AGA Leaders Respond to New York Times Colonoscopy Article

BETHESDA, Md., June 3 -- The American Gastroenterological Association issued the following news release:

Last weekend the New York Times kicked off a series on high-cost fragmented care, initially focusing on colonoscopy. The extended piece (http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?hp&_r=0) highlighted variations in costs, fees paid by public and private insurers, patient cost sharing, how use of an anesthesiologist affects costs and profiles patients whose gastroenterologists conduct the colonoscopy at seemingly inappropriate surveillance intervals.

AGA leadership read it with deep interest and responded immediately. We have deep reservations about the cost methodology employed in the article, and its failure to acknowledge the cost-effectiveness of screening colonoscopy and the dramatic reduction in colorectal cancer incidence that has emerged in recent years.

Given the complexity of the Affordable Care Act, a key question is how to ensure that this life-saving test is delivered to the right patients in a cost-efficient, high-quality manner. We cannot emphasize enough that screening colonoscopy is critical to our field's ability to advance patient care. Through our Roadmap to the Future of GI Practice (http://www.gastro.org/practice/roadmap-to-the-future-of-gi), AGA is developing tools to help your practice, thereby ensuring the fundamental vibrancy of what you do, no matter whether you are in community private practice, academic practice or in another type of setting in the U.S.

* Bundled payment model: We are developing a model to help you negotiate with payors a fixed price for the care before, during and after a colonoscopy. With bundled payments, providers share risk and have financial incentives to be prudent. Read more (http://www.gastro.org/journals-publications/gi-quarterly-practice/aga_quarterly_practice_april_5_20130.

* Quality Tools: The AGA Registry (http://www.gastro.org/practice/digestive-health-outcomes-registry) and the AGA Digestive Health Recognition Program (https://agarecognition.org/default.aspx) help you report on quality measures and achieve payor and CMS Physician Quality Reporting System standards and incentives.

* Choosing Wisely: We have been at the forefront of promoting through the high-profile Choosing Wisely campaign the need to provide colonoscopy at intervals based on guidelines. Read more (http://www.gastro.org/practice/quality-initiatives/choosing-wisely).

We have also worked with our sister GI societies on many relevant issues, including the development of guidelines for colorectal cancer screening (http://www.gastrojournal.org/article/S0016-5085%2808%2900232-1/fulltext) and a statement on sedation practices (file:///C:/Users/jduncan/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/8KWJFR7R/The%20routine%20assistance%20of%20an%20anesthesiologist/anesthetist%20for%20average%20risk%20patients%20undergoing%20standard%20upper%20and%20lower%20endoscopic%20procedures%20is%20not%20warranted).

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