Greater Success

Digestive Disease Endoscopy Center Achieves Greater Success Through Three-Party Joint Venture

For many years, Digestive Disease Endoscopy Center (DDEC) in Normal, IL, thrived as a joint venture between physicians from Digestive Disease Consultants and Advocate Bromenn Medical Center.

“We had a good foundation for DDEC, both clinically and financially,” says gastroenterologist Kenneth Schoenig, MD, the center’s medical director and administrator. “But there came a time when both the physicians and the hospital recognized the value of bringing in outside expertise.”

This expertise, they determined, would be in the form of a third-party management company.

“The significance of specialized third party management is that it really affords the physicians to be clinicians and focus on delivering care, and gives the hospital confidence that the center is being managed by experts in endoscopy center operations,” says John Hesse, MHA, vice president of business development for Advocate BroMenn.

Digestive Disease
Endoscopy Center

DDEC has been a PE Partner Since 2012. It is also partnered with Advocate BroMenn Medical Center. This 5,999 square foot facility employs six physicians.

1302 Franklin Ave # 1000
Normal, IL 61761

(309) 454-5900

“I think a third party affords an objective viewpoint in making changes to a center, including sensitive issues that sometimes a hospital and physicians cannot resolve because of competing interests.”

John Hesse, MHA, VP Business Development Advocate BroMenn

What’s in a Partnership?

When Physicians Endoscopy (PE) learned that DDEC was interested in bringing on another partner, research into the history of the center revealed a facility with an impressive performance. This is what PE looks for in prospective partners, says Bob Estes, MSPT, CASC, vice president of center development and implementation for PE.

“We feel very strongly about establishing partnerships that are collegial, ones that are physician and patient care oriented,” he says. “We also look for a business that has demonstrated some success, but could benefit from PE’s expertise. Our partners know that we are working with them because they are already doing a terrific job of delivering care.”

“Our interest is helping identify opportunities to improve upon an already great model. That was certainly the case with DDEC.”

Bob Estes, MSPT, CASC, VP, Center Dev. & Imp. PE

In 2012, PE joined the DDEC partnership. Over the past four years, DDEC has put together a long list of accomplishments.

Achieving Accreditation

One of the most significant achievements was successful accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC). “That is something we had always wanted to do, and through working with PE, we now had tools to do so,” Dr. Schoenig says. “We were not only successful in our passing but also with receiving surveyor comments with words such as ‘model center’ and ‘strong clinical strength,’ which was certainly a credit to our strong clinical staff and clinical director.”

Estes says it came as no surprise that DDEC performed so well on its accreditation survey.

“When we came in, there were already many great things established at DDEC,” he says. “They obsess about quality of care and the experience of the patient. The physicians, medical director and staff were all committed to doing what was necessary to achieve accreditation. That was everything from formalizing the structure of the governing board to reviewing, revising and approving new policies and procedures in order to meet AAAHC standards. This commitment resulted in what was ultimately a successful three-year accreditation.”

Dr. Schoenig adds, “I think one of the successes with our survey was the surveyor recognized that there were decisions we could have made that may have improved our bottom line, but could have been a diminishment in our
level of care to what would be the standard.”

“But ‘the standard’ is not good enough for us. We want our center, staff and care to be above the rest.”

Kenneth Schoenig, MD

Investing In Technology and Equipment

A significant transformation that has taken place within the center are capital investments, including those that have made the facility paperless.

“A major change we made to flow was the implementation of a clinical dictation system and electronic health
record,” Estes says. “That is significant. Not only do these systems capture all the clinical notes, but they also allow for a framework within which to meet all of the existing and upcoming requirements from the government for clinical tracking and reporting different metrics, including those that may influence reimbursement.”

Through these data collection efforts, DDEC also participates in the GIQuIC Registry. “Our involvement with GIQuIC represents another process that supports our efforts to be above the standard of care with endoscopy,” Dr. Schoenig says.

This mentality also applied to the center’s purchase of hi-definition endoscopes, new patient monitors and other medical and business equipment.

“All of the technology in DDEC is now state-of-the-art. It has certainly impacted delivery of care, as well as physician and staff satisfaction.”


Improving Finances

While DDEC was investing in clinical enhancements, it was also finding ways to reduce costs and improve its bottom line.

“PE’s market clout and access to agreements to purchase technology and equipment is certainly beneficial,” says Hesse, who also serves as one of the two hospital representatives on DDEC’s board of managers. “PE brings in GI-specific purchasing agreements which have improved the cost structure of the center.”

Physicians Endoscopy works closely with its partners to secure better payer contracts. “We have had success negotiating contracts with payers that previously either would not agree or were inflexible to discussions with the center,” Estes says. “These additional contracts allow for all in-network plans, improving access for patients. It also improves clinical flow by allowing more of the endoscopy services to come through DDEC, reducing the need for physicians to leave the center to do individual cases at the hospital.”

“We certainly still want to see endoscopy cases in the hospital, but we also know our joint venture offers a convenient, cost-effective setting for our patients, as well as being a physician satisfier.”


Another improvement to service delivery is DDEC’s approach to providing anesthesia, Estes says.

“Over the span of a couple years, we have been able to establish formal anesthesia services at the center,” he says. “It is a much more efficient model that has allowed the center to run more effectively, with the emphasis on patient care. This new arrangement has had a dramatic impact on operational flow and patient satisfaction. It has been an across-the-board improvement.”

Building Awareness

With so many positive developments happening at DDEC, the partners worked together to increase awareness of the center. These efforts included new branding, with a new logo and a new website; marketing initiatives, including direct mail to potential patients; and collaborating with the hospital on health fairs and community colon cancer awareness initiatives.

The results have been very encouraging, Dr. Schoenig says.

“Our access to care for patients has become phenomenal, both as an endoscopy center and a partnership. We have developed strengths that allow us to be more accessible and provide more efficient and appropriate care.”

Kenneth Schoenig, MD

We were able to recruit another physician to the practice who recognized the value of joining an organization focused on being a clinical leader in the industry,” Dr. Schoenig says. “When patients come in and share an experience they have had at our endoscopy center in comparison to a competitor in the industry, we are hearing very positive feedback. That is something we are very proud of.”

Full Steam Ahead

While the partners are pleased with what they have accomplished together thus far, they are not sitting on their laurels. Rather, they have their sights on building on this momentum.

“We are looking for new services that could be offered out of the center, and considering other subspecialties within gastroenterology we might be able to add to that center,” Hesse says.

“PE coming in has been able to help create greater efficiencies and position the center for growth because they are able to make third-party objective decisions that are truly in the best interest of the center.”


“Traditionally, hospital and physician conversations can be very difficult since there are often conflicting interests and responsibilities. But with DDEC, both groups have been willing to listen to PE and work together to make decisions that will help the center succeed,” Hesse says.

A Partnership Built on Common Goals

The success achieved to date has taken time, and the experience has brought all of the partners closer together, Estes says.

“Naturally, any change requires time, consideration, and special handling,” he says. “One thing I think we all did really well was we worked together as true partners, and were always sensitive to the speed with which changes would occur. We have gotten to know one another and are building a partnership built on common goals.”

He continues, “My experience working with the physicians, staff and the hospital is they truly prioritize the quality of life and experience for all stakeholders. This experience has really turned out to be what PE hoped for: an opportunity to be involved in a strong partnership with other organizations and individuals who share similar priorities.”

Dr. Schoenig adds, “I think we are all very proud of the endoscopy center and its accomplishments since the partnership expanded. Working with Advocate and PE has been a wonderful experience.”

It is an experience that has helped shape DDEC into a model for care delivery in today’s healthcare environment.

“As consumers become more cost-conscious and bear more of the financial burden for their care, we feel very fortunate that we are well positioned with the center to offer a lower-cost, high-quality alternative for endoscopy,” Hesse says.