Gastroenterology has been characterized by consolidation and the growth of management service organizations and megagroups.
"Megagroups" are defined as practices with 15 or more gastroenterologists, according to a report jointly published by consulting firm Fraser Healthcare and pharma research firm Spherix Global Insights. Megagroup gastroenterologists can overlap as members of a management service organization or health system, but some are still independent.
In larger groups, such Gastro Health and GI Alliance, private equity has played a huge hand in propelling growth. The number of private equity gastrointestinal groups grew by 28 percent, to 68, in 2021, according to the report.
Despite consolidation, many groups still lean on physician input. Southlake, Texas-based GI Alliance, the largest and most geographically dispersed gastroenterology organization in the U.S., is physician-led and majority physician-owned. While such organizations as PE GI Solutions and GI Alliance boast a portfolio of more than 600 physicians, smaller, localized groups still thrive.
The growth of these groups could be improving patient care, the Fraser report suggests.
Megagroup gastroenterologists are more likely to perform colonoscopies, endoscopies and sigmoidoscopies than gastroenterologists not in those groups.
They also have less promotional interaction with pharma, especially sales representatives, and are more likely to prescribe biosimilars, especially Inflectra, than gastroenterologists not in a megagroup, according to the report.
As consolidation continues, many gastroenterology leaders stress that patient care must be prioritized.
"We need to ensure that individual patient care isn't lost — that touch isn't lost when you need it — and that we still relate to patients as people and remember we are caregivers first," James Leavitt, MD, president and chief clinical officer of Gastro Health, told Becker's.