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:6/26/2016)... ... , ... Pixel Film Studios Released ProSlice Levels, a Media Slicing Effect ... a whole new perspective by using the title layers in ProSlice Levels to ... ProSlice Levels contains over 30 Different presets to choose from. FCPX users ...
(Date:6/26/2016)... (PRWEB) , ... June 26, 2016 , ... ... fertility once they have been diagnosed with endometriosis. These women need a treatment ... also require a comprehensive approach that can help for preservation of fertility and ...
(Date:6/25/2016)... ... ... The temporary closing of Bruton Memorial Library on June 21 due to a possible lice ... overlooked aspect of head lice: the parasite’s ability to live away from a human host, ... a necessary one in the event that lice have simply gotten out of control. , ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... As a ... Magna Cum Laude and his M.D from the David Geffen School of Medicine at ... returned to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, ... the latter, setting the bar too high can result in disappointment, perhaps even self-loathing. ... toward their goal. , Research from PsychTests.com reveals that behind the ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... Story Highlights: ... the health care industry is causing providers to review ... Deloitte offers a suite of solutions for health care ... cost optimization: labor resource analysis, revenue cycle optimization and ... outcomes and better economics ...
(Date:6/24/2016)... , June 24, 2016  Global Blood ... biopharmaceutical company developing novel therapeutics for the treatment ... today announced the closing of its previously announced ... stock, at the public offering price of $18.75 ... offering were offered by GBT. GBT estimates net ...
(Date:6/24/2016)... Research and Markets has ... 2015-2025: Applications, Technologies, Forecasts" report to their ... Electronics, Smart Skin, Structural Health Monitoring, Composite Smart ... electronics involves electronic and/or electrical components and circuits ... structures such as vehicle bodies or conformally placed ...
Breaking Medicine Technology: