Becker's ASC Review

Executive Briefing: GI Technology Trends are going to rely on information technology more. There will be electronic data warehouses for clinical and claims information that can be analyzed and studied to measure and assess quality performance. "Then we can compare performance against guidelines and see whether physicians completed the guidelines appropriately. They must administer the right tests and medication for diseases and coordinate follow-up and blood work according to the protocols. It's fairly easy to take claims data 23 and EHR data and determine if treatment was given in an automated way rather than doing chart searches to sort everything out. "Additionally, we will begin to take this same approach for endoscopic operations. We will look at what it costs to provide various services and benchmark individual performance against others to determine whether we are achieving the highest level of efficiency for the resources spent." n How ASC/AECs Can Survive Coming Healthcare Changes: Q&A With Barry Tanner of Physicians Endoscopy By Laura Miller Q: What are the biggest changes coming for ASC/AECs as a result of the current healthcare environment? Barry Tanner: I think that many of the most significant changes are yet to be determined. It seems clear that pricing pressures will continue, especially on the professional practice side. Beginning in 2014, we anticipate seeing the start of an influx of newly insured patients. However, what we don't yet know is how to determine the change that will occur in the overall payer mix. Clearly many more patients will have access to healthcare. That is a very good thing. Providers will be strained from a service perspective. Many providers will likely have increases in government-like reimbursements. The big question is how many patients will be migrating from third-party payer plans that actually support provider operations and survival to the health exchange plans. It seems clear that there is likely to be continued movement toward population management and a bundled type of reimbursement and as a result of that pressure data gathering and data management will play an increasingly larger role in healthcare delivery. Q:  What can physicians and ASC/AEC administrators do to prepare for those changes as best as possible? BT: The best thing we can do is to be extremely diligent on documenting our quality of care and the costs associated with that care. Shifting more payment reimbursement to the consumer is going to increase the need for transparency and will increase healthcare shopping. Physicians and providers in general need to change toward making their quality and costs fit that mold.   "All ASCs will need to grow the area of data gathering and data management. We know that AECs deliver extremely high quality care at the lowest possible cost. We need to work very hard to make sure that fact is widely known and appreciated." — Barry Tanner, Physicians Endoscopy CEO Q:  What core concepts in healthcare reform should gastroenterologists/ endoscopists grasp for success down the road?  What are the biggest opportunities for success? BT: For gastroenterologists, the greatest opportunities I believe lie in quality, service and cost. Overall, GI service line management, meaning tight management across the entire healthcare delivery spectrum, is going to be key. Patient experience is going to play a bigger role, again due to the healthcare shopping effect and once again transparency will be key. Consumers will be much more knowledgeable about healthcare in the future and we need to change to meet that need. Q: What areas of growth do you feel will be important for all ASC/AECs in order to survive into the future? Barry Tanner BT: I believe that AECs and the physicians who own or participate in them need to focus on fully integrating the AEC into the local delivery system. Being an island and working in the same fashion isn't going to be successful. Look to have professional management both for your practice and your AEC. All ASCs will need to grow in the area of data gathering and data management. We know that AECs deliver extremely high quality care at the lowest possible cost. We need to work very hard to make sure that this fact is widely known and appreciated. Find ways to work with the payers on cost reductions in exchange for better patient management. These are key focus areas for growth. n

• Cover