Eliminating Discretionary Use of Anesthesia Providers During Gastroenterology Procedures Could Generate $1.1 Billion in Savings per Year

by Hangsheng Liu, Daniel Waxman, Regan Main, Soeren Mattke

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Research Questions

  1. What are the financial effects of using anesthesia providers for low-risk patients undergoing routine GI procedures?
  2. Is the use of anesthesiologists justified by the medical condition of these patients in most cases?

Abstract

The use of dedicated anesthesia providers for routine gastroenterology (GI) procedures is seen as medically justifiable only for high-risk patients. Eliminating these services for low-risk patients could generate $1.1 billion in savings per year.

Key Findings

Overuse of anesthesia providers

  • The use of anesthesia providers to deliver sedation during routine gastroenterology (GI) procedures is seen as medically justifiable only for high-risk patients who require intensive monitoring.
  • But between 2003 and 2009, the proportion of GI procedures involving anesthesia providers doubled, and overall payments for GI anesthesia tripled.
  • The use of anesthesia providers varied by almost a factor of four across U.S. regions.
  • The majority of patients who received sedation from an anesthesia provider rather than the endoscopy team were not high-risk patients.

Sedation by endoscopy team would lead to substantial savings

  • Eliminating potentially discretionary use of anesthesia providers for low-risk patients could generate $1.1 billion in savings per year.

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