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Technology and the GI Industry
Technology and the GI Industry A conversation with PE GI Solutions Market Presidents
Recently PE GI Solutions President and CEO David Young sat down with Market Presidents Annie Sariego, Tracy Belsan and Cara Reymann to discuss the current state of technology in the industry and new advancements being adapted by physicians. Read their insight on the current technology landscape below.
David Young (DY): How has social media grown within the industry? Are physicians more willing to utilize it as a business tool?
thought about the impact of their online reputation, but now they are understanding that because people are home, that is the primary way to communicate and provide feedback. I think we’re certainly going to continue to see an uptick.
Cara Reymann (CR): In Virginia and Maryland there is a very large practice that includes 22 offices and 134 physicians and advanced practitioners, and we have a very heavy social media presence with them since it is a unique aspect of that market. We’ve been assisting them with support for their practice marketing program and have seen that social media has been a great way to engage with the patients. We’re seeing more than 650 engagements per month on Facebook alone, so it has been very successful.
Annie Sariego (AS): Personally, I think it’s evolving. Physicians need our support and assistance, and we can help them get where they want to go regarding social media, among other things. In discussions I’ve had they are especially interested in using it for patient reviews. If you have a young millennial looking for a physician, they are going to do their research, and the physicians want to ensure they can manage their digital reputations on social media platforms.
Tracy Belsan (TB): I believe social media has been very successful for physicians and it will be really important in the future. Physicians are interested in reputation management, search engine optimization (SEO) and what they can do for their business. I agree with Annie that patient reviews have become a big factor. Not even five years ago some physicians would have never DY: What do you see as the future of telehealth post-pandemic? Will it continue to play a role in healthcare?
David Young, President & CEO, PE GI Solutions AS: I believe the future of telehealth lies in reimbursement. It’s going to depend on how payors want to approach that in the current situation. It’s also going to be a competitive edge. If you’re in an urban and densely populated market like New York, you’ll find specific niches where it will stay due to convenience. Overall, it’s going to be practice dependent. TB: From what I’ve seen, telehealth has really trended downward. I don’t know of
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— Annie Sariego
many locations that are still using it. Telehealth has been around for a while, and COVID-19 really forced us into that modality. I see it being used very often in primary care, but not as much by GI physicians. I don’t believe we should discount it entirely, in case we were to have another severe wave of COVID appear in the future.
CR: I think we will continue to see the percentage of telehealth visits go up. Like Annie said, I think that some areas will keep it around simply for the convenience for physicians and patients.
DY: What kind of new technology or techniques are you seeing come into practices and centers?
AS: I’ve seen more practices and centers focusing on patient experiences. In a similar relationship to online reviews, new physicians and staff are being shown patient survey sheets and trained on how to specifically meet those expectations. It’s improving the quality of care and how patients view their visit.
TB: We’re seeing an increased emphasis on cybersecurity technology. Cybersecurity is a highly regulated area of healthcare, as it should be. It’s important to work with centers and practices annually to ensure the security of their systems meets required guidelines. Our physicians care about the safety of patient information.
Meet the PE Market Presidents
Ann “Annie” Sariego, RN, BS, CASC, is Market President at PE GI Solutions, overseeing business and clinical operations for PE GI Solutions’ New York and New Jersey Centers. Annie joined PE in 2011 and has over 30 years of healthcare industry experience focused in the hospital and outpatient surgery center setting.
She has a strong background in business and clinical operations in the ambulatory surgery center (ASC) arena, including ASC/hospital joint ventures, with extensive knowledge of state, federal and accrediting agency regulatory and compliance standards.
Tracy Belsan has over 30 years of healthcare experience in hospital operations, ambulatory operations and graduate medical education. Prior to her role with PE GI Solutions, Tracy served as Chief Operating Officer and Designated Institutional Officer for Dignity Health in the California market.
Prior to Dignity Health, Tracy served as Senior Vice President of Operations for Privia Health in Arlington, Virginia. In her role at Privia Health, she also served as the advocacy executive and collaborated with the AMA and AMGA on healthcare policy issues. She is also on the Board of Directors for the AMGA Voice, which focuses on advocacy and advancing healthcare issues in Congress.
Market President for the Mid-Atlantic region, Cara Reymann brings more than 20 years of progressive leadership expertise to the team at PE GI Solutions. In her role, she ensures that PE GI Solutions’ partnering physicians are supported in their practices and endoscopy centers and across their ancillary service lines such as laboratory and infusion therapy.
Prior to joining PE GI Solutions, Cara was a member of the executive team at Capital Digestive Care, originating the departments of marketing and practice operations after the company’s founding in 2009. Cara has focused her career on healthcare, helping physicians and their practices navigate change, improve processes and adopt new technologies.
CR: Some locations are trialing new AI technology for specific procedures. I believe that it can really improve the quality of care for patients. There is also new technology that can assist in the administration of infusion patients. We should all be excited about the potential of both items and how they can impact patient care.
Partnering for Improved Safety
Garden State Endoscopy & Robert Wood Johnson Barnabas announce joint venture partnership
PE GI Solutions and Garden State Endoscopy (GSE) officially announced their joint venture partnership with Robert Wood Johnson Barnabas (RWJB) in the beginning of 2022. RWJB is the largest healthcare system in New Jersey. In 2015, PE GI Solutions entered into a strategic partnership with GSE, which is accredited by the Accreditation Association for Ambulatory Health Care, Inc. and located in Mountainside, New Jersey. This new strategic partnership between PE GI Solutions, GSE and RWJB will allow all parties to scale growth planning activities that support the endoscopy center in providing a safe and efficient environment for all patients.
Advancing Endoscopy in Virginia
Capital Digestive Care and Gastroenterology, Ltd. partner to leverage PE’s platform
PE GI Solution’s strategic partner Capital Digestive Care recently announced a signed transaction with Gastroenterology, Ltd. of Virginia Beach, Virginia, a premier gastroenterology practice in Southeastern Virginia. Capital Digestive Care is the largest private gastroenterology practice in the Mid-Atlantic Region. With this transaction, two new locations are being added, along with an advanced endoscopy center and 15 board-certified providers in Southeastern Virginia. A key factor of this partnership agreement with Gastroenterology, Ltd. of Virginia Beach is the value of leveraging PE Practice Solutions—this platform streamlines operations and enhances revenue streams.
Open for Business
PE GI Solutions and Emerson Hospital create strategic partnership
PE GI Solutions recently entered a strategic partnership with Emerson Hospital in Concord, Massachusetts, to open Emerson Endoscopy & Digestive Health Center. The facility is equipped with cutting-edge equipment and is the only hospital-owned outpatient endoscopy center in the region. Emerson Hospital entered into the strategic partnership with PE GI Solutions to leverage and utilize their management services. The PE Center Solutions platform offers several opportunities for GI physicians, health systems and hospitals to build, develop and optimize a new or existing GI-specific ASC.
Congratulations Dr. Brett Bernstein!
Dr. Bernstein takes on a new role
Dr. Brett Bernstein recently accepted the position of Medical Director of GI Services for the Mount Sinai Health System in New York. Dr. Bernstein is one of the original founding members of The Endoscopy Center of New York and has been Medical Director since 2009. PE GI Solutions congratulates Dr. Bernstein on his new role!
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PE GI Solutions partners with physicians, hospitals, health systems and payers providing integrated GI solutions that focus on improving patient and clinical outcomes. Through our operational excellence and extensive network, we promote positive financial outlooks of GI practices and ASCs through the growth alignment of GI investments–all while preserving the independent practice of medicine.
MigrationTrends in accelerating outpatient migration hospital leaders should know For many years, there has been a steady migration of cases and procedures out of the hospital environment and into outpatient facilities like GI centers and Highlighting Current Trends Lambiasi identifies the following as some of the most significant other ambulatory surgery centers (ASCs). Contributing and more recent outpatient surgical trends and developments. factors have included the development of more advanced Price transparency laws and penalties. Many hospitals clinical technology, improved anesthetics and physicians have yet to comply with hospital price transparency requirebecoming more comfortable with minimally invasive ments. PatientRightsAdvocate.org assessed 1,000 accredited approaches to care. hospitals and found that just slightly more than 14% were
But over the past few years, there have been several complying with the transparency rule, according to a Februdevelopments that have accelerated and are likely to further ary 2022 report. This figure is likely to increase in the coming hasten this migration, says Ralph Lambiasi, Vice President years, in part because Centers for Medicare & Medicaid Serof Partnership Development for PE GI Solutions. “Hospital vices (CMS) penalties for noncompliance with requirements and health system leaders—particularly those tasked with have increased. The penalty for a full year of noncompliance overseeing their organization’s outpatient strategy—need currently ranges from $109,500 to about $2 million. to understand these trends so they can better assess the “As more prices are published, those consumers interested in impact on their strategy and formulate a plan to remain shopping for their care and understanding where their copay or competitive in the outpatient space,” he explains. deductible may be lower will have more information upon which
Patterns
to base their site-of-service decision,” Lambiasi says. “This plays to one of the core strengths of ASCs: lower costs.”
The “No Surprises Act,” which took effect in 2022, may further spur consumerism, he adds.
Commercial payor preference. The pandemic has motivated commercial payors to consider and adopt site-of-service policies that are more aggressively pushing patients out of the inpatient setting. “Payors are requesting more documentation from hospitals to authorize procedures and prove that the hospital is an appropriate site of care,” Lambiasi says. “It’s becoming much more difficult for hospitals to receive approval for something like a screening endoscopy for a younger, healthier patient. These cases are going to ASCs.”
In 2021, the U.S. Preventive Services Task Force (USPSTF) issued new recommendations for colorectal cancer stating that people at average risk should start screening at age 45 instead of the traditional 50. The Affordable Care Act requires most insurers to cover the costs of colorectal cancer screening tests as per the USPSTF recommendations. “This new case volume will largely go to surgery centers,” Lambiasi says. “If hospitals want to see these patients within their service lines, it’s time to start thinking about an ASC strategy.” Federal initiatives. When looking at some of the major federal developments of the past decade, Lambiasi is reminded of Steven Brill’s Time magazine article, “Bitter Pill: Why Medical Bills Are Killing Us.” “Consider recent efforts to push consumerism, such as accountable care organizations, various Affordable Care Act initiatives, the exchanges and transparency laws,” he says. “I think CMS and the federal government are trying to avoid more sticker shock to patients.” Lambiasi believes there will be more “If hospitals want to see similar initiatives down the road. “We [patients under age 50] already have site neutrality for some surgical procedures where the hospital and within their service lines, ASC are paid the same rate. Are screening it’s time to start thinking endoscopies or other elective GI cases ripe for site neutrality? If a development like about an ASC strategy.” this occurs and you’re a hospital lacking
an ASC strategy, expect to experience difficult financial and operational ramifications.”
Additional COVID-19 effects. The pandemic is likely to encourage more migration of care to ASCs—and not just because of commercial payor efforts. During periods of high COVID hospitalizations, hospitals were focused on caring for these patients and providing more emergency and urgent care, which naturally led to non-urgent patient volume going to outpatient settings. It will be difficult for hospitals to slow this momentum.
In addition, hospitals have become less appealing sites for care for patients, Lambiasi says. “Whether right or wrong, that’s going to be the perspective and bias of many patients who now associate hospitals with people sick with COVID— especially with the uncertainty around future waves.”
Then, there are the financial and personnel effects of COVID, which are being felt in every industry, including healthcare. “Perhaps before the pandemic, hospitals may have had the capital and staffing levels to consider ways to expand their outpatient portfolio and try to capture some of the surgical volume making its way to ASCs,” Lambiasi says. “That may no longer be the case, with hospital efforts more focused on returning to pre-pandemic levels of operation and accepting that some surgical cases, especially lower-acuity procedures, are not a priority with respect to new capital initiatives.”
That doesn’t mean hospitals should abandon their pre-pandemic outpatient strategy, he says. Rather, they may need to consider different approaches that will help them achieve their goals.
Physician alignment with management services orga-
nization (MSO) rollup groups. A rapidly growing trend that could siphon more surgical cases out of hospital operating rooms is physicians deciding to sell to and/or align their practices with MSO rollup groups. Such groups have become the top alternative to hospital employment in the eyes of many private groups, Lambiasi says. “The MSO could be a ‘double whammy’ for the hospitals. They would lose the opportunity to employ the physician looking to leave private practice and would most likely lose case volume to the competing ASC that the MSO-sponsored entity owns or would build.”
14%Compliance 14% of hospitals comply with the ACA transparency rule. The penalty for noncompliance ranges from $109,500 to $2 million.
Despite Challenges, ASC Opportunities Exist for Hospitals
The rapidly-evolving surgical landscape makes it clear: Hospitals and health systems need a strong outpatient portfolio; one that includes ASCs and physician partnerships. “Inpatient-to-outpatient surgical migration shows no signs of slowing down, and with an aging population, the demand for surgery is rising,” Lambiasi says. “Without such a portfolio, a hospital will likely struggle to retain surgical volume and miss out on what’s becoming an even more significant piece of healthcare.”
Hospitals uncertain how to best proceed with establishing or growing an ASC portfolio are increasingly looking to experts to help them make intelligent development decisions and facilitate the partnerships with physicians needed for outpatient surgery success. “At PE GI Solutions, we’re engaging in more discussions and entering into more partnerships with hospitals and health systems,” Lambiasi says. “We’re helping these organizations overcome their pain points and solve the multitude of challenges they’re facing today and likely to face in the coming years.”
Lambiasi expects such collaboration with hospitals to become a more substantial part of the PE GI Solutions business going forward. Among the ways the company is collaborating with hospitals and health systems: strengthening engagement and relationship with GI physicians and identifying opportunities to add ASCs to their portfolio, whether through HOPD-to-ASC conversions, joint ventures with physicians or building de novo facilities. These initiatives support the creation of endocenters, the cornerstones for gastroenterology service line integration and growth, and the development of longterm plans to account for the continued outmigration of care. “We are bringing hospitals our years of experience and expertise in the ASC and GI space,” Lambiasi says. “We’re helping these organizations overcome their pain points and solve the multitude of challenges they’re facing today and likely to face in the coming years.”
Ralph Lambiasi
is Vice President of Partnership Development at PE GI Solutions. He can be reached at rlambiasi@ pegisolutions.com.
