By Carrie Pallardy
Full article at Becker’s GI & Endoscopy
Question: Do you think independent GI practices have a sustainable future?
Scott Ketover, MD, President, Digestive Health Physicians Association, President, CEO, Minnesota Gastroenterology (Plymouth): Absolutely. The continued viability of independent GI practices is not only critical for millions of patients who count on physicians in these practices to diagnose and treat virtually all types of digestive conditions such as acid reflux disease, Crohn’s, ulcerative colitis, swallowing disorders and hepatitis, as well as colon cancer and liver disease, but also for our healthcare system as a whole. I say this not only as a gastroenterologist treating patients in my own GI practice in the Twin Cities, but also as the President of DHPA whose nearly 1,000 physicians care for 1.5 million patients each year in independent GI practices across the country. DHPA’s core mission is to educate policymakers and to work collaboratively with our fellow gastroenterologists across medical settings to ensure that the high-quality, cost-effective and integrated GI care furnished in independent practices remains a viable option for patients.
Make no mistake, high-quality GI care is delivered in many settings: hospitals, academic medical centers and physician practices. Even so, independent practices provide critical access to specialized and cost-effective GI care. As a specialty, if we have a chance of eliminating colorectal cancer as a major public health problem — and DHPA has taken the National Colorectal Cancer Roundtable’s pledge of reaching 80 percent screened for colorectal cancer by 2018 — then we must protect patient access to colorectal screening in their communities. We know colonoscopies save lives. That means we must be sure that millions of patients across the country continue to have the option of turning to independent GI practices for their cancer screening.
Independent GI practices also offer something unique in many communities — they bring together physicians of different specialties in a team approach to delivering integrated care. For one example, DHPA member practices (like many other independent GI practices) include pathologists who are trained in gastrointestinal pathology, devote their practice to diagnostic evaluation of gastrointestinal tissue, and benefit from easy access to the gastroenterologists in their practice whether through a shared electronic medical record or personal communication. Ultimately, it is the patient who benefits when physicians of different specialties are true teammates in a single medical practice.
On the cost side, there is a growing recognition on the part of the medical community and policymakers that care furnished in independent medical practices must be protected. That is why more than two dozen national medical societies, including DHPA, recently joined in a letter opposing proposed federal legislation that would eliminate the in-office ancillary services exemption to the federal Stark law. Not only would the legislation remove specialized cost-effective pathology services from GI practices, it would shift millions of patients into the higher-cost hospital setting.
In fact, a recent Health Affairs report found that hospital ownership of physician practices is often associated with higher prices and spending. Eliminating the integrated model of care furnished in physician practices would negatively impact healthcare spending and increase total cost of care. And just last month, in testimony before Congress, the Medicare Payment Advisory Commission acknowledged that payment rates in physician offices and ASCs tend to be lower than in hospitals and that one of the consequences of hospital acquisition of physician practices is shifting patients into a more expensive setting.
So, do I think that independent GI practices have a sustainable future? Absolutely. I know that the 1.5 million patients who count on the outstanding, convenient and cost-effective care delivered each year by gastroenterologists in DHPA’s member practices are counting on it. And the sustainability of our healthcare system depends on it, too.