ASGE Policy Statement on Physician Payment and Delivery Reform
The American Society for Gastrointestinal Endoscopy (ASGE) affirms the value endoscopic services provide in diagnosing and treating a wide spectrum of digestive disorders and its public health role in colorectal cancer prevention.
Our society recognizes health care costs under the current health care system are unsustainable. Overly burdensome regulations and lack of electronic health record interoperability are among the contributors to health care cost, but payment inadequacy can drive behaviors that are misaligned with efforts to encourage wise use of health care resources and value-based care.
The Medicare Quality Payment Program provides two reimbursement pathways for physicians – the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). While both pathways are intended to incentivize the delivery of high-value care, there are limitations that undermine their potential. MIPS involves a complex scoring system and participation requirements that necessitate tremendous practice investment with diminished upside potential. Ultimately, more opportunities are needed for physicians to achieve successful transition to APM participation, which should be addressed by creating and certifying new physician-focused payment models and by reducing thresholds that currently limit the number of qualifying APM participants The roll-out of MIPS Value Pathway (MVP) program by CMS has potential conceptually to reduce the collection/reporting of measures irrelevant to many gastroenterology practices but the burdens of participation currently outweigh benefits.
ASGE supports policies that alleviate administrative burden while adequately valuing the care provided for all patients, and ASGE strongly supports initiatives underway to change the physician payment system including bringing regular inflation adjustments to physician services, as CMS does for ambulatory surgery centers, hospital outpatient departments, hospital and SNF care, as well are reforming outdated physician fee schedule budget neutrality requirements
Approved by the ASGE Governing Board November 2018
Action: Updated Reimbursement and Health and Public Policy Committee
Approved by ASGE Governing Board May 2025