As a whole, the healthcare industry has come to recognize the importance of value-based care practices and the benefits they provide for patients, payers, and providers, helping to assure both the delivery of cost-effective patient care along with significantly improved clinical outcomes. While there has been much discussion surrounding these topics and the need to change physician and facility reimbursements to reward the quality of results, rather than the quantity of care provided, the implementation of desired changes has been slow, due in part to the lack in development of treatment standards and the monitoring of metrics evaluating the quality of care delivered.
The “Orphan” Condition Costing the System $2.5 Billion Per Year
If successfully utilized, value-based care in the gastrointestinal industry could positively impact one illness in particular: hemorrhoids. Despite being a common ailment, affecting up to 75% of people during their lifetime, hemorrhoidal disease has been deemed an orphan condition, currently costing the healthcare system $2.5 billion per year in diagnoses, prescription medications, and recurring physician exams, and that’s just for the employer insured population. These costs are further exacerbated by additional facility expenditures, expensive surgeries, and for many, unecessary colonoscopies that result from ineffective treatment and awarenss of the root cause. In fact, research has shown that 60% of the cost of hemorrhoid-related claims are from diagnosis without effective treatment, a serious issue impacting both patients and physicians alike.
A staggering 10.4 million people are diagnosed with hemorrhoids each year, with many more going undiagnosed. Faced with years of pain and symptoms that include itching, irritation, swelling, prolapse, leakage, and bleeding, these patients are frustrated by the lack of access to effective, long-term relief. Unfortunately, most are prescribed laregely ineffective topical medications, or when symptoms are more severe, painful and costly surgery. Delay in definitive treatment leaves patients at risk for years of continued symptoms, as well as the development of worsening disease that might not be amenable to more conservative treatment. This is unfortunate for the patients with nagging perianal symptoms, as well as for the healthcare system, which will encounter greater expense and utilization of resources when sufferers are finally treated.
A Proven Approach
Across the country, many physicians are incorporating “rubber band ligation” of hemorrhoids into their practices. This treatment has been found to be a safe and durable treatment to eliminate hemorrhoidal issues, with up to a 99% success rate. This office-based procedure places a small band around a portion of the hemorrhoid, causing the targeted tissue to scar into place, effectively eliminating hemorrhoidal symptoms. While this technique has existed since the 1960s, it was once associated with the risk of significant pain. But new developments in banding technology have minimized that risk. Patients today can undergo a quick, painless procedure and in as little as three office visits, walk out cured, without significant recovery time. Many gastroenterologists who provide banding to patients view this as an opportunity to offer true value-based care to patients, since it not only satisfies a previously unmet need, but also provides preventative care and reduces the need for colonoscopies, in addition to other costly surgical procedures.
Today, gastroenterologists are in a unique position to effectively diagnose and provide quality, economical hemorrhoid care. In an age in which value-based care is the goal, these physicians can truly influence and reduce the financial burden of this condition and directly improve quality of life and satisfaction for their patients.