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Viewpoint |

Hospital Networks and Value-Based Payment Fertile Ground for Regionalizing High-Risk Surgery

Karan R. Chhabra, AB1; Justin B. Dimick, MD, MPH2,3
[+] Author Affiliations
1Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
2Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor
3Department of Surgery, University of Michigan, Ann Arbor
JAMA. 2015;314(13):1335-1336. doi:10.1001/jama.2015.9803.
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This Viewpoint describes the shifts made by hospital networks toward a new type of surgical regionalization to improve surgical outcomes and overall clinical quality.

Recently, 3 major medical centers—Dartmouth, Johns Hopkins, and the University of Michigan—declared a “volume pledge” that restricts performance of 10 selected procedures to surgeons and hospitals that meet volume criteria.1 This followed an announcement by US News & World Report of a new analysis demonstrating poorer outcomes at low-volume hospitals.1 Both of these are derived from decades of research showing that high surgical volumes are associated with better outcomes, especially in high-risk procedures.2,3

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