The Particulars: CMS issued a national coverage determination (NCD) in 2006 that restricted bariatric procedures to be performed at centers of excellence. Data are lacking on the trends and outcomes of bariatric surgery in Medicare patients following implementation of the NCD.
Data Breakdown: For a study, researchers analyzed more than 775,000 cases of morbidly obese Medicare beneficiaries who underwent bariatric surgery between 2001 and 2010. Roux-en-Y gastric bypass was the most common operation (79%), followed by gastric banding (19%). Since 2001, the overall mortality rate decreased at an average of 23% per year, and the overall morbidity rate decreased 29% per year on average. In-hospital mortality was lower after NCD than before, but the difference was higher among Medicare patients than non-Medicare patients.
Take Home Pearls: During the past decade, the overall rates or morbidity and mortality appear to have decreased substantially among Medicare beneficiaries who undergo bariatric surgery. Both Medicare and non-Medicare patients appear to have experienced a significant reduction in mortality following the 2006 Medicare NCD, with Medicare beneficiaries benefiting the most.