Blog Post

Colonoscopy volumes are at risk. Here are 4 ways planners should protect them.

April 11, 2017

    Last month—Colorectal Cancer Awareness Month—brought some good news: Recent reports show that colorectal screening rates have gone up. Still, we have a ways to go: nearly half of adults don't get screened when they should, and a recent spike in colorectal cancer rates among millennials has caused alarm.

    What's more, recent reimbursement cuts place colonoscopies—one of the most common procedures performed at ambulatory surgery centers (ASCs)—at risk by threatening profitability. And since this service helps bring in downstream revenue, that threatens margins, too.

    To defend this ASC staple, leaders must engage in four strategies:

    1. Combat colonoscopy myths through awareness campaigns

    To be effective, campaigns aimed at increasing colonoscopies must debunk common myths around colorectal cancer: that screening is painful and that the disease is fatal, can't be prevented, and affects only white men. Katie Couric famously fought these myths when she had a colonoscopy on live television, showcasing the painlessness of the procedure and the test's preventive benefits for women. Screening rates rose shortly thereafter and persisted for nearly a year.

    Consider spearheading your own awareness effort, like the American Gastrointestinal Association's “Remember the 70s? Then it's time to get screened for colorectal cancer" campaign. Doing so can help inform your patients about when they should get screened.

    2. Boost screening through targeted patient outreach

    Targeted patient outreach can significantly boost colonoscopy volumes. Studies have proven that patients with an expired order for colonoscopy are significantly more likely to get screened when targeted with direct outreach.

    One of our member organizations does exactly this by tracking when a patient needs to schedule a preventive exam (such as a colonoscopy) through a customer relationship management (CRM) system. The organization then sends a message through the patient's preferred channel—be it via phone, text, or email. For this personalized outreach, which comes at a lower cost than live calls, they've seen response rates as high as 95%.

    3. Use navigators to increase patient commitment to care

    Given the anxiety and embarrassment that can often accompany colonoscopy due to misconceptions, patient navigators can play an important role in making sure patients actually execute on this step of their care. 

    Using culturally sensitive and encouraging language, navigators educate and comfort colonoscopy patients, dramatically reducing no-show rates. If you're among the majority of our members already employing navigators for colorectal cancer, make sure to review our best practice resources so that you're optimizing use of this program.

    4. Facilitate appropriate and expedited referrals

    Primary care physicians (PCPs) play a crucial role in colonoscopy volumes. A recommendation from a PCP is the most influential factor in determining whether a patient is screened for colorectal cancer. However, many PCPs struggle to decide the appropriateness of a referral—a major source of referral leakage—and to get their patients screened in a timely manner.

    Offering a dedicated referral support line or online physician consult platform allows referring physicians to feel confident in the appropriateness of their referrals to you. Further, offering a direct endoscopy referral system, also called direct-access or open access colonoscopy, allows eligible patients with a referral to bypass a GI consultation, thus shortening patient wait time and expanding your capacity for new volumes.

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