access at Acessa Health. “We are committed to improving awareness of all available treatment pathways for women with symptomatic uterine fibroids.”
Hysterectomy is the second most common surgery performed on reproductive-aged women and continues to be the primary treatment for women with uterine fibroids in the United States. As a result, one in three women in the U.S. will have had a hysterectomy by age 60. Uterine fibroids have been shown to impact between 70 percent and 80 percent of women before they reach the age of 55 with severe symptoms occurring in 15–30 percent of these patients1,2,3. Recent studies have concluded that less invasive alternatives to hysterectomy are underutilized in women suffering from symptomatic uterine fibroids and that providers are in many cases are not discussing or offering patients these alternatives4.
The Acessa procedure is a minimally invasive, uterine sparing alternative option to hysterectomy. Acessa can treat almost all sizes and locations of fibroids, including those within the uterine walls. The procedure requires no cutting or suturing of uterine tissue, and patients typically go home the same day and have been shown to return to work and normal function within three to five days. FDA approved in 2012, the Acessa System has been used to successfully treat more than 2,000 women. A recent article published in the Journal of Minimally Invasive Gynecology noted that the Acessa procedure holds unique promise among surgeons because it avoids the need for fibroid enucleation (morcellation) and suturing, while retaining all the advantages of minimally invasive surgery5. – Business Wire