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Invited Commentary
July 2015

Evaluating Changes in Health Care PolicyMethods Matter

Author Affiliations
  • 1Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, Maryland
  • 2Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
  • 3Survey Research Center, University of Michigan Institute for Social Research, Ann Arbor
  • 4Department of Surgery, University of Michigan Medical School, Ann Arbor
  • 5Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor
JAMA Surg. 2015;150(7):649. doi:10.1001/jamasurg.2015.120

The cost-benefit trade-offs of regionalizing elective surgery remain an important policy issue.1,2 In this issue, Bae and colleagues3 examine patient demographics following a 2006 Medicare National Coverage Decision (NCD) regarding bariatric surgery. The NCD simultaneously extended bariatric surgery coverage to all Medicare patients (previously local intermediaries determined eligibility), expanded Medicare coverage to laparoscopic adjustable gastric banding, and, most important for the Bae et al study, took the unprecedented step of restricting Medicare patients to a subset of hospitals that were designated as a Center of Excellence (COE).4

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