Colonoscopy in the Office Setting is Safe, and Financially Sound … For Now

Abstract

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.

Colorectal cancer and its delayed diagnosis: have we improved in the past 25 years?

“…Since early diagnosis programs have so far failed to significantly increase the number of patients identified in early disease stages (58)(59)(60)(61)(62)(63)(64)(65)(66), it seems that screening campaigns hold greatest promise. In our opinion, the method of choice for such campaigns is colonoscopy (67,68) because of its high sensitivity (close to 100%), the possibility of removing polyps avoiding their malignant degeneration, its safety, including a minimum acceptable number of complications (42,69), and a high degree of reported patient satisfaction (70).…”

Managed Care and the Diffusion of Endoscopy in Fee‐for‐Service Medicare

“…Medicare reimbursement rates, which are cost‐based, were (in 2007 dollars) $650 for colonoscopy and $350 for sigmoidoscopy (AHRQ, ). Private insurers pay more, and there are significant profit margins on endoscopy services, especially in outpatient settings (Luchtefeld and Kim ); thus, physician groups have formed to offer these services in competition with hospital outpatient departments (Berenson, Bodenheimer, and Pham ). Sigmoidoscopy was the incumbent endoscopy procedure, whereby the provider inserts a thin, lighted tube into the rectum to examine the lower third of the colon while the more recent colonoscopy procedure involves a longer, flexible tube to examine the entire colon.…”

Operating Room Versus Office‐Based Injection Laryngoplasty: A Comparative Analysis of Reimbursement

“…This move has been led by plastic surgeons who offer cosmetic procedures to cash‐paying patients 7 . Other cases that are moving from operating room to office‐based settings include orthopedic 8 gastroenterologic, 9 otologic, 10 and surgical oncology 11 procedures, just to name a few. Advances in imaging technology as well as surgical and anesthetic techniques have aided this trend.…”