The future value of ambulatory endoscopy centers in the United States: challenges and opportunities

Abstract

In the late 1970s, GI services began the “great migration” from the inpatient facility to the outpatient facility. The initial stage of this migration resulted in the shift of endoscopic services to the hospital outpatient department (HOPD). However, many of the inefficiencies of inpatient-based GI services affected the HOPD as well. The final phase of this migration occurred with the opening of the first Medicare-certified ambulatory surgery center (ASC) dedicated to endoscopy in 1987.1 In 2011, there were more than 5700 Medicare-certified ASCs in the United States, more than 500 of these being ambulatory endoscopy centers dedicated to endoscopy, ie, endoscopic ambulatory surgery centers (EASCs).