Gastroenterology is rapidly transforming as new technologies scale, cancer trends shift and practice economics evolve.
Industry leaders say 2026 will bring both opportunity and significant operational pressure for five reasons:
1. Rates of early-onset GI cancers are rising sharply — reshaping screening demand: The prevalence of early-onset gastrointestinal cancers is increasing worldwide, with colorectal cancer making up 54.3% of all early-onset GI cancers diagnosed in 2022, according to a July 2025 Dana-Farber report. The U.S. saw a 2.16% annual increase in early-onset GI cancer incidence from 2010 to 2019.
In response, practices must expand capacity, enhance early-detection programs and prepare for increased colonoscopy and endoscopy volumes, including among patients historically considered low-risk.
2. AI-assisted colonoscopy is improving detection and becoming part of broader GI-tech adoption: GI practices are deploying AI visual interfaces during colonoscopy to help detect precancerous lesions and using AI for scheduling, triage and patient workflow optimization.
As the technology becomes part of standard workflows, practices will need to invest in staff training, data infrastructure and quality-assurance systems, while preparing for evolving patient expectations around AI-enabled services.
3. AI-enabled patient access infrastructure is transforming how GI groups manage demand: In August, GI Partners of Illinois deployed Simbie AI’s 24/7 AI voice agents for patient scheduling, registration, order placement and patient education — creating a fully automated digital front door for the practice.
By offloading high-volume patient calls and administrative tasks, GI groups are improving access, reducing hold times and ensuring patients can self-navigate the system at any hour. As labor costs rise and staffing shortages persist, AI-enabled access platforms are becoming essential for maintaining responsiveness and scaling patient intake without adding personnel.
4. GI procedures continue to migrate to outpatient and ASC settings: Gastrointestinal procedures remain a dominant specialty in ASCs, accounting for 28.3% of all Medicare ASC volume, as demand rises from earlier screening guidelines and increased younger-onset colorectal cancer.
This growth, combined with reimbursement pressure, prior authorization hurdles, workforce shortages and rising supply costs, is pushing GI groups to expand ASC capacity through new centers, joint ventures and technology adoption to manage higher volumes and more complex outpatient cases.
5. Consolidation and PE investment saw fewer but larger deals in 2025: Private equity’s role in GI is shifting as deal volume slows but transactions grow larger and more strategic. In 2025, GI Alliance, Gastro Health and United Digestive remain the dominant platforms, and Optum’s SCA Health expanded with its acquisition of U.S. Digestive Health.
With about one in 10 gastroenterologists now practicing in PE-backed groups and reimbursement for colonoscopy with biopsy down nearly 40% over 15 years, many independent practices are consolidating for financial stability. New state-level oversight efforts attest to PE’s influence in reshaping GI market structure and governance.
