A new national analysis examining Medicare reimbursements for the top 10 GI procedures finds a sharp, long-term decline in physician payments—raising concerns about future access to gastroenterology care as the U.S. population ages. Between 2003 and 2023, inflation-adjusted Medicare physician reimbursements in facility settings fell by nearly 46% nationwide, with declines observed across all regions. While the Northeast and West consistently received higher reimbursements, the South and Midwest saw persistently lower payments despite differing levels of GI physician supply. The study highlights several paradoxes: Overall, associations between reimbursement, physician supply, and demand were observed, but these relationships were inconsistent and…
Author: Abhay Panchal
A new analysis from the randomized phase 2 Prevent Anal Cancer (PAC) Self-Swab Study, published in JAMA Network Open, suggests that home-based self-sampling for anal cancer screening can significantly improve participation among high-risk individuals and may be cost-effective from a societal perspective. Participants who self-collected samples at home had higher screening rates than those screened in clinics (89% vs. 74%). While self-sampling incurred higher direct healthcare costs, it reduced indirect burdens such as travel, time, and productivity loss—resulting in a lower incremental cost-effectiveness ratio (ICER) when viewed from a societal lens (~$25 per additional person screened). The study focused on…
Most colorectal cancer (CRC) screening tests, including fecal immunochemical (FIT) and multitarget stool DNA tests, require patients to scrape a stool sample at home before mailing it to a central lab. This requirement not only deters screening adherence but can also introduce risks of human error, environmental exposure, and transit-related issues. The multitarget stool RNA test (mt-sRNA), which comprises a FIT component and an RNA molecular component, is the only FDA-approved stool-based test for the detection of both CRC and advanced adenomas (AA) that does not require patients to perform an at-home FIT. Instead, trained technicians complete the FIT in…
Guardant Health has announced a multi-year global strategic collaboration with Merck (known as MSD outside the US and Canada) to support the development and commercialization of Merck’s oncology pipeline using Guardant’s Infinity™ Smart platform. Under the agreement, Guardant’s liquid and tissue biopsy portfolio will be used as clinical trial enrollment assays across Merck’s global oncology studies. The collaboration also includes joint efforts to develop companion diagnostics to support regulatory approvals and to co-commercialize
In this Medscape Gut Instincts commentary, Alicia H. Muratore, MD, MBA, challenges the traditional, procedure-centric identity of gastroenterology and calls for a broader, more future-ready vision of the specialty. Tracing GI’s roots back to holistic digestion, nutrition, and physiology—long before endoscopy—she argues that the next decade will once again redefine what it means to be a gastroenterologist. Emerging forces such as artificial intelligence, liquid-based cancer screening, digital health, microbiome science, and remote care may significantly reduce reliance on traditional scoping while expanding GI’s clinical influence.
In this episode of The Scope Forward Show, Praveen Suthrum speaks with Alex Noumidis, Co-founder and CEO of Nerva, a digital therapeutic platform for IBS (Irritable Bowel Syndrome) and other disorders of gut-brain interaction. They discuss the origins of Nerva, the science of psychophysiology, digital health adoption in GI, and the challenges of bringing behavioral therapies into mainstream gastroenterology. The conversation dives deep into the power of gut-directed hypnotherapy, its clinical validation, the bottlenecks in scaling access to GI psychology, and what it takes to build a product that patients actually use. They’ve seen 300,000 patients and plan to expand to all…
A joint task force from the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology has released an updated set of ERCP quality indicators, reflecting how evidence, risk tolerance, and expectations around value have shifted since the last update in 2015. The message is subtle but firm: ERCP remains one of GI’s most operator-dependent — and highest-risk — procedures, and variation in practice is no longer acceptable. The revised framework spans the full episode of care, from stricter indications before the procedure, to technical benchmarks during ERCP, to outcomes that matter to patients and health systems after discharge.…
What’s new? A research team at Tohoku University (Japan) has developed a high-fidelity endoscopic submucosal dissection (ESD) simulator that closely mimics real human tissue — including mucosa, submucosa, and muscle layers — with realistic tactile feedback, bleeding, and complication simulation such as perforations. How the simulator works: Why this matters: ✔ Provides a safe, repeatable training environment without animal models.✔ Improves procedural skill acquisition for ESD — a technically demanding procedure with risks of bleeding and perforation.✔ Can standardize advanced training globally — from beginner learners to expert practitioners seeking ongoing practice.
Insights shared with Becker’s ASC Review by five GI leaders paint a picture of a specialty in transition. While colonoscopy remains central to colorectal cancer prevention, the business model built around it is under pressure from new screening options, shifting patient behavior, and changing payer strategies. On the ground, demand remains strong — but it’s exposing operational bottlenecks that force practices to modernize and automate. At the same time, leaders are seeing real declines in screening colonoscopy volumes as stool-based and blood-based tests scale rapidly, often driven by payer-led outreach programs and consumer convenience.
Researchers at East China University of Science and Technology have developed a swallowable, biosensor-based capsule that can detect intestinal bleeding in animal models within minutes. In mice with colitis, the pill-sized microspheres safely passed through the gut, were recovered from stool, and produced light-based signals that tracked with disease severity. The appeal is obvious: colonoscopy avoidance remains a major barrier to screening and monitoring, especially in chronic conditions like IBD. This technology is positioned not as a replacement for scopes, but as a potential early signal — a way to identify who may need invasive evaluation sooner, and who might…