Upper GI cancers, including esophageal, stomach, and pancreatic cancers, remain the second leading cause of cancer-related deaths in the U.S. Gastroenterologists, with their expertise in endoscopic ultrasound (EUS), are uniquely positioned to lead the integration of emerging cancer therapies such as targeted radiotherapy. These minimally invasive, EUS-guided treatments allow for precise intratumoral delivery, especially in pancreatic cancer where surgery is often not viable. As treatment models become more collaborative and personalized, GIs are at the forefront of a care revolution—poised to drive innovation, expand access to localized therapies, and improve patient outcomes.
Author: Abhay Panchal
A landmark study presented at DDW 2025 has identified five blood proteins—CDHR2, FUOM, KRT18, ACY1, and GGT1—that can predict the development of metabolic dysfunction-associated steatotic liver disease (MASLD) up to 16 years before symptoms appear. The predictive model, derived from over 52,000 participants in the UK Biobank, demonstrated up to 90.4% accuracy at five years and 82.2% at 16 years, outperforming all existing models. Researchers suggest this ultra-early detection could revolutionize liver disease prevention through personalized interventions long before liver damage begins.
Here’s a detailed summary of the 2025 Healthcare M&A Report from VMG Health, highlighting key insights and specific points of interest related to gastroenterology (GI): General M&A Trends: Gastroenterology Specific Highlights:
Former Department of Justice officials Martin Gaynor and Jonathan Kanter warn that the growing dominance of vertically integrated health care conglomerates—like UnitedHealth Group and CVS Health—threatens competition, raises costs, and limits physician autonomy. In a JAMA opinion piece, they argue that these entities now control everything from insurance and pharmacy benefits to data analytics and physician services, creating “Big Health Care” platforms that mirror Big Tech monopolies.
There are a number of treatment options, and we’ve been fortunate that several have been approved lately for Crohn’s disease. There are the anti-TNF medications, which include medicines like infliximab, adalimumab or certolizumab. Those have been sort of our most longstanding therapies for Crohn’s. We’ve also had vedolizumab for a number of years for Crohn’s disease.
AI has the potential to revolutionize prior authorization by reducing administrative burdens and expediting approvals, but physicians remain wary that it could worsen care delays and increase denials if layered on top of a flawed system. While insurers tout AI’s efficiency, doctors fear it may be used to deny care without proper oversight—especially given past misuse by insurers like Cigna and UnitedHealth. Experts agree that for AI to improve outcomes, prior authorization must first be reformed to be more transparent, clinically grounded, and patient-focused. Otherwise, AI could merely automate inequities at scale.
Dr. Fola May, associate professor at UCLA and associate director of the Center for Health Equity, highlights the importance of patient-centered decision-making in colorectal cancer screening, noting that while colonoscopy remains the most comprehensive option—offering both detection and removal of precancerous polyps—noninvasive alternatives like stool-based FIT and FIT-DNA tests are suitable for those hesitant about colonoscopy.
Oshi Health, a national virtual gastroenterology clinic, has introduced a bold 100% fees-at-risk ROI Guarantee, tying its reimbursement directly to measurable clinical outcomes and cost savings for employers and payers. Unlike typical engagement-based digital health models, Oshi offers high-touch, multidisciplinary care through GI-specialized clinicians who collaborate in real time to drive sustained symptom control, reduce ER visits, and eliminate unnecessary costs.
Marta Wosińska’s analysis in the Brookings Institution spotlights serious concerns surrounding the unregulated compounding of semaglutide, a GLP-1 drug widely used for weight loss. Although the FDA recently declared approved semaglutide no longer in shortage, a booming market for cheaper, compounded versions—often made from bulk powder sourced from largely unregulated Chinese suppliers—continues. The absence of a U.S. Pharmacopeia (USP) quality standard means many manufacturers set their own specifications, increasing risks of impurities and substandard production.
Sap Sinha, MHCI ’22 and COO of Allied Digestive Health (ADH), is transforming gastroenterology care by blending operational excellence with innovation inspired by Penn’s Master of Health Care Innovation program. Under his leadership, ADH’s revenue soared from $70M to $200M, while achieving a perfect CMS MIPS score for quality and cost-efficiency. He digitized patient check-ins, streamlined billing with AI tools, and introduced ambient scribing technology like Suki to reduce clinician burden and enhance face-to-face care. Sinha also founded the NJ and NY Independent Physicians Practice Associations to influence health policy and amplify the voice of independent providers.