Becker's ASC Review

52 GASTROENTEROLOGY 10 colonoscopy, endoscopy developments for ASC leaders to know By Rachel Popa H ere is a roundup of the top news relating to colonoscopies and endos- copies from the past year: 1. Colorado could soon require insurers to cover colon cancer screening costs begin- ning at age 45 instead of 50 if the Colorado Cancer Coalition and the American Cancer Society's Cancer Action Network are suc- cessful in their lobbying. 2. CMS dropped its proposal for 2020 requiring gastroenterology practices to alert patients of the possibility they may be billed if their screening colonoscopy becomes therapeutic if a polyp is removed. However, the colonoscopy loophole still remains unad- dressed. A bill titled the "Elijah E. Cum- mings Lower Drug Costs Now Act," passed the House Dec. 12, and is now awaiting a vote in the Senate. 3. Colon cancer incidence rates have increased around 10 percent since 1990, an analysis by United European Gastroenterol- ogy revealed. Colon cancer rates increased 9.5 percent globally, and the disease remains the second leading cause of cancer death worldwide. However, age-standardized mor- tality rates have dropped by 13.5 percent. Researchers attribute the drop to an increase in colon cancer screening tests. 4. A rise in upper gastroenterology endosco- py to diagnose and treat esophageal diseases will propel high demand for gastrointestinal procedures in the next decade, according to Sg2's 2019 Impact of Change forecast. Rising diagnostic service volumes for gastrointesti- nal procedures will also be driven by height- ened awareness of early-onset colon cancer. 5. Fight Colorectal Cancer and Colon Cancer Coalition partnered to fund research looking at the differences in biology between patients with early-onset CRC and older-onset colorectal cancer at Rochester, Minn.-based Mayo Clinic. e organizations are donating $200,000 to fund the research. 6. While many artificial intelligence tech- nologies are still under development, the applications for AI in the field of gastro- enterology could be vast. In the last year, a handful of gastroenterology practices across the country participated in clinical trials testing cloud-based AI-inferencing systems for colonoscopies, and studies showed that AI-based computer-aided detection systems found significantly more adenomas and polyps than standard colo- noscopy alone. Gastroenterology experts said they believe AI-assisted polyp-detect- ing software will be widely adopted in the next two years. 7. New York City-based Northwell Health has launched a text and email program to reduce no-show rates for colonoscopies scheduled at two hospitals. The program, based on Conversera Health's automated platform, uses artificial intelligence to address questions and concerns related to colonoscopy, as well as the benefits of the procedure. 8. More gastroenterologists and insurance companies are beginning to prefer the sedative propofol over traditional sedation for colonoscopies, despite the increased cost. Propofol can cost $300 to $500 to administer. e drug is preferable due to its ability to put patients to sleep faster, meaning gastroenterologists may be able to find more precancerous lesions during a colonoscopy. Patients sedated with propofol also wake up easier with fewer side effects, such as nausea. 9. Jersey City (N.J.) Medical Center reduced the administrative work of getting a colonos- copy at its ASC bys eliminating preprocedure visits for eligible patients and allowing them to immediately schedule the procedure. 10. A study published in Plos One found Exact Sciences' Cologuard was less effec- tive and more costly than other CMS- reimbursed screenings. Only two strategies were cost efficient in all models: 10-year colonoscopy and an annual fecal oc- cult blood test. Cologuard was the most expensive option when compared to every screening strategy. Researchers found Co- loguard was only more cost effective than doing nothing at all. Researchers noted Cologuard was an efficient and potentially cost-effective screening option when reim- bursement rates were reduced to around $6 to $18 dollars per test. However, one model found that the test would never be cost effective. n 2 high-volume gastroenterology ASCs plan ownership changes By Angie Stewart G astroenterology Associates' two outpatient endoscopy centers — En- doscopy Center of Niagara and Endoscopy Center of Western New York — are making ownership changes involving non-physician own- ers, Buffalo Business First reports. Karen Sablyak will sell her shares in Niagara Falls, N.Y.-based Endoscopy Center of Niagara to Christina Morrison and David Young. Endoscopy Center of Niagara is one of region's busiest surgery centers, having logged nearly 5,000 procedures in 2018 with a team of five physicians. Williamsville-based Endoscopy Center of Western New York — Gastroenterol- ogy Associates' other endoscopy center — is executing a similar ownership change. The surgery center is the region's third busiest, having logged more than 15,000 procedures in 2018. When the transfer is complete, the ASC's 10 physicians will have a share of nearly 76 percent. Four non-physicians will own the rest. In addition to the two endoscopy centers, Gastroenterology Associates has medical offices in Williamsville, Niagara Falls and Orchard Park, N.Y. n

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