Becker's ASC Review

47 Key Specialties Barry Tanner "GI physicians are going to have to consolidate if they desire to remain in- dependent," says Barry Tanner, CEO of Physicians Endoscopy. "The sus- tainability of smaller independent GI practices is, in my opinion, being threatened. I encourage and support the banding together of GI practices on a regional basis in an effort to reduce overhead, increase access to vital business leadership resources and to increase access to information technology that will enable the collection and monitoring of quality data and metrics that will ultimately drive the sustainability of independent practice." Maintaining an independent practice requires recruitment, as many current GI practices rely on physicians close to retirement. Other challenges facing GI practices include: 1. Declining reimbursement 2. Data reporting 3. Increased cost for staff and health insurance 4. Health information technology purchase 5. Medicare lowering colonoscopy reimbursement "[Medicare's lowered rates] are another sad blow to gastroenterologists ev- erywhere," says Mr. Tanner. "e worst possible potential outcome from this is that many gastroenterologists may have to limit the number of Medicare patients that their practice can see and still remain economically viable. e more time GI physicians spend 'working for free,' the greater the risk of actu- ally remaining in independent practice." Endoscopy centers are vital to providing high quality, low cost GI care. Independent physicians have few other options than to reassess their practice and time management in a "thoughtful and yet compassionate way," says Mr. Tanner, to keep the practice running. But consolidation is rampant in healthcare and as the ranks of independent physicians decline it will be a challenge for physicians to work with payers and hospitals to deliver care in the right setting. One of the solutions is bun- dling episodes of care. "Although the bundling of episodic care seems inevitable, I also see it as a slippery slope simply because it has the inherent risk of altering a care plan to fit a pricing model as opposed to designing the right care plan for a particular patient's needs," says Mr. Tanner. "e underlying purpose of bundled pay- ments is to drive waste out of healthcare by encouraging providers to select the best care plan at the best cost." Colonoscopies could fit in the bundled system because they show benefit — the death rate from colorectal cancer has diminished over the past few years as testing accelerated — and the cost components are easily definable. Each component's cost is predictable. However, the expenses associated with colonoscopy are low, so payers aren't driven to develop colonoscopy bundles. "I believe that bundling for colonoscopies will gain prominence but it seems that the focus for the time being is likely to remain on higher acuity, more expensive care," says Mr. Tanner. Despite reimbursement changes and payment issues, Mr. Tanner still sees colonoscopy education and promotion as the biggest opportunity for GI/ endoscopy centers in the future. e Physicians Endoscopy centers cur- rently promote the benefits of colonoscopy screening, performed by board- certified GI physicians in the patient-friendly, accessible, low-cost, high quality endoscopy center setting. And that setting will differentiate centers from the hospital. "While there is always op- portunity to improve qual- ity, much of the improvement isn't clinical in nature but anchored more in improving the patient experience," says Mr. Tanner. "ird-party pay- ers are increasingly designing health plans to encourage pa- tients to access GI care in the freestanding ASC by structur- ing patient co-pays and de- ductibles in such a way that patients are incentivized to seek out ambulatory care out- side of the hospital outpatient setting." Many GI physicians and centers are operating at or near capacity because the patient population for colonoscopy is expanding, and physicians are focused on continuing to provide quality care that will drive future volume. ere could be outside initiatives directing patients toward high quality centers in the future as well. "As health plans continue to educate and steer customers, quality and pric- ing transparency will continue to play an increasingly important role in the growth and success of GI/endoscopy centers," says Mr. Tanner. "Endoscopy centers are and will continue to be a key part of the solution to providing high quality GI care in a lower cost setting. As a result, the future for GI-focused ASCs looks very bright to me." n Independent Practice, Bundled Payments & Medicare Reimbursement— Key Thoughts on GI Centers in 2016 (continued from cover) Call: 888.416.2409 info@eSutures.com eSutures.com We Stock It, So You Don't Have To! eSutures.com knows that efficient inventory management is the key to your facility's success. From sutures to endomechanicals, to implants and instruments, we have over 1 million items in stock and ready to fulfill your just-in-time ordering needs! • All orders placed by 3pm CST ship same day; expedited shipping is available. • Low prices everyday - no contracts and no minimum order requirements. • Brand name products sold by the box or individual unit. Use promo code: ASC10 for 10% OFF your order of $50 or more!* *Offer expires 6/30/16. Limit 1 per customer.

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