Colonoscopy in the office setting is safe, and financially sound ... For now - Commentary

Margolin, D.A. (2006) Colonoscopy in the office setting is safe, and financially sound ... For now - Commentary. Diseases of the Colon & Rectum, 49 3: 381-382. doi:10.1007/s10350-005-0246-y


Author Margolin, D.A.
Title Colonoscopy in the office setting is safe, and financially sound ... For now - Commentary
Journal name Diseases of the Colon & Rectum   Check publisher's open access policy
ISSN 0012-3706
Publication date 2006-03
Sub-type Discussion - responses, round table/panel discussions, Q&A, reply
DOI 10.1007/s10350-005-0246-y
Volume 49
Issue 3
Start page 381
End page 382
Total pages 2
Place of publication United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
PURPOSE:
In 2000, the Centers for Medicare & Medicaid Services announced a plan to allow for enhanced reimbursement for office endoscopy. This change in reimbursement was phased in during three years. The purpose of this study was to evaluate the fiscal outcomes and quality measures in the first two and a one-half years of performing endoscopy in an office setting under the new Centers for Medicare & Medicaid Services guidelines.

METHODS:
The following financial parameters were gathered: number of endoscopies, expenses (divided into salaries and operational), net revenue, and margin for endoscopies performed in the office compared with the hospital. All endoscopies were performed by endoscopists with advanced training (gastroenterology fellowship or colon and rectal surgery residency). Monitoring equipment included continuous SaO2 and automated blood pressure in all patients and continuous electrocardiographic monitors in selected patients. Quality/safety data have been tracked in a prospective manner and include number of transfers to the hospital, perforations, bleeding requiring transfusion or hospitalization, and cardiorespiratory arrest.

RESULTS:
The financial outcomes are as follows: 13,285 endoscopies performed from the opening of the unit through December 2003; net revenue per case $504 per case; expense per case has dropped from $205 per case to $145 per case; the overall financial benefit of performing endoscopy in the office compared with the hospital was an additional $28 to $143 per case depending on the insurance carrier. The quality outcomes since inception of the unit include the following: 13,285 endoscopies; 0 hospital transfers, 0 cardiorespiratory arrests; 0 perforations; and 1 bleeding episode that required hospitalization.

CONCLUSIONS:
Endoscopy performed in the office setting is safe when done with appropriate monitoring and in the proper patient population. At the time of this study, office endoscopy also is financially rewarding but changes in Centers for Medicare & Medicaid Services reimbursement threaten the ability to retain any financial benefit.
Keyword Colonoscopy
Finance
Office
Safety
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Original article: Colonoscopy in the Office Setting is Safe, and Financially Sound . . . For Now Martin A. Luchtefeld, M.D., Donald G. Kim, M.D. Michigan Medical PC-Ferguson Clinic, Grand Rapids, Michigan Diseases of the Colon and Rectum Volume 49, Issue 3, March 2006, Pages 377-382

Document type: Journal Article
Sub-type: Discussion - responses, round table/panel discussions, Q&A, reply
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