What is a "Bariatric Center of Excellence?"
Ara Keshishian one of the surgeons I have seen touted on the BS forum as one of the best if not best DS surgeon in the country and one of the few who does revisions is at a Bariatric Center of Excellence as is David Greenbaum another surgeon I see mentioned as a top DS surgeon on the DS board. Paul Kemmeter is another as well.
Not sure what all that means but thought I would point it out.
Also according to the website you linked.
The American Society for Metabolic and Bariatric Surgery (ASMBS) offers its Bariatric Surgery Center of Excellence® (BSCOE) program to all surgeons, hospitals and freestanding outpatient facilities in the United States and Canada.
That reads to me like the ASBMS is still the sanctioning body.
The American Society for Metabolic and Bariatric Surgery (ASMBS) offers its Bariatric Surgery Center of Excellence® (BSCOE) program to all surgeons, hospitals and freestanding outpatient facilities in the United States and Canada.
That reads to me like the ASBMS is still the sanctioning body.
Yes and no. It's kind of like getting the Good Housekeeping Seal of Approval. It means you meet their standards (however justified). NOT having the GHSA doesn't mean you don't meet the standards, it can mean you didn't feel the need to do so, or you exceed their standards, or you meet all but one or two that aren't important to patient care.
But yes, the ASMBS was behind it - BCBS took off with it, and other insurers followed, because they saw how the "requirements" could be exploited to suit their needs - limiting access and costs.
But yes, the ASMBS was behind it - BCBS took off with it, and other insurers followed, because they saw how the "requirements" could be exploited to suit their needs - limiting access and costs.
It means that each of them has affiliated themselves with at least ONE COE so that they can provide services to patients whose insurers require that they use a COE. Rabkin is affiliated with one or two of them as well - but he also operates at St. Mary's Hospital wihich is not a COE. That's where his self-pays generally go, because St. Mary's is flexible in their pricing.
This definitely reeks of a disgruntled patient. I had my surgery at a COE and currently work at a different COE.
I can tell you the steps that it takes to become a COE and they aren't "surgery mills" Our surgeons are passionate about their patients and certainly are not conspiring with the insurance companies, I assure you.
if you claim to know so much about the ASMBS, perhaps you would know what it takes to become a COE. I'm curious why you are so upset about this.
I can tell you the steps that it takes to become a COE and they aren't "surgery mills" Our surgeons are passionate about their patients and certainly are not conspiring with the insurance companies, I assure you.
if you claim to know so much about the ASMBS, perhaps you would know what it takes to become a COE. I'm curious why you are so upset about this.
Nope, not a disgruntled patient - if you know so much and were paying attention, you would have noticed I had my DS before the COE requirements were put in place.
This is the website of the organization that was created to implement the requirements - it has them listed.
http://www.surgicalreview.******bs/
This is about people who have not had surgery yet, and about the politics - and MONEY (always follow the money) that these bogus requirements put in specific people's pockets. And recent reports have indicated that the primary outcome of all these "important" COE designations has been decrease access to care: http://www.ncbi.nlm.nih.gov/pubmed/20956769
Arch Surg. 2010 Oct;145(10):993-7.
Reduced access to care resulting from centers of excellence initiatives in bariatric surgery.
Livingston EH, Burchell I.
Source
University of Texas Southwestern Medical Center, Dallas, 75390-9156, USA. [email protected]
Abstract
OBJECTIVE:
To determine the effect on travel distance for Medicare patients before and after Centers for Medicare & Medicaid Services required that bariatric procedures be performed at Centers of Excellence (COEs).
DESIGN:
We calculated the distance traveled to our medical center for the 2 years prior (2004-2005) and 2 years after (2006-2007) COE status was required by Medicare. We also compared the proportion of bariatric cases done in large hospitals with those for esophageal and pancreatic resections, procedures whose effects regionalization would have on patient access have been modeled.
SETTING:
University of Texas Southwestern Medical Center, a high-volume tertiary referral center for bariatric surgery.
PATIENTS:
Patients undergoing bariatric procedures.
MAIN OUTCOME MEASURE:
Travel distances.
RESULTS:
Depending on insurance status, before COEs were required, patients traveled a median of 16 to 25 miles to undergo bariatric operations at University of Texas Southwestern. After COEs were required, the median distance Medicare patients were required to travel increased 76% to 44 miles.
CONCLUSIONS:
Center of Excellence requirements have increased the travel distance required for Medicare patients. Prior research has shown that outcomes at COEs are no different than those at non-COEs suggesting that the reduced access to care resulting from requiring COE status is not beneficial.
Comment in
Arch Surg. 2010 Oct;145(10):997-8.
PMID: 20956769 [PubMed - indexed for MEDLINE]
Publication Types, MeSH Terms
LinkOut - more resources
This is the website of the organization that was created to implement the requirements - it has them listed.
http://www.surgicalreview.******bs/
This is about people who have not had surgery yet, and about the politics - and MONEY (always follow the money) that these bogus requirements put in specific people's pockets. And recent reports have indicated that the primary outcome of all these "important" COE designations has been decrease access to care: http://www.ncbi.nlm.nih.gov/pubmed/20956769
Arch Surg. 2010 Oct;145(10):993-7.
Reduced access to care resulting from centers of excellence initiatives in bariatric surgery.
Livingston EH, Burchell I.
Source
University of Texas Southwestern Medical Center, Dallas, 75390-9156, USA. [email protected]
Abstract
OBJECTIVE:
To determine the effect on travel distance for Medicare patients before and after Centers for Medicare & Medicaid Services required that bariatric procedures be performed at Centers of Excellence (COEs).
DESIGN:
We calculated the distance traveled to our medical center for the 2 years prior (2004-2005) and 2 years after (2006-2007) COE status was required by Medicare. We also compared the proportion of bariatric cases done in large hospitals with those for esophageal and pancreatic resections, procedures whose effects regionalization would have on patient access have been modeled.
SETTING:
University of Texas Southwestern Medical Center, a high-volume tertiary referral center for bariatric surgery.
PATIENTS:
Patients undergoing bariatric procedures.
MAIN OUTCOME MEASURE:
Travel distances.
RESULTS:
Depending on insurance status, before COEs were required, patients traveled a median of 16 to 25 miles to undergo bariatric operations at University of Texas Southwestern. After COEs were required, the median distance Medicare patients were required to travel increased 76% to 44 miles.
CONCLUSIONS:
Center of Excellence requirements have increased the travel distance required for Medicare patients. Prior research has shown that outcomes at COEs are no different than those at non-COEs suggesting that the reduced access to care resulting from requiring COE status is not beneficial.
Comment in
Arch Surg. 2010 Oct;145(10):997-8.
PMID: 20956769 [PubMed - indexed for MEDLINE]
Publication Types, MeSH Terms
LinkOut - more resources
you are a complete conspiracy theorist. anyone can find some sort of research/statistic to back up their claim, that doesn't make it true.
I don't care where you had your surgery or when it was, it doesn't make you correct
why are you so bitter about it? you already had your surgery, what is with the anti-COE campaign?
from someone who actually knows what they are talking about as I've gone through the steps to become a COE, you are NOT going to convince me of your theory, I assure you. I'm just curious as to why you are so adamant about it?
I don't care where you had your surgery or when it was, it doesn't make you correct
why are you so bitter about it? you already had your surgery, what is with the anti-COE campaign?
from someone who actually knows what they are talking about as I've gone through the steps to become a COE, you are NOT going to convince me of your theory, I assure you. I'm just curious as to why you are so adamant about it?
Sure, I'm a conspiracy theorist. And you are a shill for the insurance companies and surgery mill bariatric practices.
I cited peer-reviewed publications. You cite - nothing.
This issue matters becaused the insurance companies use it to deny coverage to patients who want to use surgeons *****fuse to cooperate with the **** poor insurance reimbursement rates, and because they use it as a surrogate basis for denial for the DS, which is performed by far fewer surgeons and often not at a high-throughput (I.e., surgery-mill) rate.
You don't understand the big picture of economic and reimbursement driven medical policies. Stick to what you know, which obviously isn't much.
I cited peer-reviewed publications. You cite - nothing.
This issue matters becaused the insurance companies use it to deny coverage to patients who want to use surgeons *****fuse to cooperate with the **** poor insurance reimbursement rates, and because they use it as a surrogate basis for denial for the DS, which is performed by far fewer surgeons and often not at a high-throughput (I.e., surgery-mill) rate.
You don't understand the big picture of economic and reimbursement driven medical policies. Stick to what you know, which obviously isn't much.
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