Colorectal cancer rates are rising, especially among younger adults, creating new demand and financial pressures for ASCs.
Here are five things to know:
1. Early-onset CRC is fueling procedure growth. CRC cases are increasing sharply in adults under 50. Diagnoses among 45- to 49-year-olds climbed by double-digit annual rates after the U.S. Preventive Services Task Force lowered the screening age to 45.
ASCs are on the front lines of managing the surge in screening demand.
2. Guideline changes expand the patient pool. The change in screening age from 50 to 45 led to a 62% rise in screenings and a 43% jump in colonoscopy between 2019 and 2023.
Furthermore, gastrointestinal procedures, including colonoscopies and CRC screenings, now account for 28.3% of all Medicare ASC volume.
3. Reimbursement pressures persist. Despite rising demand, colonoscopy reimbursements have not kept pace.
From 2007 to 2022, average GI reimbursement fell 7% unadjusted and 33% with inflation. Colonoscopy and biopsy reimbursements dropped 38% in that span.
Even with rising case volumes, reimbursement cuts continue to pressure GI margins.
“Decreased reimbursements put a squeeze on the money needed to cover staff and resources to deliver high-quality care,” Benjamin Levy III, MD, gastroenterologist at University of Chicago Medicine told Becker’s.
4. Workforce and capacity remain tight. ASCs are expanding anesthesia coverage and recovery space, but staffing shortages are creating bottlenecks.
“The number one obstacle we’re facing in GI is physician workforce. There is a growing demand. There’s this increasing demand for our services, and there’s a limited number of gastroenterologists,” James Weber, MD, founder and CEO of GI Alliance told Becker’s.
5. Screening uptake still lags. Even with expanded guidelines, nearly 40% of adults over 45 have not had a colonoscopy. Disparities remain across race, insurance status and geography.
Many cite fear, lack of awareness or cost as barriers, and 79% of Americans do not know the recommended screening age.
