Truven Health Analytics Study Shows Use of Anesthesia for Colonoscopies Increasing, Driving Higher Costs for Insurers and Patients

The use of anesthesia in uncomplicated colonoscopies is on the rise, driving up the cost of the procedure nationwide.

According to a new study from Truven Health Analytics, the presence of anesthesia for a colonoscopy increases the price of the procedure by as much as $500 per patient.

According to a release, the report, Can New Payment Models Address Rising Costs? The Case of Colonoscopies, examined insurance claims data for the commercially insured population. It found that the number of colonoscopy procedures with an anesthesiologist involved has tripled. In the first quarter of 2010, just 21 percent of colonoscopies conducted in a physician's office included anesthesiology services, increasing to 60 percent by the second quarter of 2012.

That increased use is also driving a hike in cost: the mean price of a colonoscopy without anesthesia that was conducted in a physician's office is about $1,040, compared to $1,515 with the presence of an anesthesiologist. The average price of a hospital- based outpatient colonoscopy without anesthesia is $1,808. That jumps to $2,200 with anesthesia. The report cites patient demand for higher levels of service as a contributor to this increase, but also lays responsibility at the feet of the current fee-for-service healthcare payment system which offers financial incentives for providers to increase the number of services associated with colonoscopies.

The study also broke down the variation in anesthesia use in different geographic regions. It found the rate of anesthesiologist participation widely differs by region. The rate of anesthesia use in the Middle Atlantic region of the US has stayed level around 60 percent from 2010-2012. The West South Central region increased from 35 percent in the first quarter of 2010 to 65 percent in the third quarter of 2012. The Pacific region, consistently the region that uses anesthesia least frequently, increased from 11 percent to 24 percent.

"The first step in addressing this sort of service inflation is to recognize it," said Bob Kelley, lead author of the study and senior vice president of analytics at Truven Health Analytics. "While patients have come to expect deep sedation for a colonoscopy, they don't anticipate the associated costs. For a consumer to fully understand their out-of-pocket costs, they need a clear picture of all of the variables, including anesthesia, site of service, and what their plan covers."

The Truven Health MarketScan Research Databases, which contain de- identified healthcare claims data reflecting the real-world medical care of over 170 million unique patients across the U.S. since 1995, and the Truven Health Outpatient Event Grouper were used to conduct this analysis.

Truven Health Analytics is a company focused on information and analytic tools.

More Information:

www.truvenhealth.com

((Comments on this story may be sent to [email protected]))