Conclusions
Changes to Medicare professional and facility fee payments for endoscopic procedures significantly affect academic and private gastroenterology practices. Dwindling professional fees – alongside increasing HOPD facility fees – make academic gastroenterology practices increasingly reliant on support from their parent health care systems. Like academic practices, private gastroenterology practices experience financial losses when treating Medicare beneficiaries. Academic and private gastroenterology practices should consider several potential responses. Although beyond the scope of this article, all practices must continuously strive to improve the quality and reduce the costs of the endoscopic procedures they perform.
Acknowledgments
The authors thank Leslie Narramore, MPA, for her insights and help with reimbursement data. They also thank Bryan Rhodes for providing financial data and Shivan Mehta, MD, MBA, for his feedback on the Relative Value Scale Update Committee process.
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Dr. Dorn is vice chief, division of gastroenterology and hepatology, associate professor of medicine, health policy & management, University of North Carolina at Chapel Hill; he has received honoraria for consulting and presentations on health reform from AbbVie and Olympus. Dr. Vesy is a gastroenterologist affiliated with Baylor University Medical Center, Dallas.
