title: Revenue from single-balloon enteroscopy is driven by anesthesia: experience from a tertiary care facility.
abstract: OBJECTIVE
  Resource-intensive endoscopic procedures have shown to generate more costs than revenue under the current reimbursement system in the USA. Single-balloon enteroscopy (SBE), a resource-intensive procedure, has never been evaluated for its financial impact at tertiary care hospitals, and thus, our aim was to determine the sources of revenue that SBE procedures generate.
  
  
  METHODS
  Retrospective review of all procedures performed using the SBE system during the first year of implementation at a single tertiary referral center. Financial data from two subspecialties in the form of revenues for physician and facility fees were collected and analyzed. Revenues were analyzed in total and as a function of payer (insurance) and physician type.
  
  
  RESULTS
  Fifty-two procedures using the SBE system were identified during the first year of implementation at a single tertiary care center. Total revenue generated for all SBE procedures was $123,714 including $64,475 dollars from physician fees and $59,239 dollars from the facility fees. Revenue generated by anesthesia physician fees was higher from Medicare cases compared to private insurance cases (p < 0.01); however, revenues from facility fees were higher for private insurance cases compared to Medicare (p < 0.01). Revenues from anesthesiology physician fees were significantly more than revenues from GI physician fees (p < 0.01). Of the three referred cases, one generated additional downstream revenues from other non-SBE-related services totaling $4727.
  
  
  CONCLUSIONS
  A large proportion of revenues generated from SBE cases come in the form of ancillary services provided by anesthesia. Projected revenue generation (and it sources) should be considered when establishing a device-assisted enteroscopy program.
authors.affiliation: Division of Gastroenterology, Loyola University Medical Center, 2160 South First Avenue, Building 54, Room 167, Maywood, IL, 60153, USA. nbanerjee80@gmail.com.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Banerjee
authors.affiliation: Department of Anesthesiology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Presta
authors.affiliation: Department of Anesthesiology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Charous
authors.affiliation: Division of Gastroenterology, Loyola University Medical Center, 2160 South First Avenue, Building 54, Room 167, Maywood, IL, 60153, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Gupta
mesh_terms: D000758:Anesthesia / Q000191:economics*; D003365:Costs and Cost Analysis; D016099:Endoscopy, Gastrointestinal / Q000191:economics* / Q000379:methods; D005251:Fees, Medical / Q000706:statistics & numerical data*; D005260:Female; D006295:Health Resources; D006801:Humans; D008297:Male; D010820:Physicians; D012189:Retrospective Studies; D063128:Tertiary Health Care
keywords: Anesthesia; Enteroscopy; Medicare; Revenue