Featured Research

from universities, journals, and other organizations

Medicare policy may limit minority access to weight-loss surgery

Date:
September 12, 2013
Source:
Johns Hopkins University Bloomberg School of Public Health
Summary:
New research indicates a decline in the number of minority patients with Medicare receiving bariatric surgery after the Medicare Center of Excellence Policy was implemented.

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."


Story Source:

The above story is based on materials provided by Johns Hopkins University Bloomberg School of Public Health. Note: Materials may be edited for content and length.


Cite This Page:

Johns Hopkins University Bloomberg School of Public Health. "Medicare policy may limit minority access to weight-loss surgery." ScienceDaily. ScienceDaily, 12 September 2013. <www.sciencedaily.com/releases/2013/09/130912203323.htm>.
Johns Hopkins University Bloomberg School of Public Health. (2013, September 12). Medicare policy may limit minority access to weight-loss surgery. ScienceDaily. Retrieved September 20, 2014 from www.sciencedaily.com/releases/2013/09/130912203323.htm
Johns Hopkins University Bloomberg School of Public Health. "Medicare policy may limit minority access to weight-loss surgery." ScienceDaily. www.sciencedaily.com/releases/2013/09/130912203323.htm (accessed September 20, 2014).

Share This



More Health & Medicine News

Saturday, September 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Sierra Leone's Nationwide Ebola Curfew Underway

Sierra Leone's Nationwide Ebola Curfew Underway

Newsy (Sep. 20, 2014) Sierra Leone is locked down as aid workers and volunteers look for new cases of Ebola. Video provided by Newsy
Powered by NewsLook.com
Changes Found In Brain After One Dose Of Antidepressants

Changes Found In Brain After One Dose Of Antidepressants

Newsy (Sep. 19, 2014) A study suggest antidepressants can kick in much sooner than previously thought. Video provided by Newsy
Powered by NewsLook.com
Could Grief Affect The Immune Systems Of Senior Citizens?

Could Grief Affect The Immune Systems Of Senior Citizens?

Newsy (Sep. 19, 2014) The study found elderly people are much more likely to become susceptible to infection than younger adults going though a similar situation. Video provided by Newsy
Powered by NewsLook.com
Jury Delivers Verdict in Salmonella Trial

Jury Delivers Verdict in Salmonella Trial

AP (Sep. 19, 2014) A federal jury has convicted three people in connection with an outbreak of salmonella poisoning five years ago that sickened hundreds of people and was linked to a number of deaths. (Sept. 19) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins