Importance Starting in 2006, the Centers for Medicare & Medicaid Services (CMS) has
restricted coverage of bariatric surgery to hospitals designated as centers of excellence
(COE) by 2 major professional organizations. Objective To evaluate whether the
implementation of the COE component of the national coverage decision was associated
with improved bariatric surgery outcomes in Medicare patients. Design, Setting, and Patients
Retrospective, longitudinal study using 2004-2009 hospital discharge data from 12 states …

Comments: This study, as well as previous studies, has demonstrated that there is no
significant difference in outcomes, both pre and post CMS policy and between COE and non-
COE designated hospitals. It would seem that Medicare policy does not have much bearing
on clinical outcomes, and perhaps this policy should be changed as this procedure
becomes safer and more common.