How the Lipedema Treatment Network Can Help Patients and Providers

Lipedema is an incurable, progressive, debilitating fat and soft tissue disorder that affects millions of women in the U.S.A and 11% of adult women worldwide.¹ Although prevalent, lipedema is not well known to the public.
 
Lipedema fat is lumpy and painful, and it accumulates in large abnormal pockets in the legs, thighs, and arms and often in the trunk. The buildup of fat is not caused by obesity, and diet or exercise and even bariatric surgery have little impact on the condition. Women who suffer from lipedema often develop lymphedema, mobility abnormalities and degenerative joint disease (mostly in the knees), which often requires joint replacement. If left untreated, these women become debilitated and eventually are unable to carry on simple activities of daily living.

We developed the Lipedema Treatment Network (LTN) as a physician management organization aimed at improving treatment of patients with lipedema. Understanding that lipedema is a painful, devastating disease that often goes undiagnosed or is misdiagnosed, we wanted to create a network of vetted and qualified providers.

What the LTN Does

LTN’s goal is to connect patients, providers, and insurance carriers with one another. Insurance coverage for liposuction as a lipedema treatment is a main concern. LTN is connecting patients with their carriers to get them approved for this surgery.

LTN’s mission is to ensure that, if patients are suffering from lipedema, they will have access to affordable and state-of-the-art lipedema treatment around the United States.
 
-       For lipedema patients, The new national network helps find physicians who are trained to treat this disease properly. LTN may also help to get the treatment reimbursed.
-       For providers, LTN will help open opportunities for providers to learn how to treat these interesting, challenging, and underserved patients, as well as help to reduce overall rising healthcare costs. LTN helps with the administrative work with carriers.
 
LTN standardizes the state-of-the-art treatment of lipedema patients by their member physicians and guides them through insurance preauthorization and reimbursement processes to make those processes easier for Lipedema patients and for their providers. It is the goal to establish a master agreement with insurance carriers on behalf of our member physicians with respect to lipedema-related services that will alleviate the hurdles of lone providers having to navigate through third party payer’s pre-certification and payment processes.
 
De-bulking of lipedema fat using a lymph-sparing liposuction technique such as water-jet assisted lipedema debulking surgery (WALDS) is the only known technique to correct these abnormal adipose tissue.¹ It drastically improves pain, tenderness, swelling and heaviness of the legs, restores patients’ mobility, and enables them to lose weight. These results have been shown to be sustained for over 12 years. The procedure can be performed safely in the correctly trained physician’s office and does not require the expense of general anesthesia or a hospital stay.

Addressing a Health Care Gap

Knowledge about the existence of lipedema in general, even among the medical community, is significantly deficient. A scant number of U.S. medical providers understand lipedema and its complexity and know how to treat it. Insurance coverage for treatment of lipedema is often problematic because it is not a well-known disorder, and specific treatment guidelines have not been well disseminated. Many patients come to our lipedema specialists after having been undiagnosed, misdiagnosed, or even mistreated by other providers previously. Not only has this situation frustrated the lipedema patients and unnecessarily delayed proper treatment but also has wasted resources for them, for their insurance carriers and for the health care system, in general.
 
The Lipedema Treatment Network centralizes the education, marketing, and communications about lipedema to patients and connects them with vetted knowledgeable providers in their geographical region. Furthermore, LTN provides expertise, training, and management assistance to their member physicians for the proper treatment of lipedema. Lastly, LTN centralizes the billing and reimbursement process for all of its providers, as it acts on their behalf with insurance carriers. As an organization representing multiple practices, we will be able to negotiate fair reimbursement rates with insurance carriers. 
 
From a provider’s perspective, dealing with a single office such as LTN, instead of multiple insurance carriers, will save time and resources. The same benefit of centralization also applies to the insurance carriers—interacting with LTN instead of with multiple providers. These cost and time-saving efficiencies benefit patients, providers and insurance carriers while keeping the care of lipedema patients in general in the office setting out of hospitals. This value-based care model is aligned with the current trend of insurance companies partnering with physician groups in order to reduce healthcare costs, deliver better outcomes and improve the response to members’ needs.² 
 
Please contact the authors for more information about the Lipedema Treatment Network.
 
Nadiv Shapira, MD, is the Chief Medical Officer of the Lipedema Treatment Network. He is a Fellow of the American Board of Venous and Lymphatic Medicine. Contact Dr. Shapira at nshapira@lipedematreatment.org or 302-294-0700.
 
Larry Wagner is the Chief Operating Officer of the Lipedema Treatment Network
Chief Operating Officer. Contact him at lwagner@lipedematreatment.org or 321-316-1787.

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References
 
1. Buck DW II, Herbst KL. Lipedema: A relatively common disease with extremely common misconceptions. Plast Reconstr Surg Glob Open. 2016; 4(9):e1043.
2. Dyrda L. Payers shifting strategy to keep clinicians independent. Becker’s ASC Review. Published Aug. 16, 2021.