The Spillover Effect of a Change in Medicare Reimbursements on Provider Behavior in the Non‐Medicare Population for Bariatric Surgery. Issue 1 (March 2016)

• Record Type: Journal Article
• Authors: Muhlestein, David B.; Wickizer, Thomas; Shoben, Abigail
• Is Part Of: World medical & health policy. Volume 8:Issue 1(2016:Mar.)
• Page Start: 74
• Page End: 94
• Publication Date: 2016-03
• Subjects: bariatric surgery -- Medicare -- hospital reimbursement; Medical policy -- Periodicals; 362.1
• DOI: 10.1002/wmh3.178
• Languages: English
• ISSNs: 2153-2028

Abstract

Abstract : In 2006, the United States' Centers for Medicare and Medicaid Services (CMS) released a national coverage determination (NCD) which required bariatric surgery procedures to be performed in accredited centers of excellence, which decreased the rate of procedures among Medicare beneficiaries. The NCD's effect on the non‐Medicare population is unknown. In this study, we evaluate temporal rates of bariatric surgery using data from the Healthcare Cost and Utilization Project's National Inpatient Sample from 1998 to 2010. We observed similar decreases in rates of bariatric surgery in both the Medicare and non‐Medicare populations with the decreases occurring concurrently. This suggests significant Medicare spillover onto the non‐Medicare population and indicates CMS has the ability to influence provider behavior beyond the Medicare population.