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Invited Commentary |

Evaluating Changes in Health Care Policy Methods Matter

Lauren Hersch Nicholas, PhD, MPP1,2,3; Justin B. Dimick, MD, MPH4,5
[+] 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.
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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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