Skip to main content
Top
Published in: Digestive Diseases and Sciences 3/2015

01-03-2015 | Review

Colorectal Cancer Screening Quality, Cost and Practice in an Era of Healthcare Transformation

Author: Martin Brotman

Published in: Digestive Diseases and Sciences | Issue 3/2015

Login to get access

Abstract

Colonoscopy for colorectal cancer screening is the largest single source of income for gastroenterologists in the USA. Despite its proven value in preventing colon cancer, it is being scrutinized by payers and regulators as a high-volume procedure with variable quality, cost and documentation. In a rapidly evolving era of reimbursement for added value (high quality, affordable cost) rather than for individual transactions/volume, gastroenterologists are under pressure to change our practices to respond to the demands of the marketplace. Excellent guidance is available through our professional societies.
Literature
2.
go back to reference Skidmore M. Social Security and Its Enemies. Boulder: Westview Press; 1999. Skidmore M. Social Security and Its Enemies. Boulder: Westview Press; 1999.
3.
go back to reference Brotman M. The new era of health care delivery: can gastroenterologists survive and thrive? GI & Hepatology News. 2013:19. Brotman M. The new era of health care delivery: can gastroenterologists survive and thrive? GI & Hepatology News. 2013:19.
4.
go back to reference Hudes BK. Larger practice groups cost more. GI & Hepatology News Correspondence. 2013:18. Hudes BK. Larger practice groups cost more. GI & Hepatology News Correspondence. 2013:18.
6.
go back to reference Lee TH, Cosgrove T. Engaging doctors in the health care revolution. Harvard Business Review. 2014;92(6):104–111. Lee TH, Cosgrove T. Engaging doctors in the health care revolution. Harvard Business Review. 2014;92(6):104–111.
11.
12.
go back to reference Sinsky CA, Dugdale DC. Medicare payment for cognitive vs procedural care mending the gap. JAMA Intern Med Health Care Reform. 2013;173:1733–1737. Sinsky CA, Dugdale DC. Medicare payment for cognitive vs procedural care mending the gap. JAMA Intern Med Health Care Reform. 2013;173:1733–1737.
13.
go back to reference Rustgi AK, Vender RJ, Wang KK. The efficacy of screening colonoscopy. 2014. Letter to the Editor. JAMA Intern Med. 2014;174:483.CrossRefPubMed Rustgi AK, Vender RJ, Wang KK. The efficacy of screening colonoscopy. 2014. Letter to the Editor. JAMA Intern Med. 2014;174:483.CrossRefPubMed
15.
go back to reference Rex DK, Schoenfeld PS. Quality indicators for colonoscopy 2014. Gastrointest Endosc Am J Gastroenterol (in press). Rex DK, Schoenfeld PS. Quality indicators for colonoscopy 2014. Gastrointest Endosc Am J Gastroenterol (in press).
17.
go back to reference Rex DK, Kahi CJ, Levin B, Smith RA, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006;130:1872–1885.CrossRefPubMed Rex DK, Kahi CJ, Levin B, Smith RA, et al. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology. 2006;130:1872–1885.CrossRefPubMed
18.
go back to reference Allen JI. The road ahead: what if GIs were accountable for preventing CRC? Clin Gastroenterol Hepatol. 2013;11:204–207. Allen JI. The road ahead: what if GIs were accountable for preventing CRC? Clin Gastroenterol Hepatol. 2013;11:204–207.
19.
go back to reference Braden GL, Allen JI. Organizing your clinical service line: colon cancer prevention. Clin Gastroenterol Hepatol. 2013;11:612–619.CrossRef Braden GL, Allen JI. Organizing your clinical service line: colon cancer prevention. Clin Gastroenterol Hepatol. 2013;11:612–619.CrossRef
20.
go back to reference McCoy AB, Melton GB, Wright A, et al. Clinical decision support for colon and rectal surgery: an overview. Clin Colon Rectal Surg. 2013;1:23–30. McCoy AB, Melton GB, Wright A, et al. Clinical decision support for colon and rectal surgery: an overview. Clin Colon Rectal Surg. 2013;1:23–30.
22.
go back to reference Singh H, Nugent Z, Demers AA, et al. The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer. Gastroenterology. 2010;139:1128–1137.CrossRefPubMed Singh H, Nugent Z, Demers AA, et al. The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer. Gastroenterology. 2010;139:1128–1137.CrossRefPubMed
23.
go back to reference Rex DK, Rahmani EY, Haseman JH, et al. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology. 1997;112:17–23.CrossRefPubMed Rex DK, Rahmani EY, Haseman JH, et al. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology. 1997;112:17–23.CrossRefPubMed
24.
go back to reference Baxter N, Sutradhar R, Forbes DD, et al. Analysis of administrative data finds endoscopist quality measures associated with post-colonoscopy colorectal cancer. Gasteroenterology. 2011;140:65–72.CrossRef Baxter N, Sutradhar R, Forbes DD, et al. Analysis of administrative data finds endoscopist quality measures associated with post-colonoscopy colorectal cancer. Gasteroenterology. 2011;140:65–72.CrossRef
25.
go back to reference Rabeneck L, Paszat LF, Saskin R. Endoscopist specialty is associated with incident colorectal cancer after a negative colonoscopy. Clin Gastroenterol Hepatol. 2010;8:275–279.CrossRefPubMed Rabeneck L, Paszat LF, Saskin R. Endoscopist specialty is associated with incident colorectal cancer after a negative colonoscopy. Clin Gastroenterol Hepatol. 2010;8:275–279.CrossRefPubMed
26.
go back to reference Baxter NN, Warren JL, Barrett MJ, et al. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopists specialty. J Clin Oncol. 2012;30:2664–2669.CrossRefPubMedCentralPubMed Baxter NN, Warren JL, Barrett MJ, et al. Association between colonoscopy and colorectal cancer mortality in a US cohort according to site of cancer and colonoscopists specialty. J Clin Oncol. 2012;30:2664–2669.CrossRefPubMedCentralPubMed
27.
go back to reference Massl R, van Putten PG, Steyergert EW, et al. Comparing quality, safety, and costs of colonoscopies performed by nurse vs physician trainees. Clin Gastroenterol Hepatol. 2014;12(3):470–477. Massl R, van Putten PG, Steyergert EW, et al. Comparing quality, safety, and costs of colonoscopies performed by nurse vs physician trainees. Clin Gastroenterol Hepatol. 2014;12(3):470–477.
29.
go back to reference Imperiale TF, Ransohoff DF, Itzkowitz SH, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287–1297.CrossRefPubMed Imperiale TF, Ransohoff DF, Itzkowitz SH, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287–1297.CrossRefPubMed
Metadata
Title
Colorectal Cancer Screening Quality, Cost and Practice in an Era of Healthcare Transformation
Author
Martin Brotman
Publication date
01-03-2015
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 3/2015
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-014-3447-1

Other articles of this Issue 3/2015

Digestive Diseases and Sciences 3/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.