Anesthesiologists Contribute to Higher Colonoscopy Cost

A new study published in the Journal of the American Medical Association revealed that having an anesthesiologist or a nurse anesthetist attending certain colon cancer screening procedures can result in hundreds of dollars being added to the overall colonoscopy cost. This added expense can amount to as much as a billion dollars for the United States. Despite the bigger bill, more and more patients these days have opted to pay for the added medical personnel to be present while they undergo colonoscopy.

Dr. Lee Fleisher, an anesthesiologist and a critical care doctor from the University of Pennsylvania, made a comment regarding the study’s findings. He said that the healthcare system in this country can’t afford to keep going down the path it is going. Medicare or health insurance companies end up paying the same rate, even if the patient is just given a sedative or painkillers before their colonoscopy. Taking a pill beforehand requires no additional employees to be present. But once the added medical personnel are brought into the room, there is an extra fee tacked on top of the already high colonoscopy cost. The reason why so many facilities rely on anesthesiologists to be there during the colonoscopy is relatively unclear. The study concluded that having an anesthesiologist or a nurse anesthetist is not a guarantee that the patient will be better sedated or will be given a higher dosage.

Dr. Soeren Mattke of the RAND Corporation in Boston said that either situation provided thorough colonoscopy sedation, but the discrepancy between pricing was unreasonable. He said that there was virtually no difference between the end results, but that the additional colonoscopy cost may be unnecessary in terms of patient safety or long-term health benefits. Unfortunately, people didn’t seem to follow this logic. In their study Dr. Mattke and his research associates monitored 1.1 million patients with Medicare and 5.5 million people who had private health insurance coverage. All subjects had undergone colonoscopy or endoscopy between 2003 and 2009. 14% of them had been billed for an anesthesiologist in 2003. But in 2009, this number doubled. In 2009, 30% of the patients had added the cost of an anesthesiologist to their colonoscopy cost. All these patients were low-risk and didn’t need very strong sedation during colonoscopy, which suggests that an anesthesiologist did not need to monitor.

But still, Medicare pays $150 additional and health insurance pays $500 for the anesthesiologist or a nurse anesthetist to be present during the colonoscopy. Though stronger medication administered and tracked by an anesthesiologist is sometimes beneficial for some patients who are scared of not being sedated enough, the majority of the time regular sedation is sufficient.

Regular colonoscopy when you turn 50 until you turn 75 is recommended as a method of colon cancer screening.  Colon cancer screening promotes early detection and can prevent cancer-related fatalities in the long run. Dr. Mattke said that bringing down health-related expenses is important, and doctors should be aware of adding costs to procedures, especially when there is no significant benefit to the patient. Patients should be made aware that the added medical personnel do not ensure better sedation or better medical care. Regular sedatives given during colonoscopy procedures are often perfectly suitable for the majority of patients. There is no need for higher dosage or more powerful drugs for such procedure, in which many cases just leads to higher colonoscopy cost.

To learn more about colonoscopy cost and reimbursement from Medicare or health insurance companies, refer to a local gastroenterologist listed in our medical directory.