Gastroenterology had a banner year in 2019, with the specialty becoming ingrained in the public's view.
From its number of high-profile consolidation cases, to the multimillion-dollar marketing campaigns of companies like Exact Sciences, to the emergence of new technologies to fight cross-contamination, the effect the specialty had in 2019 is unquestionable. Yet, what 2020 holds for the specialty is still up for debate.
Here are six of the biggest trends Becker's ASC Review reported on in 2019:
The private equity picture heats up
It's safe to say 2019 was the year of private equity consolidation in gastroenterology. The year saw the formation of three — possibly four — different platforms, and saw established entities grow, with Dallas-based GI Alliance's several deals resonating loudly throughout the specialty.
The just over 1-year-old GI Alliance has made a whopping eight deals, expanded into six states and partnered with more than 325 independent gastroenterologists. Meanwhile, Miami-based Gastro Health, the longest-tenured PE-backed platform, expanded into three different states and showed no signs of stopping anytime soon.
Undoubtedly 2020 will continue to showcase drastic consolidation, paired with the first moves of the Jamison, Pa.-based Physicians Endoscopy and Silver Spring, Md.-based Capital Digestive Care platform, and the potential establishment of a fourth platform backed by Varsity Healthcare Partners.
Colonoscopy alternatives
Across the industry, leaders continue to debate the right screening test for the majority of people. While colonoscopy reigns supreme in the U.S., researchers continue to study fecal immunochemical testing as a viable, less invasive option, and market players like Exact Sciences made big investments to boost their position as a leading diagnostic testing company.
Early-onset CRC
While colorectal cancer rates in traditional screening populations continue to fall, early-onset rates are inexplicably rising, with researchers left to scratch their heads as to why. Despite the threat of rising early-onset rates, professional societies continue to recommend the majority of populations start screening colonoscopies at 50.
The unclosable loophole
The colonoscopy loophole — an erroneous oversight which allows CMS to bill Medicare beneficiaries the full price of a colonoscopy when a screening colonoscopy becomes a diagnostic colonoscopy — continues to go unaddressed, despite several attempts to rewrite the law. Professional societies have lobbied for years to address the loophole, and a bill to address it has widespread, bipartisan support. Hopefully 2020 will be the year the loophole is no more.
Duodenoscopes go fully disposable
The nation's long national nightmare with cross-contamination may be nearing an end, concerning duodenoscopes. Boston Scientific made history when in December it became the first company to receive FDA approval for its fully disposable, single-use duodenoscope. While the company won't launch the device fully until 2020, the FDA lauded the company's accomplishment and continues to urge the increased adoption of disposable duodenoscopes.
AI
While many artificial intelligence technologies are still under development, the applications for AI in the field of gastroenterology could be vast. In the past year, a handful of GI practices across the country participated in clinical trials testing cloud-based AI inferencing systems for colonoscopies, and studies showed that AI-based computer-aided detection systems found significantly more adenomas and polyps than standard colonoscopy alone. Looking forward, GI experts believe AI-assisted polyp-detecting software will be widely adopted in the next two years.
What are your thoughts on the year? Email eoliver@beckershealthcare.com.
Note: Rachel Popa contributed to this report.
Look for our follow-up to this piece where several gastroenterology industry leaders predict what the specialty will look like in 2030.