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
Nicholas LH, Dimick JB. Evaluating Changes in Health Care Policy: Methods Matter. JAMA Surg. 2015;150(7):649. doi:10.1001/jamasurg.2015.120
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.