Navigation Links
Medicare Center of Excellence Policy may limit minority access to weight-loss surgery
Date:9/12/2013

Safety measures intended to improve bariatric surgery outcomes may impede obese minorities' access to care. This is according to a new research letter published online in the September 12 issue of JAMA which compares rates of bariatric (weight-loss) surgery for minority Medicare vs. non-Medicare patients before and after implementation of a Medicare coverage policy. The policy limits Medicare patients seeking bariatric surgery to high-volume hospitals designated as centers of excellence. Led by faculty from the Johns Hopkins Bloomberg School of Public Health, the researchers found a decline in the number of minority patients with Medicare receiving bariatric surgery after the policy was implemented.

"The Medicare centers of excellence policy was associated with a 4.7 percentage point (17 percent) decline in the proportion of Medicare patients receiving bariatric surgery who were non-white," said Lauren Hersch Nicholas, PhD, MPP, lead author of the letter and an assistant professor with the Bloomberg School's Department of Health Policy and Management. "It appears that a policy intended to improve patient safety had the unintended consequence of reduced use of bariatric surgery by minority Medicare patients."

Hospitals are recognized as centers of excellence if they submitted data to a registry, have adequate protocols for care of morbidly obese patients, and perform at least 125 bariatric procedures annually. Researchers examined bariatric surgery discharge abstracts from 228,136 patients undergoing bariatric surgery in 429 inpatient hospitals in 8 states and compared the proportion of minority patients undergoing bariatric surgery with and without Medicare before and after implementation of the policy change. Non-Medicare patients were used as a control group to isolate associations with the Medicare policy change relative to trends among all bariatric surgeries over the study period. In addition, researchers compared the number of white patients with those from all other minority groups.

Earlier studies documenting better surgical outcomes at hospitals with higher procedure volume have prompted proposals to concentrate elective surgery in high-volume settings; these policies have been little-used in practice. To date, bariatric surgery is the only procedure for which the Centers for Medicare and Medicaid Services (CMS) have experimented with restrictions to high-volume hospitals. CMS recently proposed eliminating the centers of excellence requirement after studies suggested little if any safety benefit to bariatric centers of excellence and is expected to issue a decision later this month.

"Policies restricting patients to centers of excellence could lead to serious issues including, reducing access for vulnerable populations," suggest the authors.

"Morbidity and mortality associated with bariatric surgery have declined in recent years and safety gains from limiting hospital choice are likely lower than they were when the national coverage decision was implemented in 2006," adds Nicholas. "Our findings are important for bariatric surgery and also serve as a cautionary tale about the potential for unintended consequences if selective referral policies are extended to other procedures."


'/>"/>

Contact: Natalie Wood-Wright
nwoodwri@jhsph.edu
443-703-8851
Johns Hopkins University Bloomberg School of Public Health
Source:Eurekalert

Related medicine news :

1. 1-800-Medigap, Medicare Supplement Expert, Announces Its A+ Better Business Bureau Accreditation
2. Medicare Study Examines Mental Health Effect of Superstorm Sandy to Improve Future Disaster Response
3. Obamacare Changes Network to Medicare from United Health Care for All Policy Holders of Pre-existing Health Insurance Plan
4. Health Data Intelligence Introduces a New Dashboard to Analyze Hospital-Level Medicare Provider Charges and Payments
5. Lower-cost drug substitutions could mean big savings for Medicare patients, government
6. Novus Medical Detox Predicts Taxpayer-Paid Drug Abuse Amid Medicare Fraud, Urges Federal Regulations
7. Atlantic Information Services’s Medicare Advantage News Reports on Plan Drop-Outs from Massachusetts Dual-Eligibles Demo
8. Southern District of New York Settles False Claims Act Case Against Multi-State Provider Group Servicing Medicare and Medicaid Patients
9. Rates of cardiovascular procedures differ for medicare beneficiaries
10. Lowering costs for higher-cost medicare patients through better outpatient care may be limited
11. New Avalere Analysis: Top Five Medicare Part D Plans with the Lowest Average Premiums Have Preferred Pharmacy Networks
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... , ... June 27, 2016 , ... "FCPX editors can ... inside of Final Cut Pro X," said Christina Austin - CEO of Pixel Film ... Final Cut Pro X users can now reveal the media of their ...
(Date:6/27/2016)... , ... June 27, 2016 , ... ... edge technology to revolutionize the emergency ambulance transport experience for the millions of ... of how Uber has disrupted the taxi industry through the use of technology. ...
(Date:6/26/2016)... ... June 26, 2016 , ... On June 10-11, 2016, A Forever Recovery, ... Festival and World’s Longest Breakfast Table in Battle Creek, MI, where the rehabilitation facility ... home to some of the world’s leading providers of cereal and other breakfast foods. ...
(Date:6/26/2016)... ... ... Kasmer, a legally blind and certified personal trainer is helping to develop a weight loss ... plans to fix the two major problems leading the fitness industry today:, ... , They don’t eliminate all the reasons people quit their exercise program ...
(Date:6/25/2016)... ... 2016 , ... Austin residents seeking Mohs surgery services, can now turn to ... Dr. Russell Peckham for medical and surgical dermatology. , Dr. Dorsey brings specialization to ... fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was under the direction of ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Research and Markets ... Market - Forecast to 2022" report to their offering. ... method for the patients with kidney failure, it replaces the ... from the patient,s blood and thus the treatment helps to ... chloride in balance. Increasing number of ESRD ...
(Date:6/23/2016)... Roche (SIX: RO, ROG; OTCQX: RHHBY) announced that it ... (procalcitonin) assay as a dedicated testing solution for people ... Roche is the first IVD company in the U.S ... assessment and management. PCT is a sepsis-specific ... blood can aid clinicians in assessing the risk of ...
(Date:6/23/2016)... 2016 Bracket , a leading clinical trial ... clinical outcomes platform, Bracket eCOA (SM) 6.0, at the ... – 30, 2016 in Philadelphia , Pennsylvania.  ... Assessment product of its kind to fully integrate with RTSM, ... eCOA 6.0 is a flexible platform for electronic clinical outcomes ...
Breaking Medicine Technology: