to grow revenue might not be as viable as before. “ASCs are often advised to bring more providers in, work longer days and add more rooms to their cen- ters. While these are good ideas, there needs to be a thorough understanding of the expense impact of each of these and how they impact the existing center workflow and provider quality of life. “If ASCs are seeing their revenue flattening, they should be thinking about creative ways to improve reve- nue,” he says. “If they do not, centers are likely to experience net income decline as cost increases outpace rev- enue growth.”

Explore New Revenue Sources in GI

Consider new procedures, ancillary services and payment models BY ROBERT KURTZ


iven the market trajectory, it might be time for GI ASCs to explore

additional revenue sources. If ASCs that rely solely or heavily

on gastroenterology (GI) are finding themselves under financial stress, they would be wise to undertake efforts that can help counter what is likely a mount- ing issue, says gastroenterologist James Weber, MD, president and chief execu- tive officer of Texas Digestive Disease Consultants in Southlake, Texas. “We view this as a great time to

explore new revenue opportunities,” Weber says, “especially since we are witnessing increasing pressures on reimbursement for our traditional pro- fessional services.”


The dependence GI ASCs place on performing endoscopic procedures to drive revenue also is under pres- sure, says gastroenterologist Charles Accurso, MD, founder and medical director of the Central Jersey Ambu- latory Surgery Center in Hillsborough Township, New Jersey. “We are start- ing to see market innovations and dis- ruptors, such as Cologuard, that could potentially decrease the number of procedures gastroenterologists per- form in ASCs. This is a perfect time to look for new revenue streams that can help keep GI ASCs financially viable.” David Young, president of Physi- cians Endoscopy in Jamison, Pennsyl- vania, says traditional ways for ASCs

Opportunities Aplenty One of the first ways ASCs should look at to grow revenue, Weber says, is add- ing new GI procedures. “We are explor- ing bringing in procedures that have been more traditionally performed in the hospital that we can safely perform in the ASC. Hemorrhoidal banding, for example, is a procedure that should be part of a gastroenterologist’s skill set— it is a great service to the patient with a great return for the ASC. Other exam- ples include esophageal banding, per- cutaneous endoscopic gastrostomy (PEG) placements, endoscopic ultra- sound (EUS) and endoscopic retrograde cholangiopancreatography (ECRP).” Bringing ancillary services your ASC currently outsources under internal control can give your bottom line a nice boost, Weber says. “Consider pathol- ogy services. You can send all biopsy specimens to an anatomic pathology lab controlled by the GI group, perform the technical and professional components and bill globally.” If going down this route, ensure good quality people are preparing slides and hire a pathologist to read the slides, he advises. Furthermore, spend time on the back end carefully negotiating the contracts as insurance companies are aggressively trying to cut these rates. “We have found suc- cess with keeping our pathology rates

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