Becker's ASC Review

28 GASTROENTEROLOGY 4 factors that will make or break a gastroenterology practice in the next 2 years By Patsy Newitt G astroenterologists are still recovering from the COVID-19 pandemic and adapting to new changes in how they practice medicine. Here are four factors that could make or break a gastroenterology practice in the next two years, according to four gastroenterologists. 1. Payer regulations. A recent decision by Empire BlueCross BlueShield to not allow members to have outpatient endoscopies in an outpatient hospital setting is one factor concerning Maurice Cerulli, MD, a gastroenter- ologist at New Hyde Park, N.Y.-based Northwell Health and associate professor at Hempstead, N.Y.-based Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. "Since I work at an academic medical center, I perform all my procedures in such set- tings," he said. "I am concerned that other payers may follow, which could leave us with Medicare, Medicaid and sliding-scale patients for our outpatient procedures. Such decisions affect academic medical centers disproportionately since they tend to have higher costs [and] perform more labor in- tensive, sophisticated procedures with more experience accessories." 2. Technology. Rajiv Sharma, MD, of Digestive Health Associates in Terre Haute, Ind., said adaptability and acceptance of technology's role in medicine will help his practice. "We have to evolve," he said. "We need to use remote methods to connect with patients and referring providers via HIPAA-compli- ant platforms. In my practice I created virtu- al work modules to streamline check-in and checkout processes to minimize time spent in the office. It has been a mega success for patient care coordination and has resulted in cost savings with reduced overhead." Joe Feuerstein, MD, of Boston-based Beth Israel Deaconess Medical Center said telemedicine would be a factor that boosts competition among practices. "Many patients and practices have been using telemedicine during the pandemic," he said. "is has completely changed how we practice medicine. Telemedicine is likely here to stay for the long term. is increases competition among practices, as the reach of a practice embracing telemedicine is much greater and the ability for larger telemedicine companies to reach patients is increased as well. Practices need to be aware of this and decide how they will embrace telemedicine and balance seeing patients in clinics and virtually." 3. Workforce. Frederick Askari, MD, PhD, director of the Wilson Disease Program at Michigan Medicine in Ann Arbor, said hir- ing staff was a key factor for his practice. "e biggest challenge is twofold: mandates from senior management to open endos- copy on Saturdays, and difficulties hiring a workforce, maintaining morale and retaining employees willing to do so," he said. 4. Finances. Dr. Feuerstein pointed to changes in reimbursement rates. Practices need to keep an eye on how they evolve. "Long-term reimbursement rates will likely change for both patients seen in clinics and virtually, and it will be very important for practices to monitor this carefully as they assess the balance between reimbursements and facilitating virtual patient appoint- ments," he said. Dr. Sharma emphasized the importance of identifying inefficiencies that could affect revenue. "You have to know your pain points and bottlenecks," Dr. Sharma said. "It is critical for you to measure your office inefficiencies and correct them, otherwise they will lead to revenue loss and practice failure." n 3 tips for GI success: Q&A with Linda Lee By Patsy Newitt L inda Lee, MD, the medical director of endoscopy for Boston-based Brigham and Women's Hospital, spoke with Becker's ASC Review to give tips for gastrointestinal practices to succeed in the next two years. Here are her three tips: 1. Hospital-based practices should seek to have ambulatory endoscopy cen- ters perform routine procedures, as insurance companies may be starting to penalize hospitals for performing these in a hospital setting. 2. GI practices should focus on increasing efficiency by investing in technol- ogy that enables physicians and endoscopy units to work more efficiently. In endoscopy, this may include artificial intelligence options to help not only with polyp detection, but also with peri-procedural work as well as with inven- tory management and patient calls. In the clinics, this would include auto- mated dictation services and/or scribes. 3. Increase support with advanced practice providers who can either see patients with physicians — which allows physicians to see more patients in a session and bill at a higher rate than advanced practitioners can on their own — or have advanced practitioners staff their own clinics and see inpatient consults. Even though the billing will be lower, increased access will generate more procedures and other studies. n "You have to know your pain points and bottlenecks." - Dr. Raviv Sharma, Digestive Health Associates

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