Office endoscopy or an endoscopic ambulatory surgery center?

Gastroenterologists are examining alternatives that allow delivery of effective and efficient care. Office endoscopy once provided such opportunities. Time efficiency, control of practice outcomes, and enhanced patient relationships were powerful incentives to perform office endoscopy. However, newly imposed physician procedural fee reductions and heightened concerns about quality of care are strong negatives for performing quality office endoscopy. These issues necessitate consideration of an office-based endoscopic ambulatory surgery center (EASC), where licensure, peer review, and credentialing essentially guarantee a high level of quality in the provision of endoscopy. Furthermore, state-licensed and Medicare-certified EASCs offer the advantages of office endoscopy and allow collection of a facility fee to offset the costs of providing the service. This article details the advantages and risks of developing an office-based EASC.