Center of excellence designation: Pros and cons: Comment on 'Reduced access to care resulting from centers of excellence initiatives in bariatric surgery'.

摘要

Livingston and Burchell found a 3-fold increase in the number of Medicare patients seeking surgery, and a 14-mile increase in the median distance traveled, following the Medicare national coverage determination in 2006. They conclude that the Medicare COE requirement decreases access to bariat-ric surgery, without any resulting patient benefit.