Many independent specialty groups are heading into 2026 under mounting margin pressure. Dr. Geogy Vennikandam, chief operating officer of GI Partners of Illinois, said his organization is responding by treating margin compression as an operational problem that can be engineered around, not a fixed reality.
“As 2025 winds down and into 2026, our biggest margin pressures mirror what many independent specialty groups like ourselves are facing,” he told Becker’s, pointing to three major margin pressures shaping GI’s financial landscape: rising labor costs, payer reimbursement compression and increasing administrative friction.
What differentiates Chicago-based GI Partners of Illinois, Dr. Vennikandam said, is its refusal to accept those pressures as inevitable.
“We have not accepted margin pressure as a fixed reality,” he said. “We’ve actively built levers to protect and expand sustainability…These levers do more than defend margin. They systematize structural sustainability.”
Here are the five levers GI Partners of Illinois is using to strengthen long-term sustainability:
1. Site-of-service optimization
The first lever is shifting appropriate GI volumes away from hospital outpatient departments and into GI Partners of Illinois’ outpatient network.
Dr. Vennikandam said the group continues to move cases into five small business units and affiliated ASCs in order to “maintain quality while dramatically lowering costs for both patients and payers.”
2. ASC expansion and aligned partnerships
GI Partners of Illinois is also doubling down on ambulatory strategy, both through ownership and partnerships.
“We’re deepening our ASC footprint and exploring new ASC partnerships that align surgeons, GI and anesthesia in a unified value structure,” he said. “That’s one of the most reliable protectors in our playbook.”
He also drew a distinction between specialty-focused and multispecialty centers, arguing that GI-specific centers are structurally more resilient as reimbursement pressure intensifies.
“Our ASC is GI-specific and GI-only. The multispecialty centers are the ones that get into trouble,” he said. “Too many cooks in the kitchen is when things get messy.”
3. Enterprise AI to reduce friction
A distinctive part of GI Partners of Illinois’ margin strategy is its AI deployment across administrative and clinical workflows.
Dr. Vennikandam said the organization is using AI tools not as pilots but as infrastructure aimed at reducing overhead growth and improving yield. The group has inked several AI partnerships so far — including Athelas Insights for revenue-cycle optimization, Acucare for EHR data, Simbie AI for virtual call center operations, Bookend AI and Tandem Health for prior authorization and pharmacy workflows, and Heidi AI for documentation efficiencies.
“AI-driven service line redesign has been major,” he said. “It reduces administrative FTE growth, shortens cycles and improves yield without increasing overhead.”
The strategy is also defensive. Dr. Vennikandam noted that payers are increasingly using automation to deny claims, and GI Partners of Illinois believes practices need comparable tools to protect revenue.
“Payers are using AI for denials,” he said. “”For years, we haven’t been able to fight fire with fire.”
4. Revenue recaptured by AI
Dr. Vennikandam told Becker’s that one of the most unexpected financial wins of 2025 was a practical revenue recapture enabled by AI.
GI Partners of Illinois’ patient financial agreement includes a $250 late/no-show fee for procedures. Historically, the group rarely collected it. One practice site logged more than 3,000 no-shows in 2024, he said, largely because their EHR could not store credit cards or auto-charge patients when policy was triggered.
With Athelas, that changed.
“Athelas brought that into our arsenal. We were able to capture a lot of, what I call, low-hanging fruit,” he said.
5. Scale to strengthen payer contracting
Dr. Vennikandam also tied operational strategy to payer negotiations. GI Partners of Illinois is positioning itself for value-based discussions by leaning on its size, data and outpatient footprint.
“We’re leveraging our size as the largest independent GI group in Illinois,” he said. “Our data, quality metrics and ASC network make us uniquely credible in negotiations.”
