Gastroenterology is heading into a turbulent year as site-of-care shifts, evolving technology and economic pressures collide with rising demand and complexity.
Five disruptions in particular are poised to reshape GI care delivery within the specialty in 2026:
1. Rising early-onset GI cancer rates driving a surge in screening demand: Earlier and more frequent gastrointestinal cancer diagnoses, particularly colorectal cancer, are expanding the screening population and reshaping GI capacity needs.
As incidence rises among younger patients, practices are seeing sustained growth in colonoscopy and endoscopy volumes, including from individuals previously considered low risk. To keep pace, GI groups are being pushed to expand procedural capacity, strengthen early-detection pathways and reconfigure access models to accommodate higher and more complex screening demand heading into 2026.
2. GI case mix grows more complex, chronic and multidisciplinary: GI leaders report a clear shift toward higher-acuity and more complex care, with increased use of advanced endoscopy and rising volumes tied to chronic conditions such as inflammatory bowel disease, metabolic liver disease and gastroesophageal reflux disease.
Screening demand remains strong but is becoming more risk-stratified, while a growing share of patients now require coordinated, multidisciplinary management across nutrition, hepatology and chronic care models. Looking to 2026, practices expect continued growth in liver disease-related demand, broader use of AI-supported clinical pathways to route cases by complexity and heightened expectations for same-day access and short-interval follow-up.
3. AI-enabled patient access infrastructure reshaping how GI practices manage demand: GI groups are increasingly turning to AI-driven access platforms to handle rising patient demand without expanding staff.
By automating functions such as scheduling, registration, order placement and patient education through 24/7 voice agents, practices are reducing call volume, shortening wait times and allowing patients to navigate care outside traditional business hours. As labor costs climb and staffing shortages persist, these AI-enabled digital front doors are becoming a critical tool for maintaining access, responsiveness and scalable growth heading into 2026.
4. Migration of GI procedures to outpatient and ASC settings disrupting site-of-care strategy: Gastrointestinal procedures continue to shift out of hospitals and into ASCs, where GI now represents a dominant share of Medicare ASC volume. Rising demand driven by earlier screening guidelines and increased younger-onset colorectal cancer is accelerating this migration, while reimbursement pressure, prior authorization requirements, workforce shortages and higher supply costs intensify operational strain.
In response, GI groups are expanding ASC capacity through new centers, joint ventures and technology investments to manage higher volumes and growing procedural complexity in outpatient settings heading into 2026.
5. Shifting payer expectations disrupting how GI practices negotiate, align and prove value: As reimbursement pressure intensifies and payer expectations evolve, GI leaders are fundamentally rethinking how they engage with insurers.
Practices are moving away from passive fee-for-service contracting toward tighter payer alignment, value-based arrangements and data-driven negotiations that demonstrate quality, efficiency and cost containment, particularly in the ASC setting. To remain competitive, GI groups are investing in analytics, care coordination infrastructure and patient financial education while becoming more selective about payer partnerships.
Heading into 2026, leaders expect success to hinge on demonstrable outcomes, operational consistency and the ability to position GI practices as high-performing partners of choice for payers and employers.
