GI growth opportunities to boom by 2030

Several gastroenterology leaders joined Becker's to discuss the biggest opportunities for ASC growth in the next five years.  

Here are three key growth areas they identified:

Colon cancer screening options 

Neal Kaushal, MD, a gastroenterologist from Sonora, Calif., highlighted colon cancer screening as the most promising growth area for ASCs. This is largely driven by revised guidelines recommending screenings begin at age 45, as well as the lingering backlog of elective endoscopy cases from the COVID-19 pandemic.

"The demand for endoscopic services nationwide has reached an all-time high," he said. "Furthermore, cost pressures are increasingly – and almost exclusively – pushing elective screening procedures to the outpatient ASC setting."

The migration presents a "significant opportunity – both clinical and commercial – for GI groups and institutions to capitalize on providing quality patient care in a manner that is both cost efficient and profitable," he explained. 

Benjamin Levy III, MD, from University of Chicago Medicine, echoed these sentiments. He noted that the growing demand for colorectal cancer screenings has created a pressing need for gastroenterologists and ASCs to scale up their procedural capacity.

"Over the next 5 years, ASCs will have the opportunity to ramp up throughput goals and to increase productivity," he said. "Many ASCs are positioning themselves to insurance companies as a cost-effective alternative to hospital-based colonoscopies. ASC colonoscopy volumes will likely continue to rise to accommodate the growing patient volume."

Additionally, advancements in non-invasive screening methods such as Cologuard, FIT, and Shield are expected to boost follow-up colonoscopy procedures, further driving growth for ASCs.

Expanding service lines 

Sumana Moole, MD, gastroenterologist at Suwanee, Ga.-based Merus Gastroenterology & Gut Health, told Becker's that a big growth opportunity for ASCs is "expanding the range of services they offer and adopting advanced techniques traditionally reserved for hospital settings."

Dr. Moole cited procedures such as endoscopic ultrasound and endoscopic submucosal dissection for gastrointestinal neoplasms that could be "transformative" if offered in an ASC setting. 

ASCs are already known for delivering better outcomes, shorter patient stays and lower costs compared to hospitals, he said. Integrating new technologies and leveraging AI could significantly broaden their capabilities, attracting more patients and payers alike.

Site-neutral payments 

Sap Sinha, COO of West Long Branch, N.J.-based Allied Digestive Health, identified site-neutral payment reform as a potential game changer for ASCs.

"If there is site service neutralization in payments from CMS, i.e., facility payments are same irrespective of hospitals and ASCs, there will be no incentive for certain cases that are still being done in the hospital and will lead to moving more cases to ASCs," he told Becker's. 

Currently, Medicare reimbursement rates for ASCs average just 50% of what hospital outpatient departments  receive for identical services, according to the Ambulatory Surgery Center Association. Legislative efforts to implement site-neutral policies, supported by several policymakers, could lead to a significant shift in case volumes from hospitals to ASCs, helping curb overall healthcare costs.

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