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Reference Payment Reduces Spending on Colonoscopy

Last Updated: September 08, 2015.

Implementation of reference payment for colonoscopy can reduce spending with no significant impact on complications, according to a study published online Sept. 8 in JAMA Internal Medicine.

TUESDAY, Sept. 8, 2015 (HealthDay News) -- Implementation of reference payment for colonoscopy can reduce spending with no significant impact on complications, according to a study published online Sept. 8 in JAMA Internal Medicine.

James C. Robinson, Ph.D., from the University of California-Berkeley, and colleagues examined the effect of reference payment for colonoscopy. Data were included for 21,644 California Public Employees' Retirement System (CalPERS) enrollees who underwent colonoscopy in the three years prior to implementation of reference payment (January 2012), and 13,551 patients who underwent colonoscopy in the two years after implementation. Control group data were included for 258,616 enrollees in Anthem Blue Cross; these patients were not subject to reference payment initiatives during the study period.

The researchers found that the implementation of reference payment increased use of low-priced facilities by 17.6 percent, after adjustment for patient demographic characteristics, comorbidities, and other factors (P < 0.001). Reference payment was responsible for a 21.0 percent reduction in the price after adjustment for other relevant factors (P < 0.001). There was also a small but statistically insignificant decrease in procedural complications in association with reference payment (P = 0.47). CalPERS saved $7.0 million on spending for the procedure in the first two years after implementation.

"Implementation of reference payment for colonoscopy was associated with reduced spending and no change in complications," the authors write.

The CalPERS provided support for this research.

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