When researchers sent trained callers posing as patients to 35 bariatric surgery centers in North and South Carolina, they uncovered a surprising finding: insurance wasn't the problem — the system itself was. Nearly 1 in 3 centers (31.4%) couldn't be contacted at all after multiple attempts, with up to nine centers having incorrect contact information. Among those that could be reached, almost all accepted both private insurance and Medicaid, and wait times were the same regardless of coverage type.

The bigger issue? A maze of pre-appointment requirements. Of the 24 reachable centers, 27 required patients to complete steps before even scheduling — things like online applications, seminar attendance, primary care referrals, or screening questionnaires. Eight centers demanded two or more of these steps upfront.

By the Numbers:

• 35 bariatric centers studied across NC and SC
• 31.4% (11 centers) could not be reached despite multiple call attempts
• 94.3% of centers accepted Medicaid
• Median wait time for initial appointment: 20 days (no difference by insurance type)
• 27 centers required at least one pre-appointment step before scheduling

Why it matters: Bariatric surgery is the most effective treatment for obesity, yet it remains drastically underused. This study shows that the access gap isn't just about coverage — it's about clinics creating unnecessary friction. Streamlining scheduling processes could meaningfully improve care access for millions of patients.