Gastroenterology practices acquired by private equity raised colonoscopy prices after the deals closed but showed no measurable change in quality, according to a study cited in a new American College of Gastroenterology workforce report.
The report, from ACG’s Workforce of the Future Task Force, was published Sept. 22 in a supplement to The American Journal of Gastroenterology. The task force considered PE ownership as one factor that could affect the future supply of GI physicians. It relied on a 2025 study in JAMA Health Forum that analyzed 1.3 million commercially insured colonoscopies performed from 2012 to 2021 at 3,897 practice sites.
Here are seven things to know:
1. Prices rose after acquisition. Colonoscopy prices at PE-acquired practices went up 4.5% compared with independent practices, according to the study. The increase started right after the acquisitions.
2. The increase was steeper in concentrated markets. Practices with a large share of their local market raised prices 6.7%, according to the study. A separate 2023 report from the American Antitrust Institute and UC Berkeley’s Petris Center found the largest post-acquisition price increases in markets where PE firms controlled more than 30% of the market, according to the ACG report.
3. Volume and spending rose too. After acquisition, spending per physician increased 16%, colonoscopies per physician rose 12.1% and unique patients per physician rose 11.3%.
4. Quality stayed flat. The researchers found no statistically significant changes in any of six quality measures: polypectomy rates, incomplete colonoscopies, cardiovascular complications, serious GI complications, nonserious GI complications and any complication.
5. The volume gains started earlier. Spending and volume per physician were already rising at practices before PE firms bought them, the authors acknowledged. That makes it hard to say how much of the growth came from the acquisitions themselves.
6. GI was one of PE’s main targets. PE acquisitions of physician practices grew more than sixfold from 2012 to 2022, according to the 2023 report. Dermatology, ophthalmology and gastroenterology accounted for most of the deals.
7. The task force sees one possible upside. Because PE-backed physicians see more patients, the task force concluded that more corporate ownership of GI practices “may modestly increase GI supply from increased productivity.”
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