Is high acuity the new normal in GI?

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As colonoscopy demand rises, driven in part by more diagnostic referrals for patients under 55, GI leaders are also seeing patients trend older and more medically complex.

Omar Khokhar, MD, a gastroenterologist and managing partner at Illinois GastroHealth in Bloomington, joined Becker’s to discuss how his 2025 case mix shifted toward higher-acuity work and why he expects that trajectory to continue in 2026.

Editor’s note: This interview was edited lightly for clarity and length. 

Question: How did your case mix change in 2025? What changes do you expect in 2026?

Dr. Omar Khokhar: In 2025, we saw a noticeable tilt toward higher-acuity colon and therapeutic cases, coupled with fewer low-value, “screening-only” visits. Patients who show up now tend to be older, more comorbid and requiring more procedural nuance. AI-assisted polyp detection also nudged us into more complex polypectomy work.

Looking to 2026, I expect this shift to continue:

  • More therapeutic work as screening cohorts age.
  • More incidentally complex patients because primary care access remains constrained.
  • More alignment with anesthesia; giving them the resources to care for sicker patients.

Q: What is the biggest growth opportunity you’re looking at in 2025?

OK: Expanding GI access through modular care models — opening up evening and weekend blocks, harnessing nurse practitioners for pre-procedure optimization to prevent cancellations, and building referral pathways that reduce leakage to high-cost settings. Digital scheduling and navigation is the next step. When you remove friction from referral to prep to procedure, volume follows.

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