Complete Endoscopy Care™

Complete Endoscopy Care™Fully Managed Endoscopic Service Line

A complete endoscopy service line for hospitals that need one — without having to settle for rotating locums. A dedicated team of GI proceduralists assigned to your region. Every referral, prep, pathology, and follow-up handled. Live in 4–8 weeks.

See the numbers ↓
$3.0M
Topline annual revenue
$1.9M
Annual hospital contribution
2,000+
Procedures per year
4–6
Doctors you'll know by name
Modern endoscopy suite
The problem

An empty endoscopy block is the most expensive thing a hospital can have.

Rural and community systems lose $20,832 in contribution margin every procedure day the block sits idle. A 6-month recruitment search burns through $1.6M before the new hire takes a single case — and one in ten searches fails outright. Hospitals fall back on locums and end up paying premium daily rates for a body in the room, with no one owning the patient journey before or after the procedure.

$20,832
Lost per procedure day the block is empty
14 cases × $1,488 contribution margin
6–12mo+
Average GI recruitment search
10%+ end without a hire
$170–220K
Direct cost to recruit one GI
Search fee + sign-on + relo + onboarding
$1M+/yr
True cost of running locums
Body + credentialing + lost continuity

Why locum coverage isn't a service line

Locums fill shifts. They don't run programs. Six structural realities the literature and the staffing-industry data are consistent on:

6–12 different physicians cycle through per year.
Typical GI locum assignment is 4–8 weeks; longer ones run 72–120 days. CMS's Q6 60-day cap on reciprocal billing pushes hospitals to cycle providers before the limit. A permanent vacancy filled by locums sees a different proceduralist roughly every 1–2 months.
Vendor sprawl is real.
UnityPoint Health, a three-state system, ended up with more than 20 separate locum vendors — each with its own contracts, rates, and processes. Multi-vendor sprawl is the typical end state of years of gap-filling, not the exception.
~30% of the bill rate isn't physician time.
If a GI locum bills $200/hr to the facility, roughly $130 reaches the physician. The remaining ~30% goes to agency fees, credentialing support, malpractice tail coverage, and travel logistics. Hospital MSO and HR teams absorb additional hours per cycle.
Scope is rarely written down.
GI locum scope ranges from endo-only ("minimal consults") to full clinic + inpatient + procedures + call. The locum literature consistently warns physicians to "always get scope in writing" — meaning vague scope is the norm. Hospitals spend energy renegotiating it every rotation.
Follow-up has no owner.
Pathology results, abnormal findings, surveillance reminders, PCP letters — the patient journey extends weeks beyond the procedure day. When the locum leaves, those tasks fall to whoever is around. Often, no one. Surveillance volume leaks years later when patients can't reach the doctor who saw them.
Patients prefer continuity. Outcomes do too.
86% of patients consider a regular physician important; continuity of care is associated with lower mortality. Rotating locum coverage degrades both the patient relationship and the long-term referral pattern from PCPs in your service area.
Sources: CHG State of Locum Tenens 2025 (90% of facilities use locums; UnityPoint 20-vendor case); CompHealth / AMN / Locumstory 2025 (assignment lengths, agency markup); Noridian / CMS Q6 modifier guidance (60-day cap); Locumslife 2026 (GI scope variation); BMJ continuity-of-care meta-analysis; Swedish 2024 GP-preference study (PMC11627799 narrative review); Merritt Hawkins / AMN 2025 recruitment incentives; CMS OPPS 2025; PubMed 39225554 (prep failure baseline 18–35%).
The service

A dedicated team of GI proceduralists. Every patient covered, end to end.

A managed GI endoscopy service line that runs alongside your existing operations — not on top of them. A small, stable team of 2–4 board-certified GIs assigned to your region, rotating consistently so your hospital sees the same faces year over year. Care management built in. Live in 4–8 weeks with no EHR integration project.

What we operate

  • The proceduralist team — 2–4 GIs assigned to your region, pre-credentialed at your hospital, rotating in on a known schedule
  • Intake and screening discussion — PCP-routed and self-referred patients, multilingual
  • Direct-access pre-screening — eligibility, anticoagulation, ASA class, family history
  • Pre-procedure care — multi-touch prep coaching from day fourteen through procedure morning
  • Pathology and PCP letters — results delivered to patient and referring physician
  • Post-procedure follow-up — day one symptom check, day five-to-seven results review
  • Surveillance scheduling — AGA / ACG / USMSTF guideline intervals, automated outreach

What the hospital does (almost nothing)

  • Provide the procedure block, anesthesia, and facility staff — same as today
  • Book the final slot in your existing scheduling system — the only handoff
  • That's it. No EHR integration, no IT project, no recruitment search, no overhead build-out
  • Your existing GI practice operates entirely unchanged

A team, not a stranger

Dedicated GI group serves your region year after year. Compare to 10–16 different locums cycling through per year.

End-to-end care

From the referral fax through to the surveillance reminder three years later. One program, one protocol.

Direct-access intake

Eligible patients route straight to the procedure schedule. No avoidable clinic visit.

Live in weeks

eFax referrals, HIPAA SMS, browser dashboard. BAA-covered vendors. No EHR integration.

How the team works. Each visit is a full work week: 3 procedure days plus a fly-in and a fly-out. Members of your assigned team rotate through on a published schedule, so your nursing staff, schedulers, and PCPs know who's coming. The team shares protocols, shares the care management platform, and reviews cases together — the same way modern hospitalist and anesthesia groups work. Continuity sits with the program, not with one person.
The comparison

Same procedure block. The four options to fill it.

Three procedure days per week deliver about 2,016 procedures and roughly $3M in annual contribution margin. The cards below show what each option costs the hospital each year. The chart below shows what the hospital earns under each option over three years.

Year 1 options

Do nothing
−$3.0M
Year 1 net — opportunity foregone
$20,832 per uncovered procedure day. ~$8,200 per calendar day. The block stays empty; PCPs in your service area shift referrals to neighboring systems. The pattern is hard to reverse.
Hire employed
−$0.9M
Year 1 net — underwater after recruitment
$1.6M lost during 6-month recruitment search. $200K direct recruitment cost. Doc starts mid-year and contributes ~$0.9M in second-half net. One in ten subspecialty searches restart.
Run locums
+$1.4M
Year 1 net — coverage with constant churn
$3.0M in revenue from intermittent coverage, less $1.23M for locum daily rates and the staff to fill what locums don't cover. ~$360K in changeover gap losses (a new locum every 4–8 weeks; 6–12 different physicians cycling through per year).
OUR SERVICE
Complete Endoscopy Care
+$1.9M
Year 1 net — full year of clean coverage
$3.0M in revenue from day-one coverage, less $1.10M fixed annual fee. No recruitment lag, no changeover gaps, no EHR project. A dedicated team of 2–4 GI proceduralists rotating through on a published schedule. Travel costs included.

Three years out, the paths diverge

Cumulative hospital contribution margin if you start today, assuming you have block capacity to fill. Every uncovered month is contribution that doesn't come back.

Cumulative hospital contribution +$6M +$4M +$2M $0 −$2M Today Year 1 Year 2 Year 3 RECRUITMENT LAG $20,832 / uncovered procedure day +$5.7M +$3.9M −$1.8M vs. contract +$3.1M −$2.6M vs. contract −$1.8M trough — doc starts at Year 1: CEC +$1.9M · locums +$1.4M · employed −$0.9M
Complete Endoscopy Care — day-one coverage, fixed $1.10M / yr fee. No gaps, no churn.
Run locums — 6–12 different physicians per year. Some changeovers smooth, some catastrophic (vendor switches, holiday gaps, credentialing delays, last-minute cancellations). The CMS Q6 60-day rule forces cycling. Cumulative gap cost: ~$1.1M over three years.
Hire employed — the block burns ~$270K every month it sits empty. A six-month recruitment search puts you $1.6M+ underwater before the doc walks in. One in ten subspecialty searches restart.
$1.6M+

In contribution margin lost during a typical six-month recruitment lag. $3M+ at twelve months. Over $4.5M if the search fails and restarts. Every uncovered procedure day is $20,832 in margin that doesn't come back — whether you're searching for a hire or covering with locums whose coverage is "the body but not the bundle."

What each option actually delivers

The dollar comparison is close. The service comparison isn't.

Feature
Complete Endoscopy CareFully Managed Turnkey Endoscopy
Hire employedif you can
Run locumsrotating coverage
Coverage & Continuity
Day-1 coverage
✓
×
6–12mo lag
✓
Stable care-team continuity
✓
2–4 same team
✓
×
6–12 strangers/yr
Long-term PCP relationships
✓
✓
×
Permanent (vs. revolving door)
✓
If recruit holds
×
Pre-Procedure Care
AI-led screening discussion
✓
×
×
Direct-access pre-screening (out of the box)
✓
×
×
Eligibility / anticoag / ASA triage
✓
Manual
Manual
Multi-touch prep coaching (Day −7 → AM-of)
✓
×
×
Day-of confirmation & no-show backfill
✓
Manual
×
Multilingual patient education / HIPAA SMS
✓
×
×
Procedure Block
Dedicated proceduralist team
✓
2–4 docs
✓
solo
×
Pre-credentialed at your hospital
✓
✓
×
60–120d/cycle
Operates alongside existing practice (no turf overlap)
✓
×
integrates
Partial
Scope-matched (no over-hiring risk)
✓
×
✓
Post-Procedure & PCP Loop
Pathology delivery automation
✓
×
×
PCP letter generation
✓
Manual
×
Day 1 + Day 5–7 follow-up automation
✓
Manual
×
Surveillance scheduling at guideline interval
✓
Manual
×
Implementation & Risk
No EHR integration required
✓
×
N/A
Goes live in 4–8 weeks
✓
×
✓
Fixed annual cost (no comp/rate volatility)
✓
×
×
BAA-covered HIPAA infrastructure
Hospital builds
×
✓
"Manual" means hospital staff handle it internally — doable for low volume, increasingly painful as the service line grows.
How it works

The complete cycle of care.

From referral to surveillance, every step is owned by one team. Surveillance reminders bring patients back into the cycle three years later — the loop closes.

One team. One protocol. Every step. 01 Referral & intake Triaged within hours of arrival. 02 Pre-procedure care Multi-touch prep coaching. 03 The procedure Same team, every block. 04 Post-procedure care Pathology, PCP follow-up, and surveillance reminders.
The technical reality: referrals arrive by eFax (Doximity, Medsender). Patient communication runs over HIPAA-compliant SMS and email (Twilio Healthcare, Luma Health, Klara). Staff use a browser dashboard. Final slot booking happens in your existing scheduling system — the only handoff. BAA-covered vendors throughout. No EHR integration project.
The outcome

$1.9M to the hospital, every year.

A recurring contribution to the bottom line for every year the service runs — with no recruitment search, no rotating coverage, and no integration project.

Endoscopy service
~2,016
Procedures per year
Three procedure days per week, fourteen cases per day, forty-eight weeks. Modular up or down.
$3.0M
Annual contribution margin
At a typical fifty / ten / forty Medicare / Medicaid / commercial mix and forty percent variable cost.
$1.9M
Net to the hospital, after fee
Day-one coverage. Continuous care management. No EHR project. Live in 4–8 weeks.
Run the numbers against your own payer mix, scope, and market rates in the calculator below.
Security & compliance

HIPAA-compliant infrastructure throughout.

SOC 2 platforms only. Business Associate Agreements with every vendor. No consumer-grade tools touch patient data.

HIPAA-compliant

Business Associate Agreements with all vendors. PHI encrypted at rest and in transit.

SOC 2 vendors only

Infrastructure runs on certified platforms throughout.

Tracking & Analytics

Full audit trails for referral routing, prep outreach, and scheduling actions. Transparent reporting on all automation activity.

All third-party vendors are vetted for HIPAA compliance and maintain signed Business Associate Agreements. Patient data never touches consumer-grade services or unvetted infrastructure.
Run the numbers

Your inputs. Your numbers.

Adjust scope, payer mix, recruitment lag, and locum rates against your market. The model compares hospital net under each option side by side.

1. Scope
2345
Default scope is three procedure days per week, fourteen cases per day, forty-eight weeks — about 2,000 procedures annually.
2. Payer mix & per-case revenue
Payer mix must sum to 100%.
Sources: CMS OPPS 2025 (Medicare blended ~$1,400); commercial HOPD frequently exceeds $2,500 facility alone (Johns Hopkins facility-fee analysis).
3. Service fee
Default scales with scope: 2 days = $900K, 3 days = $1.1M, 4 days = $1.3M, 5 days = $1.5M. Includes the proceduralist team's compensation, malpractice, travel costs (flights, lodging, per diem), care management platform, and operations. Standard delivery model: 3 procedure days + 1 fly-in + 1 fly-out per visit.
4. Compare: hire employed
Whole-FTE math: you can only hire whole people. Six to twelve month recruitment search; ten percent of subspecialty searches end without a hire.
5. Year one: recruitment lag
Average physician time-to-fill is 195 days. Rural and hard-to-fill subspecialty searches often run 12–24 months. Direct cost includes search fee, sign-on bonus, relocation, and onboarding (Merritt Hawkins / AMN 2025).
6. Compare: run locums
Daily rate ~$3,500 for GI subspecialists; rural premium 20–40% (CompHealth / CHG / Medicus 2025). Roughly 30% of the bill rate is agency overhead, not physician pay.
Pre-screening + intake (~$120K), prep coaching (~$80K), pathology delivery and PCP letters (~$100K), surveillance tracking (~$50K), continuity-loss rework (~$100K), credentialing churn 6–12 cycles per year (~$50K). Total $500–600K to staff or build the wraparound a contracted service includes natively. Note: typical GI locum assignments run 4–8 weeks (72–120 days for longer roles), and CMS's Q6 modifier caps reciprocal-billing at 60 continuous days — making cycling structurally unavoidable for permanent vacancies.
Each new locum cycle creates a 30–120 day credentialing window. Even with overlapping coverage, real-world Year 1 sees 2–4 weeks of fully uncovered procedure days from cancellations, vendor switches, and onboarding gaps. At default scope, each gap day costs $20,832 in foregone contribution margin.

Hospital net per year

$1,800,000
—

Procedures per year

2,016
—

Per-case economics

$2,480 gross · $1,488 contribution margin
—
Side by side, same block:

Year one advantage vs. hiring

$0
—

What's included

✓ Referral intake and screening discussion
✓ Direct-access pre-screening — eligibility, anticoag, ASA
✓ Multi-touch prep coaching, day −7 to morning of
✓ Day-of confirmation and no-show backfill
✓ Dedicated team of 2–4 GIs assigned to your region
✓ Pathology delivery and PCP letter generation
✓ Day 1 and day 5–7 follow-up
✓ Surveillance scheduling at guideline interval
✓ Multilingual patient education over HIPAA SMS
✓ No EHR integration. Live in 4–8 weeks.
Get started

Stop burning a hole in the schedule.

Three steps from first conversation to a live procedure block. Your existing GI practice doesn't change. Your endoscopy capacity does.

1

Scope conversation

Confirm procedure days, payer mix, and contract scope against your numbers.

2

Setup, 4–8 weeks

eFax routing, BAAs, dashboard, care team onboarding. No EHR integration.

3

Go live

Your assigned team starts the first block. The care team takes over patient management from day one.

Run the numbers Schedule a conversation