Becker's ASC Review

42 GASTROENTEROLOGY Many colonoscopies end with surprise medical bills, study says By Eric Oliver N early 1 in 12 colonoscopies without an associated intervention ended with an out-of-network claim, according to a new study published in the Annals of Internal Medicine in October. Medpage Today reported on the study, which examined claims data from 118,769 elective colonoscopies that were performed with in-network endoscopists and facilities. Researchers found that 12.1 percent of those procedures had an associated out-of-network claim. Median rates for the surprise claims were $418, with the majority of claims resulting from out-of-network anesthesiologists (64 percent of cases). Patholo- gists accounted for the second most surprise claims (40 percent of cases). Out-of-network claims were more likely to occur in cases with an intervention. In cases with visual inspection only, anesthesiologists accounted for an out- of-network claim 95 percent of the time. Surprise medical bills related to colonoscopies are illegal because the ACA eliminated consumer cost sharing for colonoscopy, according to the report. Karen Joynt Maddox, MD, of Washington University School of Medicine in St. Louis, told Medpage that the study was concerning because colonosco- pies should be covered without cost sharing. "Ultimately the people losing are the patients, so we need to find a path forward to end surprise billing," Dr. Joynt Maddox said. Note: Dr. Joynt Maddox is not affiliated with the study. n Meet ACG's next president, Dr. David Greenwald By Eric Oliver D avid Greenwald, MD, was elected as the 2020-21 president of the American College of Gastroenterology during the college's virtual 2020 meeting, Oct. 23-28. Dr. Greenwald is the director of clinical gastroenterology and endoscopy at Mount Sinai Hospital in New York City. He will direct the college's programs around continuing medical educa- tion, advancing patient-related skills in gastroenterology, advocating for the specialty in national and state medical affairs, and offering guidance around health policy issues and clinical investigation. Dr. Greenwald has served in leadership roles for the GI Quality Improve- ment Consortium and the National Colorectal Cancer Roundtable. He cur- rently serves as co-chair of the roundtable's public outreach committee. On the appointment, Dr. Greenwald said: "Moving forward into uncertain territory after an extraordinary and challenging year, my objective is to help ACG members focus on their professional relationships and treasure them. Our physician and other professional colleagues are intelligent, caring, sensitive, and have so much to share." n COVID-19 patients with GI symptoms had worse outcomes than patients without, study says By Eric Oliver C OVID-19 patients with gastrointesti- nal symptoms had higher admission rates to hospitals and intensive care units and higher intubation rates than those without GI symptoms, according to a poster presented at ACG 2020, Oct. 23-28. Researchers reviewed the electronic records of 1,003 COVID-19 patients between March 12 and April 3. e records included de- mographics, presenting symptoms, labora- tory data and clinical outcomes. Symptoms included fever, loss of appetite, body aches, cough, shortness of breath, smell loss, chest tightness, diarrhea, nausea/vomiting and abdominal pain. Researchers had data for 921 patients. About 22.4 percent (206 patients) reported at least one GI symptom. Nausea and vomiting was the most common GI symptom for 61.7 percent of patients. COVID-19 patients with GI symptoms were older, had higher body mass indexes and were more likely to have diabetes and hypertension. ese patients had lower mean hemoglobin, calcium and albumin, and higher creatinine and aminotransferases. Researchers concluded: "Analyzing the predictive value of GI symptoms based on number of initial GI symptoms showed a stepwise increased likelihood of worsened outcomes when compared to those without GI symptoms. GI symptoms in COVID-19 patients were present in up to 22.4 percent of patients and were associated with worse outcomes aer adjustment for demograph- ics, comorbidities and all other clinical symptoms." ACG denoted the poster as an ACG Award Winner, an ACG Newsworthy Abstract and an ACG Outstanding Poster Presenter. n

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