The payer trend affecting gastroenterology care

Prior authorizations are one of the biggest roadblocks for gastroenterologists to secure reimbursements. 

Eugenio Hernandez, MD, senior vice president of clinical affairs for Miami-based Gastro Health, joined Becker's to discuss how prior authorizations affect colonoscopy reimbursements. 

Question: What payer trend is affecting ASCs the most right now? 

Dr. Eugenio Hernandez: The most challenging payer trends affecting ASCs right now are the policies that require prior authorization or advanced notification for colonoscopies and other relatively routine endoscopic procedures. While these policies place an additional administrative burden on ASCs, the bigger issue is that they could potentially harm patients because of limited, delayed, or denied care.

Q: How will a potential economic downturn affect ASCs in 2024?

EH: Most economists do not believe there will be a significant economic downturn in 2024. We share that viewpoint and do not think ambulatory growth will be substantially impacted this year. If anything, a potential economic downturn may soften the labor market and could drive more people back into the workforce.

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