How the payer tug of war is changing the GI workforce

Gastroenterologists continue to play tug of war with payers over reimbursement rates.

Here's how three gastroenterologists see this struggle affecting gastroenterology's workforce.

Note: These responses have been lightly edited for length and clarity.

Robert Pecha, MD. President of Gastroenterology Medical Clinic (Folsom, Calif.): Our biggest challenge for both the endoscopy center as well as our practice (separate companies) is our inability to communicate with insurance companies to negotiate rates. We are too small for them (e.g., Blue Cross) to talk to us. What they don't seem to realize is that small raises to independent practitioners prevents those physicians from defecting to large hospital-based practices that charge all insurers much more.

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Pooja Singhal, MD. Gastroenterologist at SSM Health (St. Louis): In my opinion, the decision to potentially leave the field of gastroenterology that one has spent an average of 14 years of investment to train and practice is based on multiple factors. Higher demands of productivity, constant annual cuts by insurance companies for procedure reimbursements and lack of autonomy ultimately lead to a lack of job satisfaction at the price of personal life sacrifices.

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Pankaj Vashi, MD. Department Head of Gastroenterology and Nutrition at City of Hope Chicago (Zion, Ill.): My major concern regarding procedure reimbursement is continued increase in costs of doing procedures and denials from payers with decreasing payments especially by government payers. The only way ASCs can survive is by increasing efficiency and volume and maintaining quality care.

Read the full story here.

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