Goal: 

The goal of this study was to determine the financial impact of adopting the US Multi-Society Task Force (USMSTF) polypectomy guidelines on physician reimbursement and disposable equipment costs for gastroenterologists in the academic medical center and community practice settings.

Background: 

In 2020, USMSTF guidelines on polypectomy were introduced with a strong recommendation for cold snare rather than cold forceps technique for removing diminutive and small polyps. Polypectomy with snare technique reimburses physicians at a higher rate compared with cold forceps and also requires different disposable equipment. The financial implications of adopting these guidelines is unknown.

Materials and Methods: 

Patients that underwent screening colonoscopy where polypectomy was performed at an academic medical center (Loma Linda University Medical Center) and community practice medical center (Ascension Providence Hospital) between July 2018 and July 2019 were identified. The polypectomy technique performed during each procedure was determined (forceps alone, snare alone, forceps plus snare) along with the number and size of polyps as well as disposable equipment. Actual and projected provider reimbursement and disposable equipment costs were determined based on applying the new polypectomy guidelines.

Results: 

A total of 1167 patients underwent colonoscopy with polypectomy. Adhering to new guidelines would increase estimated physician reimbursement by 5.6% and 12.5% at academic and community practice sites, respectively. The mean increase in physician reimbursement per procedure was significantly higher at community practice compared with the academic setting ($29.50 vs. $14.13, P<0.00001). The mean increase in disposable equipment cost per procedure was significantly higher at the community practice setting ($6.11 vs. $1.97, P<0.00001).

Conclusion: 

Adopting new polypectomy guidelines will increase physician reimbursement and equipment costs when colonoscopy with polypectomy is performed.

中文翻译：

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遵循指南的成本：采用美国多社会工作组息肉切除术指南的财务影响的多中心分析

目标： 

本研究的目的是确定采用美国多社会工作组 (USMSTF) 息肉切除术指南对学术医疗中心和社区实践环境中胃肠病学家的医师报销和一次性设备成本的财务影响。

背景： 

2020 年，USMSTF 提出了息肉切除术指南，强烈建议使用冷圈套器而不是冷钳技术切除微小和小息肉。与冷钳相比，使用圈套技术的息肉切除术对医生的报销率更高，并且还需要不同的一次性设备。采用这些指导方针的财务影响尚不清楚。

材料和方法： 

确定了2018 年 7 月至 2019 年 7 月期间在学术医疗中心（洛马琳达大学医疗中心）和社区实践医疗中心（阿森松普罗维登斯医院）接受结肠镜检查并进行息肉切除术的患者。确定了每个手术期间进行的息肉切除术（仅镊子、仅圈套器、镊子加圈套器）以及息肉的数量和大小以及一次性设备。实际和预计的提供者报销和一次性设备成本是根据应用新的息肉切除术指南确定的。

结果： 

共有 1167 名患者接受了结肠镜检查和息肉切除术。遵守新指南将使学术和社区实践场所的估计医师报销分别增加 5.6% 和 12.5%。与学术环境相比，社区实践中每次手术的医师报销平均增加显着更高（29.50 美元对 14.13 美元，P <0.00001）。在社区实践环境中，每次手术的一次性设备成本的平均增加显着更高（6.11 美元对 1.97 美元，P <0.00001）。

结论： 

采用新的息肉切除术指南将增加在进行结肠镜检查和息肉切除术时的医生报销和设备成本。