Matthew B McNeill1, Shannon Chang2, Farhad Sahebjam2, Adam J Goodman2, Seth A Gross2, Samuel H Sigal2. 1. Department of Medicine, New York University School of Medicine, 550 First Avenue, 15-1539, New York, NY, 10016, USA. matthew.mcneill@nyumc.org. 2. Division of Gastroenterology, New York University School of Medicine, New York, NY, USA.
Abstract
GOAL: The purpose of this study was to assess the effect of decreased colonoscopy reimbursement on gastroenterologist practice behavior, including time to retirement and procedure volume. BACKGROUND: In 2015, the Centers for Medicare and Medicaid Services proposed reductions in colonoscopy reimbursements. With new initiatives for increased colorectal cancer screening, it is crucial to understand how reimbursement changes could affect these efforts. STUDY: Randomly selected respondents from the American College of Gastroenterology membership database were surveyed on incremental changes in practice behavior if colonoscopy reimbursement were to decrease by 10, 20, 30, or 40 %. Data were analyzed using both Pearson's Chi-square and analysis of variance. RESULTS: Two thousand and nine gastroenterologists received the survey with a 16.3 % response rate. Procedure volume significantly decreased with degree of reimbursement reductions (p < 0.001). With a 10 % decrease, 72 % of respondents reported no change in the number of colonoscopies performed. With a 20 % decrease, 39 % would decrease their procedure volume, while 21 % of respondents would increase their procedure volume. With a 30 and 40 % decrease, procedure volume decreased by 48 and 50 %, respectively. In terms of retirement, current plans predict a cumulative retirement rate of 29.4 % at 10 years. More than 42 % of respondents plan to retire after 2030. In the 2014-2023 retirement subgroup (N = 74 responses), there was a significant hastening of retirement year at 20 % (p = 0.016), 30 % (p < 0.001), and 40 % (p < 0.001) reimbursement reductions as compared to baseline responses. CONCLUSION: Decreasing colonoscopy reimbursements may have a significant effect on the effective gastroenterology work force.
GOAL: The purpose of this study was to assess the effect of decreased colonoscopy reimbursement on gastroenterologist practice behavior, including time to retirement and procedure volume. BACKGROUND: In 2015, the Centers for Medicare and Medicaid Services proposed reductions in colonoscopy reimbursements. With new initiatives for increased colorectal cancer screening, it is crucial to understand how reimbursement changes could affect these efforts. STUDY: Randomly selected respondents from the American College of Gastroenterology membership database were surveyed on incremental changes in practice behavior if colonoscopy reimbursement were to decrease by 10, 20, 30, or 40 %. Data were analyzed using both Pearson's Chi-square and analysis of variance. RESULTS: Two thousand and nine gastroenterologists received the survey with a 16.3 % response rate. Procedure volume significantly decreased with degree of reimbursement reductions (p < 0.001). With a 10 % decrease, 72 % of respondents reported no change in the number of colonoscopies performed. With a 20 % decrease, 39 % would decrease their procedure volume, while 21 % of respondents would increase their procedure volume. With a 30 and 40 % decrease, procedure volume decreased by 48 and 50 %, respectively. In terms of retirement, current plans predict a cumulative retirement rate of 29.4 % at 10 years. More than 42 % of respondents plan to retire after 2030. In the 2014-2023 retirement subgroup (N = 74 responses), there was a significant hastening of retirement year at 20 % (p = 0.016), 30 % (p < 0.001), and 40 % (p < 0.001) reimbursement reductions as compared to baseline responses. CONCLUSION: Decreasing colonoscopy reimbursements may have a significant effect on the effective gastroenterology work force.
Entities:
Keywords:
Colonoscopy; Colorectal neoplasm; Early detection of cancer; Endoscopy; Health insurance reimbursement; Medicare
Authors: Tait D Shanafelt; Omar Hasan; Lotte N Dyrbye; Christine Sinsky; Daniel Satele; Jeff Sloan; Colin P West Journal: Mayo Clin Proc Date: 2015-12 Impact factor: 7.616
Authors: Brenda K Edwards; Elizabeth Ward; Betsy A Kohler; Christie Eheman; Ann G Zauber; Robert N Anderson; Ahmedin Jemal; Maria J Schymura; Iris Lansdorp-Vogelaar; Laura C Seeff; Marjolein van Ballegooijen; S Luuk Goede; Lynn A G Ries Journal: Cancer Date: 2010-02-01 Impact factor: 6.860
Authors: D C Rockey; E Paulson; D Niedzwiecki; W Davis; H B Bosworth; L Sanders; J Yee; J Henderson; P Hatten; S Burdick; A Sanyal; D T Rubin; M Sterling; G Akerkar; M S Bhutani; K Binmoeller; J Garvie; E J Bini; K McQuaid; W L Foster; W M Thompson; A Dachman; R Halvorsen Journal: Lancet Date: 2005 Jan 22-28 Impact factor: 79.321
Authors: William A Primack; Kevin E Meyers; Suzanne J Kirkwood; Holly S Ruch-Ross; Carrie L Radabaugh; Larry A Greenbaum Journal: Am J Kidney Dis Date: 2015-04-22 Impact factor: 8.860
Authors: David H Kim; Perry J Pickhardt; Andrew J Taylor; Winifred K Leung; Thomas C Winter; J Louis Hinshaw; Deepak V Gopal; Mark Reichelderfer; Richard H Hsu; Patrick R Pfau Journal: N Engl J Med Date: 2007-10-04 Impact factor: 91.245
Authors: Teppo J Heikkilä; Harri Hyppölä; Jukka Vänskä; Tiina Aine; Hannu Halila; Santero Kujala; Irma Virjo; Markku Sumanen; Kari Mattila Journal: BMC Med Educ Date: 2015-10-05 Impact factor: 2.463
Authors: Evan L Reynolds; Kevin A Kerber; Chloe Hill; Lindsey B De Lott; Brandon Magliocco; Gregory J Esper; Brian C Callaghan Journal: Neurology Date: 2020-07-17 Impact factor: 11.800