GI is expanding fastest in many of the states projected to have the thinnest physician supply by 2036:
Where the growth is:
At least 16 new GI practices launched in 2026, with seven concentrated in the South (Alabama, Georgia, Florida, South Carolina, Texas, Arkansas). A 2025 report from Research and Markets identified the Southeast as holding the largest share of the national ASC market. That growth, the report noted, is fueled by increasing demand for outpatient procedures and the region’s high volume of physician-owned centers.
North Carolina led the nation with eight new ASCs in 2025 (tied with California), followed by Texas (four), and Alabama and Mississippi (three each) — more than 20 new ASCs opened across the South last year alone.
Recent system-level moves include Nashville-based TriStar Southern Hills, Novant Health’s new Hardeeville, S.C., location, Mercy’s new Oklahoma City digestive health institute, and Maury Regional’s expanded Columbia, Tenn., practice.
Nationally, GI case volume rose 19% from 2023 to 2024, from 349 to 416 cases per center, per HST Pathway benchmarking, and Medicare-certified single-specialty GI ASCs grew by 122 centers from 2018-2023.
Where the shortage is:
HHS’ Health Resources and Services Administration projects a national shortfall of roughly 630 gastroenterologists by 2036. The steepest gaps are in Nevada, Wyoming, Alaska and Montana, which are projected to meet only 33%-50% of demand. Additionally, Oklahoma, South Carolina, Arkansas and Mississippi fall below 70% adequacy. New York, Massachusetts and Pennsylvania are the only states projected to run a surplus.
The collision:
Three states show up on both lists. Florida, South Carolina and Arkansas are all in active GI build-out mode, yet HRSA projects Florida short by 360 physicians and puts South Carolina and Arkansas below 70% adequacy by 2036. The practices and systems expanding fastest in these states may be building capacity they won’t be able to staff within a decade.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
