25 Sep Bariatric Surgery: Centers of Excellence Programs and Minority Access

MedicalResearch.com Interview Invitation
Dr. Lauren Hersch Nicholas Ph.D
Research Affiliate, Population Studies Center.
Faculty Research Fellow, Survey Research Center
University of Michigan

MedicalResearch.com: What are the main findings of the study?

Dr. Nicholas: We found that a Medicare policy designed to improve the safety of bariatric surgery was associated with 17% decline in the share of Medicare patients from minority groups receiving bariatric surgery.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Nicholas: We were surprised to find that the COE policy was associated with the unintended consequence of reducing minority access to bariatric surgery, one of the few treatments that has been shown to help with weight loss and comorbidity resolution for morbidly obese patients.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Nicholas: Our findings highlight the need for ongoing evaluation of payer and policy initiatives to ensure that they are having the desired result.  Our results also challenge the conventional wisdom that selective referral policies will only impact patients by increasing travel time- our results suggest that some patients chose not to have surgery when their preferred hospitals were unavailable.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Nicholas: Future research should consider ways of implementing selective referral policies without creating barriers to patient access to care.

Citation:

Bariatric Surgery In Medicare patients Before and After Implementation of a Centers of Excellence Program
Lauren Hersch Nicholas and Justin B. Dimick.
JAMA. 2013 Feb 27;309(8):792-9. doi: 10.1001/jama.2013.755.
Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI 48109

Last Updated on March 19, 2014 by Marie Benz MD FAAD