In 2021, the U.S. Preventive Task Force lowered the recommended age for colonoscopy procedures from 45 to 50, creating a tidal wave of new patients across the industry.
Now, U.S. gastroenterologists and practices have millions of additional patients seeking colonoscopies that were not doing so five years ago.
This shift has been advantageous for many ASCs, as the demand for these procedures has continued to rise, especially in the outpatient setting.
"The U.S. Preventive Services Task Force recently changed the colonoscopy guidelines to begin screening at age 45 due to an increased incidence of colorectal cancer being diagnosed at age 49. The thought was to perform screening colonoscopies on patients at age 45 in order to remove polyps before they have a chance to grow into cancer," Benjamin Levy III, MD, a gastroenterologist at University of Chicago Medicine, told Becker's. "Also, colorectal cancer is more easily treated when caught at earlier stages. The market for outpatient colonoscopy procedures at ASCs and in hospitals has skyrocketed because all of a sudden, there are 19 million additional Americans between the ages of 45-49 who need screening colonoscopies. ASCs and gastroenterologists should work to increase colorectal cancer screening rates in local communities to help prevent cancer."
While the "business boom" of an increased number of colonoscopy patients may be advantageous for ASCs, it could also exacerbate some struggles.
The U.S. is expected to see a shortage of 1,630 gastroenterologists in the next year, making it more difficult for patients to get in for these procedures. While new alternatives to in-office colonoscopies, like GI cancer blood tests, are being developed, the American Gastroenterological Association has warned that these tests are not yet ready to fully substitute a colonoscopy.
Additionally, the cost of a colonoscopy to patients and reimbursement rates for physicians have not increased enough to battle rising inflation and the rising cost of doing business.
A diagnostic colonoscopy at an ASC cost patients just $60 more in 2022 than in 2018. In addition, adjusted average reimbursement for GI procedures dropped by 7% and 33%, respectively, from 2007 to 2022, and reimbursements for colonoscopy and biopsy decreased by 38% during that period.
While an increased interest in colonoscopies at ASCs could, initially, be good for the facilities' bottom lines, physicians may continue to struggle with declining pay rates for these procedures and not having enough bandwidth to care for a rising number of patients, leading to more stress and burnout.