Question: What are the biggest threats and trends in gastroenterology?
Dr. George Dickstein: Many of the threats to gastroenterology are not new:
A push toward finding clinically relevant and financially secure ways to participate in bundled payments or pay-for-performance models of care, while taking care not to sacrifice quality for efficiency.
The annual and sometimes erratic pressures of rate reduction from CMS and commercial plans [with some draconian and sudden reductions by some large regional commercial plans being a more important driver of risk this year than usual].
A continued lack of integration of many electronic health systems, which still leads to fragmented and suboptimally coordinated care.
The proliferation of blood and stool tests for colorectal cancer screening as opposed to colonoscopy. These are now covered by many federal and commercial payers. What financial impact will this have on practices? More importantly, what is the socie