One ASC's experience bundling payments for colonoscopy reaps success: 6 takeaways

Charles Accurso, MD, medical director of the Digestive HealthCare Center and Central Jersey Ambulatory Surgery Center in Hillsborough, N.J., recently discussed his facility's experience with bundling payments for colonoscopies, according to an AIS Health report.

Dr. Accurso spoke at the recent National Value-Based Payment and Pay for Performance Summit in San Francisco. Digestive HealthCare Center has signed two bundled payment contracts for colonoscopy, including a contract with Horizon Blue Cross Blue Shield of New Jersey.

Here are six takeaways from Dr. Accurso:

1. Colonoscopies are relative easy to bundle because it is a very common procedure, the time frame for the procedure is easy to define and it's both diagnostic and therapeutic.

2. The Horizon agreement is a retrospective episode of care contract, whereas the other contract with a regional third-party administrator is prospective. Both feature evidence-based quality measures, including adenoma detection rate, cecal intubation rate and patient satisfaction.
3. The contracts achieved savings by providing the service at an ASC, which is more cost-efficient than inpatient or outpatient hospital settings. The center also standardized care to decrease variation across all contracts.

4. The first three years of the Horizon colonoscopy program has yielded a 97 percent patient satisfaction rate. Additionally, Digestive HealthCare Center has achieved shared savings every quarter since then.

5. According to Dr. Accurso, a retrospective model with fee-for-service and shared savings is easier to implement than the prospective model, unless the GI practice controls all the services.

6. Additionally, there are opportunities for bundling payments for other GI conditions, including chronic liver disease and gastroesophageal reflux disease.

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