02 Sep 2021

PE Platform US Digestive: “There’s still tremendous green space within GI” (Interview)

“There’s still tremendous green space within gastroenterology.” – Interview with Gabriel Luft, Dr. Mehul Lalani & Jerry Tillinger of US Digestive Health
US Digestive Health is one the eight private equity backed GI platforms in the country.
In this open-ended conversation, Dr. Mehul Lalani (VP, US Digestive), Gabriel Luft (Principal, Amulet Capital Partners), and Jerry Tillinger (CEO, US Digestive Health) talk about how the platform has evolved.
It was interesting to learn that from the PE platform’s perspective there’s plenty of room to grow. We talked about whether PE in GI platforms would go public and how long they see the model to continue in GI.
We went back and forth on a few points – especially on whether the company expects disruption from digital health.
Don’t miss this unique deep dive interview that brings together the GI physician, the CEO and the PE partner.
Key insights from this interview (45+min):
“Since we formed up, we’ve got about 60% more physicians in the group”
Regional or national partnerships?
“As a physician, is it easy to work with private equity organizations or is it hard?  What was it that Dr. Mehul did not expect?”
What was Amulet Capital’s original thesis when they started looking at gastroenterology?
What is Amulet Capital’s exit timeline? (second bite)
“We never want to be in a position where the market is dictating what we need to do for our business and partners”
Did the PE platform provide leverage in negotiations with hospitals and insurances?
How do health systems benefit from partnering with US Digestive?
“The nice thing about being regionally focussed is when we talk to a payor, we can approach within a wide space in their market”
How is US Digestive’s growth strategy different from other private equity based platforms?
“There’s still tremendous green space within gastroenterology. There’s still tremendous growth opportunity regionally and nationally”
From a gastroenterology practice perspective, how is US Digestive different from other private equity platforms?
What happens if the business of GI is disrupted with new technology? (e.g. Cologuard or AI)
What is the future of GI?
Will any private equity backed platforms go public?


The Transcribed Interview:
Praveen Suthrum: Mehul, Jerry and Gabe from US Digestive Health, I am so happy to see all of you again and I want to warmly welcome you to The Scope Forward Show.
Dr. Mehul Lalani: Praveen, I wanted to first thank you for all the work you’ve done in helping educate gastroenterologists, you know via multiple media avenues, including books, conferences and telecasts. It’s been a pleasure learning from you. And I am just grateful for the education that all the gastroenterologists across the country have been able to receive. Secondly, it’s an honour privilege for three of us representing US Digestive to be on your show today.
Praveen Suthrum: I am so glad to hear that. Let me first start by asking you, US Digestive Health was formed in 2019, it’s about a couple of years now. So, what has been the story so far?
Dr. Mehul Lalani: We initially began by combining two groups in the same county in Pennsylvania to form an organization called RGI. This, took a tremendous amount of time and resources to merge together. After we were successful in this merger, we began to think more broadly of how we could consolidate further in the state of Pennsylvania. And that led to discussions with two other larger groups, which were not in our counties about how to best prepare for the future. And we really realized pretty quickly that in order to come together, to thrive in a healthcare market with large consolidated healthcare systems and market dominant payers, we needed a good capital partner with the resources and experience in healthcare to make the merger successful and to grow quickly. And that’s
Praveen Suthrum: What are some recent updates on what’s been happening with US Digestive?
Jerry Tillinger: Since we formed up, we’ve grown pretty dramatically. We’ve got about 60% more physicians in the group; we’ve added six new organizations to US Digestive Health. We have also put a tremendous amount of energy into building a strong management team with deep operational experience and that’s been a strong focus. We’ve developed a lot of consolidated resources, a consolidated pathology lab, for example, that does the pathology for all of our practices on electronic data warehouse that covers all of our EHR’s. So, each practice remains on its native EHR that they use when they came on, but we’re still able to manage it across the network and have immediate access to the data we need to lead the group. So, by investing in all that infrastructure, we’ve really poised the organization for another wave of growth and we see that coming this year. As groups got out of COVID, and we’re able to focus more on the same opportunities that Mehul is describing.
Praveen Suthrum: These partnerships that you have formed with other groups, the six groups, have they all been regional or have they been out of state as well?
Jerry Tillinger: Thus far, they’re all within Pennsylvania. And I know we’re going to talk about strategy later in the discussion, but that plays into that exact view of how we build value for the organization.
Praveen Suthrum: I want to go back to Mehul before getting to Gabe. I’m sure you must have had certain assumptions about private equity. But once you got started as a physician working in private equity led organization, what was it that you did not expect? Was it easier than you thought? Was it harder than you thought? Because a lot of gastroenterologists out there have this very question, they have notions about private equity. So, they would want to know from you. Is it easy to work with private equity companies? or is it hard? or what didn’t you expect from that standpoint?
Dr. Mehul Lalani: I think we did our due diligence when we picked our partner and we picked Amulet. One of the things we liked with Amulet was that they weren’t heavily concentrated on many different investments, we were one of their prime investments. So, we knew that getting involved with them, they would have the resources and time to put into our business. And that was very, very helpful, especially in a time of crisis. We essentially had great communication with them on a regular basis. Emails, zoom calls, they were available really whenever we needed them. So, that was what we expected, growing into the merger, but that’s actually what panned out in reality also.
Gabriel Luft: I just want to say, having gone through the last couple of years with our physician partners, our management team, I could not be more impressed with the group of people that we partnered with. They’ve achieved pretty significant progress. They’ve developed a platform from three separate medical groups initially to a platform with administrative scale, where there’s greater visibility into what’s happening on a daily basis, throughout the organization, including with the providers, and then yet to Jerry and his team, they navigated through a global pandemic. And I think actually, frankly, COVID, one of the shining silver linings uncovered was the trust and the partnership that it allowed us to develop.
We obviously, as you can imagine, in many challenges we had to navigate through, we did it together in a spirit that we all had intended. But you never really know that about GI’s, assessing private equity, it is a big decision, it’s a major transition. I think there are similarities across investors and there are also differences. And so, like Mehul described, one of our core tenants is that we do have a more concentrated fund. So in for our first fund we only invested in four companies, for a second fund will probably be five or six. But that can compare with 10 or 12, for other for the average private equity fund. And so that means that we that all of our investments have to work and that we also can allocate more of our time and resources towards each one.
That said, we also have a physician first approach to our digital practice management investments, and that’s enshrined in our clinical governance agreements. And so, I think that’s another thing I would say that, yeah, if I were to advise, GI is thinking about this, not all those are equal. We think that maintain that bright line around kind of Clinical Decision-Making clinical governance is really important. And I think that’s what’s allowed. Yeah, and that’s what enables really successful partnership, is it allows the doctors to do what’s right for their patients and maintain the autonomy over their clinical practice.
Jerry Tillinger: One of the one of the moments for me, where I realized, what Amulet had really brought to the table was when COVID first started. They were supporting us all through our growth. Obviously, we started with two of us and the MSO. So, we were very much building from scratch, and they were filling in a lot of blanks. As we built our team, Amulet was backstopping us in a lot of ways. But when the wave of COVID started arriving in March, they were the ones that actually said, you guys need to be prepared for a massive shift and potential shutdown. Most of us in healthcare have never seen that. You know, we’ve been through natural disasters where a hurricane might roll through town and shut us down for two or three weeks, or some other disaster might arrive. But we’ve never had systemic blow to the industry the way we did with COVID.
The broader experience that the Amulet team had across multiple industries, had them much more mentally ready for what might happen to us if this pandemic truly panned out. So about 10 days before the shutdown arrived, Gabe and his team were telling us, you need to have a plan ready for that. So, the day the governor of Pennsylvania announced the stay-at-home order in the shutdown, all but urgent and emergent activities. We already had the plan ready to go. We already had our HR team ready; we had our ops plan ready; we had a communication plan ready and we would not have been there without Amulet prodding us.
Praveen Suthrum: Gabe, what was the original thesis when you set forth, when you started looking at gastroenterology and then when you finally partnered with Mehul and team?
Gabriel Luft: I think a little bit of context might be helpful. So, our experience has been across a variety of areas in healthcare, one of which is in managed care, which is pretty unique for a firm our size, particularly given where you have consolidated managed care is today. But we’ve and managed care organizations, I’ve worked in the managed care organizations I’ve worked in on both. If you’ve resource and value-based payment, you’re contracting out from the other side of the table. And so, the way we look at our investments, particularly ones that involve commercially reimbursed healthcare services is really from the industries organization on our local and regional level, and then how you interact with those various players. And so, that was really what underpinned our thesis was can you create a scaled group within a region or however you define, however those local payers and health systems are kind of organized, can you create a skill group in that region so that you have a more even negotiation stance, and actually be a better partner for those organizations. And so far, it’s really worked out.  We have been able to successfully grow our business within Pennsylvania, we’ve been able to parlay that into benefits with both the health system level and the managed characterization level. And I think we’ve been able to be a better partner for both of those organizations.
On the thesis, the other piece was really around gastroenterology. We chose GI as one of our first ones for that fund. The things we like about GI is obviously, a specialty that as I said performs procedures and the lowest cost of care. It serves both a procedural endoscopy and a chronic disease component with IBD, which have a nice kind of balancing and from a portfolio perspective. And, on the procedural side, your colonoscopies, are both preventive and curative, which is kind of unique in healthcare. And then on the IBD side, it’s a chronic disease that requires, it’s a sensitive patient population that requires ongoing maintenance. And so, those were kind of the things we liked about GI.
I think, we saw the 70% penetration rate amongst the screening colonoscopies as an opportunity for growth, to be able to serve that additional 30% of people who are not getting required screenings. And we also saw the beginning, when we first did the investment, (there were) beginning signals of the expanding market opportunity, with the guidance around 45- to 49-year-olds. And then on the on the GI side, we’re seeing increasing acceptance for the payers in the 45- to 49-year-olds, and we’re taking a more sophisticated approach to increasing our screening rates.
Praveen Suthrum: So most private equity firms have also a timeline in mind, three to seven years averaging at about five. We saw gastro health recently get the second bite, and it was timed very well, it was exactly five years since they got started. With COVID, how’s that timeline playing out for you? Or do you not worry about it at all for the moment?
Gabriel Luft: I think COVID definitely created additional work and then additional challenges. But as far as growth goes, I think we’ve by and large, hit our plan. I think we are where we would have expected it to be. Like I said, there were definitely things in the interim that we had to kind of get through. But I think we put in a lot of the infrastructure that we expect to put in, we’re in a position to start to scale, and we’re starting to see the real benefits in Pennsylvania. And then we’re also starting to look out into our next date where we can replicate a similar strategy.
So, I think from a timing perspective, I’m not sure that we’re too far off. And sometimes it has been benefited from COVID. I think some of the smaller groups who were independent, who maybe like Jerry said, didn’t act as quickly or as they ramp back up had to kind of push some of their own savings back into the practice to fund working capital, that may have helped facilitate some of the growth of experience. It’s hard to say because you can’t prove  factual, but generally speaking, I think we’re not too far off from where we expected.
As far as timing goes, it’s pretty fairly unique for us in our fund documents. We have the ability to hold for a long period of time. On average, we’ve held we underwrite to five years, we’ve I think we’ve exited in about four. But we never want to be in a position where the market is dictating what we have to do for our business or for our partners. We also use very low leverage relative to other private equity firms. And it’s for a similar reason, we want the ability to pursue our growth strategy in any environment. So, I think going into COVID, our portfolio, on average was levered around three times, and there were significantly more. We had simply more access to debt. We just think there’s enough growth opportunity to healthcare that you don’t have to financially engineer returns and it works both ways. If everything’s going great, the mathematics show you make more money. If things aren’t going great, then you have to be you’re doing your lenders, returns, you can have the opposite effect on returns. And sometimes in difficult environments, the best opportunities for growth present themselves. And so that’s just a little bit about our flavor.
Praveen Suthrum: I’m going to get to you Jerry and get to some of the execution aspects of it. I know we spoke around the time of Scope Forward and at that time, you had just joined US Digestive and one of the things that you told me was that it could give you leverage, or it could give the physicians leverage with the regional hospitals with negotiating on insurances and so on. Now two years out, curious to know did it play out?
Jerry Tillinger: I think it did. In fact, it played out even better than we had anticipated when you and I spoke two years ago. Our relationship with the payers and the hospitals have never been stronger. We’ve got agreements, all varieties with the health systems in our communities. In some cases, their call coverage, in some cases, their co management. We have lease agreements to support advanced endoscopy services, we’re releasing physician time to them to make those services available to more patients. All of those are working well. And I think the health systems appreciate the fact that we bring a more robust group to the table.
Praveen Suthrum: I wanted to ask from their point of view. So now in Pennsylvania, they are a large health system very, very consolidated. So why wouldn’t they do this on their own? How are they negotiating with you? What’s in it for them?
Jerry Tillinger: The cost to build a medical group in a health system, particularly with high end specialties, like GI is enormous. And so, when we approach them with a much more modest cost to stabilize management and call coverage for their facilities, they usually end up saving a dramatic amount of money by partnering with a group like ours. And again, it’s almost impossible for them to get that kind of stability in the market.
Even for health systems that cover a wide geography, it’s not really feasible for them to take, say, a gastroenterologist who’s working in downtown Philadelphia, and say, “well now you’re going to go work in Central Pennsylvania for three months”. That’s on paper, that sounds fine. But in reality, that’s not really an option. So, to have strong local groups that are providing services at your medical center and we’re taking on the heavy lift of making sure that the operations run smoothly, that the improvement and replacement process happens without them having to worry through that, this is something they’re generally happy to outsource.
Praveen Suthrum: How about negotiating with insurance companies?
Jerry Tillinger: The payers, and Gabe touched on this really well. Prior to US Digestive Health coming on board, a group of our scale would have required nine different agreements with nine different medical folks. When we negotiate our contracts, they get 140 providers across a wide swath of the state with a single agreement. That’s a tremendous value for them. Just on the operational and administrative side, it brings value to them. Then you look at the next level of what they’re trying to achieve in value contracting, and potentially moving into risk bearing environments. A small group has neither the economic resources nor the expertise to participate in those agreements. And we do, we’ve got the experience from my background, from Gabe’s background and the resources that Amulet has brought to the table, to capitalize us to go into those agreements.
In fact, we’re leading those discussions with the payers, pushing them towards value pathways where we see opportunity to bend the cost curve to the benefit of the patients, the payers and ultimately the medical group. That’s something you just can’t do without scale. If you’re going to assume risk, you have to be able to cover a geographic area effectively, so that the leakage of patients outside the group is minimized. And again, we’re able to do those across wide swaths of the geography in a way that no other GI group in the state of Pennsylvania can. Not even the health systems have the geographic and service scope that we do.
Praveen Suthrum: How do you see these conversations evolve with value-based care?
Jerry Tillinger: What I found, is that the expertise at the payer level is widely variable. We are actually collaborating with them in one case to actually bring in a third party with deeper expertise to work on GI specific pathways together. They have the data across the broader cost spectrum. We know what our patients cost when they come through our door. We don’t necessarily know how much that same patient is spending on a GI related condition when they go to the emergency room, the hospital, other specialists, other treatment modalities.
The payers have that data, but they don’t necessarily have the expertise to manage that cost in a cohesive way. So, we’re coming to the table with them and working towards pathways where we can assume more responsibility, have better direction for patients, move them from high-cost treatment locations into lower cost settings. And even then, the cost curve clinic, there’s more and more information about the way you’ve bend the long-term cost curve with either aggressive early treatment or screening treatments and other conditions. If you can partner with the payers down that pathway with the scale that’s needed to actually affect the whole population, you can bend that cost curve overall and that’s what the payers really need as a partner.
 
Praveen Suthrum: So, are you hoping to do this in the coming year or are you having these conversations already?
Jerry Tillinger: We are having the conversations now. COVID definitely put a delay on that of all the priorities that were on everybody’s scale, building a new value contract fell behind managing COVID, and getting operational again. So, we put a pause on that for a couple of months. We’re actually in negotiations with one of the largest payers in the state to build that kind of program now. And we’re hoping to take that exact dialog to the other major payers and replicate that across the state.
The nice thing about being so regionally focused is that when we talk to a payer, we can approach it with a wide space in their market. It doesn’t really help that much if Blue Cross Blue Shield of Pennsylvania, one of the big blues carriers here, we’re talking have a big footprint in another state. That doesn’t mean anything for them. They need to focus on the membership that they have in Pennsylvania, and we’re able to do that with them very well.
Praveen Suthrum: Okay. Let’s switch gears and talk about your growth strategy and all your organizational strategy. How’s it different than the other private equity platforms which are out there? And I want to add a little bit to the question here, which is, in the beginning, many platforms talk about doing a regional play, and you are also talking about it now. But then very quickly, they change tact and they moved on to different states, everybody started acquiring practices in different geographies. I’m curious to know, what is your strategy now and what’s it going to be in the coming years?
Jerry Tillinger: I think our strategy is pretty consistent in that we’re focusing on building regional scale to create value, not regional scale for its own virtue. But because it allows us to work with the payers, it allows us to consolidate services to make them more efficient. Our Pennsylvania centralized pathology lab is an example. We brought the cost per unit down by nearly 30% compared to the local labs that most of our groups were running prior. That’s not something that’s that you can necessarily do when you’re scattered across multiple states and multiple regions of the country. So, in any geography where we might expand beyond Pennsylvania, our focus is going to be to replicate the success we’ve had here. We’ve successfully built value for all of our stakeholders by doing that with depth in the market.
So, as we look at potentially a second state footprint, we’re going to look for an opportunity to do the same thing, where we can start with a major group in the market so that we’ve got a good strong base, and take the infrastructure we built within our management team, and use that infrastructure to create the same value for additional groups in the state to join. For smaller groups joining a platform that’s already within the state, they need to see value coming from that. That’s it’s critical that there be creative improvements in the way they perform.
I was actually involved in some of the PPMs back in the 90’s. And saw with crystal clarity that while they built scale, they didn’t build value beneath that scale. And so that has definitely coloured the way we view this investment, that it’s not simply to grow stronger and grow revenue. The revenue growth is great, but I need to grow my actual profitability per unit below that so that my physicians and my investors all see growth in value for the dollars we’re putting out. As a strategy, I think that’s critical for the industry, that is we look at the other platforms around the country, we want them all to be successful and executing on that. Because we see the future of GI, based on these platforms, the ability to execute at an operational level is going to define success for these organizations. There’s still tremendous green space within GI, where it’s somewhere between 10 and 15% of the gastroenterologists in the country are involved in these platforms. That’s a very small number, so there’s still tremendous growth opportunity regionally and nationally. So, we don’t see slowing down in this approach anytime soon.
Gabriel Luft: Just to kind of build on that a little bit, I think what Jerry said is exactly right. I think we want to grow in a way that creates industrial scale that accrues back to your organization. That we’re not looking to grow by acquiring EBITDA in different markets. If we’re going to do that, we want to make sure that we can leverage that scale through to exit in a better place. For our business and also for our physician partners, at least from the investor perspective, I think it’s really positive. And there are somewhat when it signals is that the value proposition is resonating with GI groups, and then there’s ability to transact in a lot of other physician’s specialties, it’s been a much slower pace and so that kind of factors into people’s decisions, when they’re thinking about what can they achieve over their investment horizon.
Sometimes the best entry points into a state are not necessarily the biggest urban markets, it could be a second-tier city, if you have a strong group there and it’s a growing market. There’s a variety of things that kind of go into that. And I think if you look across the country, there’s still very long list of opportunities to go after both for us and other groups.
Praveen Suthrum: Mehul perhaps you can answer this question, for the average GI practice out there, in this region, there’s at least one other private equity platform, one strategic platform, and if you go further out, there is another private equity platform. So, for them with everybody knocking on the doors, how would they tell you apart from the others?
Dr. Mehul Lalani: I think, Jerry and Gabe mentioned some of the traits that our organization has that may be different from some of the other platforms. We went through this process, two years ago and we really had to interview multiple platforms, multiple investors, and try to figure out what the best approach for us was. Our theory was that if we’re able to grow regionally and scale and actually provide services, which we could not provide prior to doing this transaction, we would be successful.
So, all the platforms, I think maybe there is a misconception amongst gastroenterologist across the country, that all of the PE platforms are all the same, and they’re really not the same. There is no one size fits all for a gastroenterologist. I think, the one thing about these platforms that you need to really do is take your time and get the pitch from each of these platforms, understand what they’re trying to accomplish, because they may be trying to accomplish the same thing. But they’re approaching in a different way. And our focus was not to just grow nationally for the sake of growing, we wanted to provide services that we could not otherwise provide in our market to begin with and we defined our market as Pennsylvania. So, I think, every group really needs to understand, obviously, the pros and cons of private equity. But they also need to understand that each of the platforms has its unique characteristics and there is no one size fits all.
Gabriel Luft: I’d also just say kind building on that is a big decision. I think with us, at least, when we enter a market, we really want to deliver for that market. So, it should be I think they should just think about what they want to achieve, and what their existing position is. And we’ve already put a lot of effort into Pennsylvania, so it’d be a lot of bandwidth that we can dedicate to that. And that may resonate with some people, and it’s certainly different than some of the other platforms out there. And there’s other value propositions for the other groups as well. Not to kind of understate that the clinical governance is really important in all these deals that’s been enshrined, right can’t change without physician approval, or consent. And so, I think that’s another thing that these doctors should look at. There are certainly different approaches, some groups have different terms and others they have a different level of involvement in some of these activities and it’s within the kind of practice. I think that’s an area of due diligence it’s just they look at as well.
Praveen Suthrum: Let’s switch gears again, and I want to talk about some of the recent announcements, not private equity announcements, but digital health announcements in gastroenterology which might impact the current way of doing business in GI. Let’s take an example from today, I saw an announcement from Mahana Therapeutics, that has a digital therapeutics platform for chronic conditions like IBS, so they’ve raised $61 million. And last week, there was an announcement Artificial Intelligence company in gastroenterology raise $30 million to do a better polyp detection. Today again, it was interesting that Google put a paper out there, it could be very recent. But the whole point of that was the AI algorithm is now able to detect accurately, if it is correct 97% accuracy in detecting a polyp and so on.
Then you have companies like exact sciences doing several acquisitions, getting very heavily into the aspect of using tool desks, beyond genetic tests to screen populations with many others that are working in the space of liquid biopsy, not just for one cancer, but multiple cancers. A final comment that I heard, though I don’t see the announcement about it, but Blue Cross apparently cut the colonoscopy reimbursements by 20% down south in one of the states.
So, when I look at all this together, I want to ask all of you if this thesis does not hold or pave, the industry makes a shift. What is the plan B? What happens to the EBITDA assumptions, which have been made on number of procedures and physicians coming on board expected to do certain number of procedures in the future? But what if the procedure itself takes a turn and GI as an industry goes to its next level? What happens then?
Jerry Tillinger: I’ll take first stab at that one. We’ve always believed that there’s a role for digital health and these new technologies within gastroenterology. Frankly, anything that improves the screening rate of 60 to 70% that we see across the country would be a tremendous benefit is we are looking at these technologies and modalities. We are trying to integrate them into the practice in a way that brings the best service to the patients and meets them where they want to be met. We’ve already started on our program to integrate AI into our colonoscopy procedures. We see that as a huge advance in the industry. Anything that raises our detection rate and number of polyps located is going to continue to advance the way colonoscopy remains the gold standard in the industry.
As Gabe mentioned before, it’s one of the only treatments in all of healthcare that is both diagnostic and provides treatment at the same time, none of the other modalities can provide that kind of treatment to the patients. And even in an environment where we might see in advance, some of those other detection models. The patients who have positive results in those still need to come in and have those polyps removed. So, while we see these things changing the industry, we also see them as a collaboration in the industry. We still think that at this point, none of those technologies are ready for primetime. We don’t see that the liquid biopsy and stool-based tests are at a level they need that it competes with the quality and performance of colonoscopy. And if AI continues to raise our detection rate, I think that’s going to raise the bar even higher.
So, in the near and medium term, we don’t see that changing the way we work. As we look at the way the industry is evolving back, it’s moving in the other direction, we’ve now added millions of people to the screening population in the 45 to 49 demographics. We think that’s a huge advance and frankly, I believe that number is going to continue to go down. We’ve had too many people in the 35 to 45 range, who have come down with colorectal cancer that could have been prevented. And we see over time as we advanced the technology that that number is going to continue to grow. So even if there’s an adjustment in the way people are using those other technologies for screening, I don’t see it moving the needle in terms of demand for high quality gastroenterologists performing colonoscopy services.
Gabriel Luft: Jerry really well said. The only additional thing I’d add just on us is as I mentioned before, our approach in general is to have more conservative balance sheet. And so, for this or for any kind of risk, it allows us to have flexibility. I am in 100% agreement with Jerry, I think that really as it relates to colonoscopy, we’re very excited about the outcomes from the use of artificial intelligence. I think colonoscopy is going continue to get better. And I do think that if there are opportunities to add additional solutions to the mix allows us to bridge that gap from 70% screening to closer to 100 and ultimately deliver better care to our community. That that’s our mission.
Dr. Mehul Lalani: Praveen, I would just add that technology is always going to advance, right? Whether it’s healthcare or non-healthcare, there’s always going to be advancements in technology. You’re always going to have to embrace technology and change and adapt as much as you can going forward, that’s going to be a necessity to survive. The one thing that you can’t take away in health care is the cognitive ability of physicians, right? You can’t take that away with technology. So, there’s always going to be a demand for service for gastroenterologists across the country. There’s only what, 14,000 to 15,000 gastroenterologists across the country. The cognitive ability there, that’s always going to be a need. So whatever advances in technology, it’s still not going to diminish from the demand of gastroenterologists and other Physicians across the country.
Praveen Suthrum: So, for the gastroenterologist to apply the cognitive ability, they need time, but they’re very busy inside of the endoscopy room, largely doing colonoscopies. That’s why I’m asking what is the plan B? Doctors are busy, and while maybe the industry is shifting a little bit from underneath their feet, so if that happens, then how do we tap into the cognitive abilities of the gastroenterologist? I have these conversations weekly. And what I see the tendencies that I see for the average GI practice out there is to find more number of ways to do more cleaning, because that’s easy, or it’s established. And that’s the way the business of GI has evolved in the last 15 years. My question is, what if you know, this is disrupted and it changes now, then what?
Dr. Mehul Lalani: Well, I think there’s always going to be disruption, right? I mean, you had stool fit testing that came into the market, they said that was going to disrupt things. You had virtual colonoscopy, you said that’s going to disrupt things, there’s always going to be disruption in healthcare. So, right now colonoscopy is the gold standard, one day, it won’t be the gold standard, right? We just don’t know exactly when that’s going to happen. But I mentioned, cognitive service is not going to go away, chronic disease management is not going to go away. You’re still going to need to have a physicians use their brains to navigate these kinds of situations.
And if colonoscopy goes away, there may be other technologies that gastroenterologists are going to have to employ. But we don’t see colonoscopy going away for a long time. I mean, it’s still remain the gold standard. So obviously, there are new modalities that are coming up that are improving, we expect that they’re going to improve. But the demand for gastroenterology services, whether it’s procedural or non-procedural is not going to go away.
Praveen Suthrum: So, I want to further our conversation and ask you about your vision for the future of GI. Where do you see all this go for the next five years?
Jerry Tillinger: I think for the gastroenterology industry, we’re going to see consolidation continue to happen. That the advantages of being in a group like this where you’ve got shared resources, and the ability to leverage size and strength to improve operations is only going to grow. I think the platforms that are developing now have real legs, and you will not see them breaking apart. That the ones certainly the way we’re approaching this, the value creation that’s happening with the doctors, the ability to bring higher quality care, and a more efficient operation. And the ability to let them still practice in an environment that suits them personally, respecting the local culture is a key tenant of what we do. So when we bring groups on board, we do not have homogenize them into a single, this is how you have to do it, because this is our guidebook. We leave a lot of individual freedom within the local practice environment, whether that’s scheduling or other decision making, not only because we think it’s more efficient, it’s about quality of life for the doctors.
The physicians, in smaller practices and medium practices, part of the reason they chose that life, instead of joining a health system is that they wanted the freedom to be entrepreneurial, to have some level of control over their lives. And keeping that there is critical for us to attract the best talent and the best doctors as successors to those current members. And by embracing that we’ve really got a very well satisfied physician group. They’re happy with the way they work. And if you interview deeper into our organization, what most of them will say is that the USDH MSO does not mess with them, so to speak, we don’t come in and tell them, hover over them and tell them how to operate. We bring a lot of expertise to the table. And in the background, we’re making things very efficient. But on the day to day lives, the way they see patient’s environment in which they work, they still exercise a lot of control in that space. And I see that as the secret sauce for this wave of consolidation. It’s not just about the numbers, it’s also got to be about the quality of life for the providers and the quality of care for the patients.
Praveen Suthrum: I want to ask Gabe a question from a private equity standpoint. Do you see five years from now, PE funds investing in GI groups or do you expect the market to saturate by then? And would PE funds start putting together GI groups with other specialties? What would happen? What is your view?
Gabriel Luft: I think they’ll continue to be consolidation. I think there’s any runway well beyond five years. I mean, Jerry mentioned 10 to 15%. I think if you exclude the ASC businesses, it’s still closer to 10% of the gastroenterologist who are involved in in groups like this, I think there’ll be consolidation. I hope that consolidation we hear less about that example you gave the group Blue Cross plan he tried to you know, I guess push around whatever groups were in that state, I don’t think that would happen in Pennsylvania. And I’m sure it wouldn’t happen in a variety of other states that didn’t have large consolidators.
I think that, our groups are going to continue to professionalize or invest in technology, I hope that the screening rates improve in the next five years. Remember people were dying from colon cancer each year, continue reduce based on that, I think that you were going to see, going into kind of a multispecialty environment. I think, I’m not sure that that’s exactly where things are going to go. It just depends on how ultimately, who the owners of these businesses are. You do see some of the platforms moving downstream, so I know that some of larger platforms have their colorectal surgeons, for instance. I think for each group it’s going to be a kind of market-by-market determination. The Imperialist release they know the kind of their health system partners and others, that where you have kind of bolt on market contact.
Praveen Suthrum: Do you see any groups going public?
Gabriel Luft: My opinion today is different than it was a couple of years ago. I think there have been some recent vision practice management IPOs that have traded, that are trading at a pretty incredible valuation. Businesses like Life Stance, which is really a traditional practice management business focused on on-site training at a high revenue multiple, so that may entice people into doing it on the GI side and or on other kind of vision specialties. I’m not sure that it’s necessarily the best platform for the upper GI. But I’m very interested to see how that ultimately plays out.
Praveen Suthrum: Any final words of wisdom, from one gastroenterologist to the others who are listening in Mehul?
Dr. Mehul Lalani: I think, GI groups will need to continue to embrace change in healthcare. You know, the groups that are the most adaptable will be the most successful. You know, telemedicine has and will continue to evolve to a place in every practice. We’re going to see continued growth in GI nurse practitioners and physician assistants at every level of GI practice.
Our colleagues across the country, as you know, Praveen are very cordial, and opening to sharing ideas. So, if you’re interested in private equity, talk to them they’ll inform you of some pros and cons, make the best decision for your group. Obviously, first and foremost, you have to keep patient care as your priority and continue to do what’s best for your patients. But then after that, you have to do what’s best for your practice. Whether it’s you and that should include your younger and older partners, because you want it to be fair, if you’re not fair to your younger partners it won’t be successful.
Praveen Suthrum: Anything else before we close that you wanted to talk about?
Jerry Tillinger: Follow on to what Mehul was saying. I think the younger partner factor is really important. This can’t simply be a retirement vehicle for the senior Doc’s. I would also advise groups to look a little bit further ahead. Some of the groups that have approached us about joining have done so because they felt they were under threat. Either the payers were assaulting their ability to maintain a revenue stream appropriate to what they needed to keep the practice running, or their health system was threatening them saying join us or else kind of approach. When you reach that point, you are at a sort of a desperation moment. And in those cases, those groups were their timing was perfect, because we were in the market and able to step in, and really help protect them from that kind of assault on their integrity.
The smarter move is to look a little bit further down the line and find a platform where that security is already a part of your practice before those threats materialized. There’s no wiser move they can make them to join the right platform in their area that brings them that strength and support. So, they have it in their back pocket if it’s ever needed.
Praveen Suthrum: Excellent. Thank you so much Gentlemen. This was fantastic, I thoroughly enjoyed this conversation. And thanks for encouraging the segways of our conversation. It was totally fun for me, and I look forward to chatting with you all again.
Dr. Mehul Lalani: Thank you very much.
Jerry Tillinger: Thank you Praveen.
Gabriel Luft: Thank you, really appreciate.

_


By Praveen Suthrum, President & Co-Founder, NextServices. 

COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
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28 Aug 2021

Curated GI articles August 27th, 2021: CMS pays for 10 GI procedures at ASCs vs. HOPDs (Becker’s GI)

Curated GI articles August 27th, 2021:
CMS pays for 10 GI procedures at ASCs vs. HOPDs (Becker’s GI)
International Physician Compensation Report 2021: Do US Doctors Have It Better? (Medscape)
Medscape’s US and International sites surveyed their Physician members to learn about salary, job satisfaction, and the impact of COVID 19 on Income.
6 pivotal growth opportunities for GI  (Becker’s GI & Endoscopy)
Five leaders in gastroenterology spoke with Becker’s ASC Review on what they see as the biggest opportunity for growth in ASCs.
CMS pays for 10 GI procedures at ASCs vs. HOPDs (Becker’s GI & Endoscopy)
CMS’ procedure price look-up tool allows users to compare average pay for several procedures in ASCs and hospital outpatient departments.
Physician pay remained stagnant while productivity slumped in 2020,  survey finds (Fierce Healthcare)
The survey by  AMGA Medical group reached nearly 400 medical groups representing more than 190,000 providers.
Podcast: Google’s Head of AI Talks About the Future of the EHR and Technology in Medicine  (Medscape)
Dr. Jeff Dean discussed his predictions for how EHRs will evolve in healthcare and some of Google’s current projects.
24% of hospitals expect GI demand to soon exceed provider capacity, survey says (Becker’s GI & Endoscopy)
21% of surveyed hospitals think telehealth is routinely leveraged in gastroenterology, according to a survey from management consulting firm McKinsey & Co.
Are hospital M&As helping or hurting healthcare’s digital health push? (eMarketer)
Healthcare M&As have been ramping up, especially as organizations look to build out their digital health capabilities—but it’s raising anti-competitive alarms.
63% of Q2 physician practice deals had private equity buyers (Becker’s ASC Review)
Bass Berry & Sims published a report in JDSupra, a legal analysis publication, outlining deals for the first half of 2021.
3 key issues in gastroenterology (Becker’s GI & Endoscopy)
Three GI leaders on some of the biggest issues in the industry as compiled by Becker’s.
Colorectal surgery during pandemic linked to worse outcomes in COVID-19 negative patients  (Healio)
According to a study published in the Journal of Gastrointestinal Surgery, worse outcomes were seen in COVID-19 negative patients who underwent colorectal surgery during the pandemic.
Private equity firm acquires ASC in $7.6M deal (Becker’s ASC Review)
An unnamed private equity group purchased an ophthalmology clinic and ASC in Louisiana for $7.65 million.
Podcast: IBD & COVID-19: How to Manage Patients Amid the Pandemic (ReachMD)
Dr. Peter Buch addresses important questions with Dr. Asher Kornbluth, Clinical Professor of Medicine and Gastroenterology at Mount Sinai School of Medicine in New York
Microbiome Startups Promise to Improve Your Gut Health, but Is the Science Solid? (Medscape)
Startups are charging consumers hundreds of dollars, but is there enough research to show that it’s actually working?
ASC’s budget 3% staff pay raises in 2021 + 5 other benefits (Becker’s ASC Review)
According to the ASC Association’s 2021 Salary & Benefits Survey, ASCs are focused on staff recruiting, retention, salary increases, and additional benefits this year.
Q&A: Determining the gut microbiome’s impact on psychiatric disorders (Healio)
Patients with psychiatric disorders including depression, bipolar disorder, and schizophrenia have significantly different gut microbiomes.
GI Alliance in 2021: 5 updates (Becker’s GI & Endoscopy)
Southlake, Texas-based GI Alliance has more than 500 locations and more than 600 physicians.  Here’s what the company has been up to in 2021.
What’s worrying GI leaders? (Beckers GI & Endoscopy)
Rising COVID-19 infections and subsequent delayed GI procedures are worrying gastroenterologists and GI executives.
74% of insurers are worried they won’t meet No Surprises Act requirements (Becker’s Payer Issues)
Respondents said they don’t know how they will obtain the provider estimates required for the AEOBs that the act requires.
New discovery enhances understanding of colorectal cancer (Medical University of South Carolina)
Researchers discovered a novel mechanism that shows a certain gene mutation can allow tumors to evade detection by the immune system in CRC patients.
Maternal obesity, weight gain increase risk for CRC among adult offspring (Healio)
In utero events – or events in early life – are important risk factors for CRC and may contribute to the alarming increase of CRC in young adults.
Cases From the Frontiers of Endoscopic Ultrasound in 2021 (Gastroenterology & Endoscopy News)
The frontiers of EUS are rapidly changing to include many new endoscopic tools and devices. Read More for case studies involving different techniques.
Capsule Endoscopy a Triage Tool for Endo Patients (Gastroenterology & Endoscopy News)
Video capsule endoscopy limits the amount of aerosolized virus particles to which physicians are exposed, and improves localization of GI bleeding compared with traditional endoscopy.

More Hot headlines in GI
Big Tech In Medicine: How Amazon, Apple, Microsoft, Google, IBM & NVIDIA Disrupt Healthcare (Medical Futurist)

Reducing burnout depends on changing the culture of medicine (Healio)


Fujifilm launches endoscopic video imaging tech (Bakersfield)


Google dismantles health division in strategy overhaul (Mobi Health News)


U.S. hospital patient volumes move back toward 2019 levels, McKinsey survey finds (Healthcare Finance)


Disparities in health care spending, outcomes persist in US, studies show (Healio)


Eight predictors of upper gastrointestinal bleeding after heart attack (Medical Express)


The biggest concern for ASCs today? The staffing crisis, says one clinician
(Becker’s ASC Review)


Some Antibiotics May Affect Immunogenicity in IBD Patients (Medcsape)


Videos: Interviews with GI Leaders  (NextServices)

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COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
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21 Aug 2021

Curated GI articles August 20th, 2021: Colonoscopy backlog could take ‘years to recover from’ – MNGI Digestive Health

Curated GI articles August 20th, 2021:
Colonoscopy backlog could take ‘years to recover from’ – MNGI Digestive Health
100+ stats on physician compensation (Becker’s ASC Review)
Here’s how physician compensation and physician specialties stack up in more than 100 key statistics.
Colonoscopy backlog could take ‘years to recover from’ – CFO of MNGI Digestive Health (Becker’s GI & Endoscopy)
The deferment of elective procedures such as screening colonoscopy that occurred during COVID-19 has created a backlog of procedures.
AGA publishes practice update on complications after bariatric, metabolic surgery (Healio)
The updates address how clinicians should treat major postoperative complications, as well as the comprehensive knowledge needed to carry out various interventional endoscopic techniques.
4 recent GI moves (Becker’s GI & Endoscopy)
From Florida to Chicago, here are four recent moves in gastroenterology compiled by Becker’s GI & Endoscopy.
PodcastStrategies for the growth of independent GI groups and the business of Healthcare  (Gastro Broadcast)
Dr. Michael Weinstein talks with Scott Becker about how he became interested in surgery centers and the business of healthcare and publishing.
Podcast: Women in GI innovation (Small Talks, Big Topics by AGA)
Drs. Amrita Sethi and Mythili Prabhu Pathipati discuss innovation in clinical practice. They also share how to create a career focused on innovation and resources to help expand network.
Podcast: Insights on the Surgical Management of IBD (GI Insights)
Join Dr. Peter Buch and colorectal surgeon Dr. Amanda Ayer to understand issues that still surround the surgical management of IBD.
Exact Sciences reports positive results of Oncoguard Liver test (Medical Device Network)
The Oncoguard Liver liquid biopsy test had 82% early-stage sensitivity, as well as an overall 88% sensitivity and 87% specificity for HCC detection.
AI Improves Detection of Gastric Neoplasms During Routine Endoscopies (Medscape)
The system has the potential to assist endoscopists in obtaining targeted biopsies and reducing gastric neoplasm miss rates in clinical practice.
Biden administration invests more than $19M to expand telehealth (Healio)
The funding will help drive the innovation necessary to build clinical networks, educational opportunities, and trusted resources to further advance telehealth
6 physicians share their best career decisions (Becker’s ASC Review)
Accepting new opportunities and continuing education were a couple of decisions physicians told Becker’s have been the best of their career so far.
Predicting the future of healthcare: 10 takeaways from HIMSS21 (Healthcare Dive)
19,000 onsite attendees in Las Vegas mulled over what’s next for AI, Telehealth, Cybersecurity, Femtech, and more.
Early-onset colorectal cancer may not be biologically different from average-onset disease (Healio)
The analysis included 1,446 patients aged younger than 50 years with a pathologic diagnosis of colorectal cancer from January 2014 to June 2019 at Memorial Sloan Kettering Cancer Center.
10 recent health IT innovation partnerships (Becker’s Health IT)
10 recent health IT vendor contracts and go-lives accelerating digital transformation efforts at healthcare organizations.
Aspero Medical Inc. receives U.S. patent for micro-texturing Pillar technology used in Endoscopy Procedures (Globe News Wire)
The Medical device startup aims to enable physicians to diagnose and treat more effectively, while reducing patient trauma.
Higher vitamin D intake may decrease risk for CRC (Healio)
The results of the study were obtained by calculating the total vitamin D intake of 94,205 women aged 25 to 42 years.
What 5 of the biggest ASC companies did in the past 60 days (Becker’s ASC Review)
The 10 most notable things some of the major ASC companies have done in the last 60 days complied by Becker’s.
Video: Stress burnout in Gastroenterology (Medical World News)
Dr. Benjamin H. Click from The Cleaveland Clinic speaks on the importance of Mindfulness and Wellness.
Maven Clinic nabs $110M funding round and a boost from Oprah to reach unicorn status (Fierce Healthcare)
The $110 million series D funding round was backed by female investor Deena Shakir, partner at Lux Capital, and got a boost from Orpah Winfrey as a new backer.
Gastroenterology & Artificial Intelligence: Global Summit scheduled on 25th Sept, 2021 (ASGE)
This year’s Summit will showcase how to get started with AI in GI and endoscopy, apply AI to daily endoscopy practice, challenges faced in AI in GI and AI and clinical applications.

More Hot headlines in GI
CDC Panel Backs Third COVID Shot for the Immunocompromised (MedPage Today)

Kids in Low-Income Countries More Likely to Die From Congenital GI Anomalies (Medscape)

Healthcare’s Biggest Cybersecurity Challenges and How to Prevent Them (Hackernoon)

Association of the Frequency and Quantity of Alcohol Consumption With Gastrointestinal Cancer (JAMA Network)

WHO releases global guidance for HBV, HCV elimination (Healio)

Microsoft’s move into healthcare – a timeline (Healthcare Global)

Health IT Needs to Play Catchup with Customer Service for Patients (MedPage Today)

American Society for Gastrointestinal Endoscopy postpones GI Outlook (Healio)

UnityPoint Clinic — FD adds gastroenterology partner (The Messenger)

Videos: Interviews with GI Leaders  (NextServices)

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COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
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13 Aug 2021

Curated GI articles August 12th, 2021: Google AI detects elusive polyps | Digital GI co raises $61 million

Curated GI articles August 12th, 2021:
Google AI detects elusive polyps | Digital GI co raises $61 million
Mahana Therapeutics raises $61 Million to Support Commercialization and Development of Digital Therapeutics (Business Wire)
Mahana Therapeutics has raised a total of $81 million to develop and commercialize its pipeline of digital therapeutics.
6 recent GI sales, partnerships (Becker’s GI & Endoscopy)
Gastro Health onboarded a new practice, and a private equity firm acquired an endoscopy center. Compiled by Becker’s, here are six recent sales and partnerships in gastroenterology.
State-by-State breakdown of 50 best hospitals for gastroenterology & GI surgery (Becker’s GI & Endoscopy)
California is leading with the most hospitals in U.S. News & World Report’s 2021-22 rankings for best gastroenterology and GI surgery hospitals.
3 Major GI Groups Support COVID Vax Mandates for Health Care Workers (Gastroenterology & Endoscopy News)
The ACG, AGA, ASGE are among the roughly 90 medical groups which have endorsed a call to require health care workers to receive a COVID-19 vaccine.
Google researchers develop AI system for improved colorectal polyp detection (Mark Tech Post)
Google’s new technology can help detect colorectal polyps using machine learning while improving incomplete detections.
3 biggest ASC trends from the past week (Becker’s ASC Review)
Becker’s ASC Review Editor-in-Chief Laura Dydra laid out the three biggest stories from this past week in an episode of Becker’s Ambulatory Surgery Center Podcast.
IBD Risk Rises With Higher Ultraprocessed Food Intake (Medscape)
Individuals who consumed more ultraprocessed foods had a significantly increased risk of developing IBD than those who consumed less, according to data from more than 100,000 adults
Making the impossible possible-How Medtronics is Changing HealthCare (Fast Company)
Medtronic engineers are using AI and machine learning to sift through mountains of data and develop the next generation of sensing technologies to overcome Global Health challenges.
JPMorgan’s healthcare venture eyes investments in telehealth, data analytics (Becker’s Health IT)
JPMorgan’s new healthcare company Morgan Health launched in May as a continuation of Haven is gearing up to further invest in digital healthcare with $250 million to spend.
IBD: COVID-19 Vaccination Still Effective in Immunosuppressed (Medscape)
Full vaccination against SARS-CoV-2 was more than 80% effective at reducing infection in people with inflammatory bowel disease (IBD) who were taking immunosuppressive medications.
Podcast: The Consolidation of Healthcare -What Does it Mean for Investors? (McGuire Woods)
Join host Geoff Cockrell and Cascade Partners founder and managing director Rajesh Kothari as they discuss what consolidation and other major industry trends mean for the healthcare investor.
With The Transparency Rule In Effect, Colonoscopy Prices Suggest High-Price Hospitals are all over the Place (Health Affairs)
Despite the frequency with which patients seek a colonoscopy, the distribution of its negotiated price on the nationwide commercial market remains unknown due to the lack of price transparency.
AI-assisted endoscopy reduces gastric neoplasm miss rate (Healio)
According to study results, the combined number of diagnoses was 49 gastric neoplasms in 47 patients in the AI group and 44 gastric neoplasms in 43 patients in the routine group.
Colonoscopy Obstacles for Vulnerable Patients After an Abnormal FIT (MedPage Today)
In a qualitative study, frequently cited obstacles to colonoscopy completion after an abnormal FIT included social determinants of health, organizational factors and patient cognition.
Doctors may be able to send patients Zoom link in the future (Mobi Health News)
Though the providers’ experience will be the same, allowing for host controls and virtual backgrounds, patients will simply need to click a link to join the meeting.
ASCs to halt surgeries as COVID-19 surges? Execs prep for next few months (Becker’s ASC Review)
An increasing number of ASC’s and health systems in the Southern States like Texas, Louisiana, and Florida are delaying elective surgeries to focus on COVID-19 patients.

More Hot headlines in GI
IRA Capital Completes Sale of Medical Office and Life Science Portfolio to Nuveen for $620.4 Million (PR Newswire)

Incomplete resection increases risk for future, advanced neoplasia in colorectal polyps (Healio)

Surgery Partners inks deal with New York Endoscopy Center (Becker’s GI & Endoscopy)

Several Risk Factors Tied to Fatal Post-Liver Transplant Infections (MedPage Today)

Colorectal Polyps Often Recur After Incomplete Resection (Medscape)

Employer’s mull health insurance surcharges for unvaccinated (Becker’s Payer Issues)

Probiotics Show Promise for Symptoms of Functional GI Disorders (MedPage Today)

What will ASC competition look like in 5 years? (Becker’s ASC Review)

Videos: Interviews with GI Leaders  (NextServices)

_
COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
button_download
07 Aug 2021

Curated GI articles August 6th, 2021: Digital GI company raises $30 million from Eli Lilly and others

Curated GI articles August 6th, 2021:
Digital GI company raises $30 million from Eli Lilly and others
Gastro Health adds 7-physician practice in Virginia (Becker’s GI & Endoscopy)
This will be Gastro Health’s 11th partnership in the region. It has partnerships in six states: Florida, Alabama, Washington, Virginia, Ohio and Maryland.
Eli Lilly joins $30M Series A financing for startup bringing AI analysis to endoscopy (MedCity News)
The artificial intelligence-based technology of Iterative Scopes brings computer vision analysis to endoscopic images.
Exact Sciences announced its Q2 2021 results. Here are 14 takeaways from the earnings call (NextServices)
Total revenue was $434.8M, an increase of 62%. The company anticipates Screening revenue of $1,100-$1,125M, Precision Oncology revenue of $530-$540M, and COVID-19 testing revenue of $75-$80M.
21 new ASCs in July (Becker’s ASC Review)
From Massachusetts to Arizona, here are the 21 ASCs opened or announced in July, as reported by Becker’s ASC Review.
Biotech and pharmaceutical company team up to identify GI biomarkers (Becker’s GI & Endoscopy)
Through the partnership, Second Genome will pair its sg-4-sight discovery engine with Arena’s Cultivate clinical trial to identify microbiome biomarkers.
How One Drive-By Clinic Fought Declining CRC Screening Rates (Medscape)
The Flu-FIT program is designed to increase CRC screening among adults and to give healthcare providers an opportunity to promote this among their patients at the time of their annual flu vaccine.
3 PE GI Solutions Partner Centers Receive AAAHC Accreditation (KPVI)
The Digestive Disease and Endoscopy Center, South Broward Endoscopy, and Access Surgery Center have successfully passed AAAHC Accreditation survey.
Medscape Physician Assistant Career Satisfaction Report 2021 (Medscape)
The decision comes after Atrium Health and Novant Health announced that vaccines would be mandatory for staff, spurring hundreds of healthcare workers to protest against the requirement.
Verily launches AI research center in Israel, picks up Google Health projects (Fierce Biotech)
Google’s Verily also hopes to pick up the torch from the tech giant’s previous work in digital health, such as the use of AI to help detect suspicious polyps in real time during screenings for colorectal cancer.
InterVenn Biosciences Raises $201 Million for AI-driven Glycoproteomic Platform, Liquid-Biopsy development (Business Wire)
The company utilizes a glycoproteomics biomarker interrogation platform using AI and mass spectrometry for next-gen precision medicine.
Gastroenterologist pay by years of experience: 12 stats (Becker’s GI & Endoscopy)
Gastroenterologists earn an average salary of $406,000, the seventh highest-paid medical specialty in 2021, and reach their highest rate of compensation after about 15 years of practice.
Docs Fight Back After Losing Hospital Privileges, Patients, and Income (Medscape)
Physicians did not lose their privileges because of a clinical failure. Rather, it was because of hospital’s decision to enter into an exclusive contract with another set of providers.
Five common financial mistakes physicians often make (Healio)
Here are the five top financial mistakes Dr. Bhatia has seen in fellow physicians, especially at the beginning of their careers. As published in the ‘Forward Thinking column in Orthopedics Today’, a Healio publication.
CMS grants additional reimbursement for single-use duodenoscope (Becker’s GI & Endoscopy)
The add-on is applicable to Boston Scientific’s Exalt Model D Single-Use Duodenoscope, a device designed to eliminate infections caused by ineffective reprocessing of reusable duodenoscopes.
Digital Therapeutics Extend Their Reach in Neurology (Medscape)
In wake of promising results and several ongoing clinical studies, neurologists (and other doctors) may soon be prescribing video games alongside conventional therapies for several conditions.
Podcast: Diversity, Equity and Inclusion in GI with Sophie M. Balzora, MD (Healio)
In this podcast episode, Sophie M. Balzora, MD, FACG, discusses  the importance of having a true diversity, equity and inclusion initiative in the health care field and more.
Twitter Found to Be Key GI Educational Tool (Gastroenterology & Endoscopy News)
According to findings from a survey of more than 230 gastroenterologists and other GI-focused providers who use the social media app.
Huge wins for GI in Labor-HHS bill  (AGA)
The House bill includes AGA language directing NIH to study the pandemic’s impact on CRC screenings in minority communities.

More Hot headlines in GI
Cerecor announces positive results for CERC-002 in Crohn’s disease treatment (Healio)

North Carolina GI practice mandating COVID vaccine for workers (Becker’s GI & Endoscopy)

Healthcare out-of-pocket spending rises to $491B (Becker’s Payer Issues)

The Open-Source Movement Comes to Medical Datasets (Stanford University)

5-physician endoscopy center sold in New Mexico (Becker’s GI & Endoscopy)

Personalized feedback, positive reinforcement aids NAFLD patients (Healio)

JPMorgan’s new health business makes inaugural investment in start-up Vera Whole Health (CNBC)

Procedure-less intragastric balloon is cost-effective in obesity management (Healio)

The Link Between Your Gut and Heart Health (Everyday Health)

Controversies in Gastroparesis: Discussing the Sticky Points (AJG)

The role of tech in public healthcare (Healthcare Global)

Videos: Interviews with GI Leaders  (NextServices)

_
COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
button_download
04 Aug 2021

Exact Sciences announced its Q2 2021 results. Here are 14 takeaways from the earnings call.


Exact Sciences announced its Q2 2021 results.
Here are 14 takeaways from the earnings call.
Let’s start with some numbers:
◘ Total revenue was $434.8 million, an increase of 62% (compare that to $268.9 million in Q2 2020 and $402.1 million in Q1 2021)
◘ Screening revenue was $263.9 million, an increase of 101% (compare that to $131.3 million in Q2 2020 and $240.3 million in Q1 2021)
◘ Precision Oncology revenue was $137.8 million, an increase of 34% (compare that to $103.0 million in Q2 2020 and $129.4 million in Q1 2021)
◘ COVID-19 testing revenue was $33.1 million, a decrease of 4% (compare that to $34.6 million in Q2 2020 and $32.3 million in Q1 2021)
◘ Screening revenue included a one-time downward adjustment of $12.1 million related to the passing of the contractual deadline to submit claims for previously completed Cologuard tests.

Takeaways
1/  Exact Sciences tested 850,000 people in Q2 2021 with Cologuard, Oncotype DX and COVID test.
2/ Over 60,000 tests were performed using Cologuard. There was a significant increase in tests between the 45 to 49 age group.
3/ Exact Sciences expects a total revenue between $1.705 billion and $1.745 billion for the year 2021.
4/ 8,000 new healthcare providers ordered Cologuard during this quarter and nearly 244,000 have ordered since launch.
5/ The growth in Precision Oncology was primarily driven by Oncotype DX breast in the U.S.
6/ Exact Sciences acquired PFS Genomics for $33 million (PFS Genomics is a company focused on reducing unnecessary radiotherapy treatment in patients with early-stage breast cancer).
7/ Two main pandemic-related dynamics impacting the screening business: reduced physician office access and fewer in-person wellness visits.
8/ 44% of primary care doctors are doing fewer in-person wellness visits when compared to pre-COVID levels.
9/ Since the availability of Cologuard, Exact Sciences has estimates that it has helped detect precancerous polyps in more than 200,000 people and early-stage treatable cancer in more than 30,000 people.
10/ Cologuard is well positioned to help screen the 19 million Americans and research shows that Cologuard’s specificity is greater than 95% in the age group 45-49.
11/ Exact Sciences predicts that more than 600,000 people will be eligible for their second Cologuard test this year and 1 million people next year.
12/ Oncotype DX breast test was recently approved for national reimbursement in Italy, which makes Oncotype accessible to nearly 25,000 breast cancer patients in that demographic.
13/ Exact Sciences also plans to initiate a prospective interventional randomized trial for FDA registration.
14/ Over the next 24 months, Exact Sciences is planning several key milestones to bring 6 innovative cancer diagnostics from their pipeline to the patients in need.
Kevin Conroy, Chairman and Chief Executive Officer quoted “Our international presence will accelerate the availability of future advanced cancer tests all around the world. Exact Sciences plans to transform cancer care by providing patients valuable insights at every step of their diagnosis and treatment. We are working to build the best digital infrastructure and diagnostics”.

References: 
Exact Sciences (EXAS) Q2 2021 Earnings Call Transcript (The Motley Fool)
Exact Sciences Announces Second Quarter 2021 Results (Exact Sciences)
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COVID-19: The Way Forward for Gastroenterology Practices
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02 Aug 2021

Curated GI articles July 31st, 2021: Healthcare M&A on track for record year

Curated GI articles July 31st, 2021:
Healthcare M&A on track for record year
Exact Sciences Announces Second Quarter 2021 Results (PR Newswire)
Total revenue was $434.8M, an increase of 62%. The company anticipates Screening revenue of $1,100-$1,125M, Precision Oncology revenue of $530-$540M, and COVID-19 testing revenue of $75-$80M.
Healthcare M&A on track for record year (Becker’s Hospital Review)
Physician practices and services saw 26 deals this June, up from 16 last June. Four of the deals were completed by Gastro Health, which acquired gastroenterology practices in northern Virginia.
8 Recent reports on COVID-19, GI: Liver transplantation, malnutrition, vaccine response (Healio)
These stories include research on liver transplantation, hepatitis B, GI symptoms that persist in patients post-COVID infection and more.
Hawaii hospital onboards state’s first AI-powered endoscopy system (Becker’s GI & Endoscopy)
Pali Momi Medical Center reportedly is the first in the state to acquire an AI image-guided interventional endoscopy system. AI is used in image-guided endoscopic procedures and reduces radiation exposure to patients and staff.
Understanding the No Surprises Act (HealthLeaders)
The No Surprises Act, represents a significant change in the way out-of-network providers can bill and be reimbursed. Starting January 1, 2022, the legislation prohibits providers from balance billing members under certain conditions.
Enhancing Drug Delivery With Ultrasound – Boosts Treatment of Gastrointestinal Tract Disorders (SciTechDaily)
MIT spinout Suono Bio is advancing a new approach that uses ultrasound to deliver drugs, including nucleic acids like DNA and RNA, to the GI tract more effectively.
Endoscopic management highly successful in treatment of gastric leaks after resection for cancer (Healio)
According to a study published in Therapeutic Advances in Gastroenterology, internal endoscopic drainage should be the first line endoscopic treatment of anastomotic fistulas when possible.
Fallout of the CMS 2022 pay proposal for ASCs: 3 notes (Becker’s ASC Review)
If finalized, the proposed CMS 2022 Hospital Outpatient Payment Prospective System and ASC Payment System rule may have lasting ramifications for ASCs and the healthcare system.
Data Highlight Profound Social And Emotional Impact of IBD (Gastroenterology & Endoscopy News)
A recent survey of over 300 IBD patients found that more than eight in 10 said they have anxiety, and over half said their illness limits their ability to live up to their potential.
USA Today: Telehealth can be lifesaving amid COVID-19, yet as virus rages, insurance companies look to scale back (DHPA)
Most other insurers plan to reduce coverage of the visits in September even though Medicare and Medicaid are likely to cover them far more generously through the end of the year.
High-Fructose Corn Syrup Ups CRC Risk, More Data Suggest (Medscape)
In a study of 33,106 participants who provided dietary intake of high consumption of simple sugar and sugar-sweetened beverages (SSBs) noted increased risks for colorectal adenomas, particularly rectal adenomas.
New gastric intestinal metaplasia diagnosis codes for ICD-10-CM (AGA)
Ten new diagnosis codes for gastric intestinal metaplasia will be available for reporting as of Oct. 1, 2021.
Obesity does not increase risk for serious infection in biologic-treated IBD (Healio)
Obesity was not associated with an increased risk for serious infection among patients with IBD treated with biologics, according to research published in Clinical and Translational Gastroenterology.
Combined Analysis of Risk Factors in NAFLD (Medscape)
A comprehensive study of 57 NAFLD patients concluded BMI had the strongest association with histological fibrosis, but PNPLA3 gene variants, gut bacteria and dietary factors underscore the multifactorial pathogenesis of NAFLD.
Founder and Former Chairman & CEO of Exact Sciences, Joins PAVmed Subsidiary Lucid Diagnostics (Business Wire)
Multitarget FIT yielded better diagnostic accuracy in the detection of advanced adenomas compared with basic FIT, according to research published in Annals of Internal Medicine.
AGA convenes seven groups to call for a unified public health response to NASH epidemic (AGA)
AGA in collaboration with seven professional associations convened an international conference of 32 experts to develop a multidisciplinary action plan to improve care for the growing population of patients with NASH and NAFLD.
Digital Therapeutics And Changing Future Of Healthcare (BW Healthcareworld)
CVS Caremark and Express Scripts with a market share of 53 per cent in the United States now support DTx in health plans. A study revealed, overall, 44 per cent of physicians showed interest in prescribing medical apps for patients.
Top 5 reasons physician finances worsened in 2020 (Becker’s ASC Review)
Forty-six percent of physicians reported their financial state as worse in 2020 than 2019, Medical Economics reported in its 92nd physician report.
Using Artificial Intelligence to Make Use of EHRs Less Painful (JAMA)
In a study with gastroenterology doctors it was noted that AI can be used as a first-pass technology to reduce the workload of a clinician who must wade through voluminous old records.
Treatment Gaps for Patients With Metastatic CRC (OncLive)
Reactions to the increase in prevalence of metastatic colorectal cancer (CRC) among a younger patient population despite treatment advances.
Seres, after earlier success, fails a key test for microbiome drugs (BioPharma Dive)
An experimental drug from Seres Therapeutics failed a Phase 2 study of patients with mild or moderate ulcerative colitis in a setback for an emerging class of medicines known as microbiome therapeutics.
Jonathan Bush, NBA star invest in healthcare price transparency startup (Becker’s Health IT)
Former Athenahealth CEO Jonathan Bush and Golden State Warriors NBA player Klay Thompson recently joined a $5 million investing round for healthcare price transparency startup Turquoise Health.

More Hot headlines in GI
Webinar: Scope Forward – The Future of GI is Now in Your Hands (Sonic Incytes)

ABCs of Colon Cancer by NY’s highly respected GI veteran Dr. Iswara (Pat Brady)

Risks, Prevention of C diff Transmission During Transition (Medscape)

Amwell scoops up two digital health companies for $320M as tech M&A heats up (Fierce Healthcare)

VIDEO: Telemedicine changes face of care for IBD patients (Healio)

PathAI enters into clinical diagnostics through acquisition of Poplar Healthcare Management (PR Newswire)

10 gastroenterologists to know (Becker’s GI & Endoscopy)

Circulating micro-RNA diagnoses NASH in patients with NAFLD (Healio)

Walmart signals continued healthcare expansion in 37 states (Healthcare IT News)

Some IBD Treatments in Pregnancy Had No Effect on Kids’ Infection Risk
(MedPage Today)

Videos: Interviews with GI Leaders  (NextServices)

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COVID-19: The Way Forward for Gastroenterology Practices
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24 Jul 2021

Curated GI articles July 23rd, 2021: 8 recent GI expansions

Curated GI articles July 23rd, 2021:
8 recent GI expansions
What will PE do to GI care? 4 physicians weigh in (Becker’s GI & Endoscopy)
Four gastroenterologists told Becker’s ASC Review how they predict private equity will affect the GI landscape and patient care.
New Insurance Policy Irks Some GIs (Gastroenterology & Endoscopy News)
Patients insured by Empire BlueCross BlueShield will now need preapproval to receive care in a hospital outpatient setting if another facility, such as a freestanding ASC, could be used instead.
AGA publishes clinical practice update on chemoprevention of colorectal neoplasia (Healio)
The American Gastroenterological Association published a clinical practice update to describe the role of medications for the chemoprevention of colorectal neoplasia.
8 recent GI expansions (Becker’s GI & Endoscopy)
GI Alliance expanded to Utah, Colorado and Illinois in the past month. Here are eight recent expansions from gastroenterology practices and groups.
No Surprises Act Passes, Targeting Unexpected Bills (Gastroenterology & Endoscopy News)
The No Surprises Act goes into effect on Jan. 1, 2022. It prohibits out-of-network providers or facilities from balance billing patients in both emergency and nonemergency settings.
More Patients Willing To Switch To Doctors With Better Digital Tools (PYMNTS.com)
Gen Z, millennial and bridge millennial patients willing to change to physicians offering better digital healthcare management tools went from 31 percent in 2020 to 35 percent in 2021.
3 hospitals, health systems taking advantage of AI in gastroenterology (Becker’s GI & Endoscopy)
Becker’s ASC Review reports on three hospitals and health systems exploring artificial intelligence in gastroenterology and endoscopy care so far this year
‘It’s an obvious step backwards’: ASC execs pan CMS’ 2022 proposed pay changes (Becker’s ASC Review)
ASC owners and executives are critical of CMS’ plan to cut procedures from the ASC payable list and add several surgeries back to the inpatient-only list after removing them in January.
Clinical Characteristics and Treatment Response in Microscopic Colitis Based on Age at Diagnosis (Physician’s Weekly)
There are no significant differences in Microscopic Colitis (MC) treatment response based on age or disease subtype. These findings support treating patients with MC based on symptom severity rather than age.
You’re Missing Microbes. But Is ‘Rewilding’ the Way to Get Them Back? (The New York Times)
The science behind the idea of restoring the intestinal microbiome to an ancestral state is shaky, skeptics say, and in some cases unethical.
Building a Better FIT Test for Colon Cancer Screening (Medscape)
An antibody-based multitarget fecal immunochemical test (mtFIT) is more accurate in detecting advanced neoplasia compared with the standard FIT test, without compromising specificity, report Dutch researchers.
Study: Exposure Therapy for Irritable Bowel Syndrome Saves Money (MedPage Today)
At 6 months after treatment, a return-on-investment analysis showed a return of $5.64 for every $1 invested in ICBT with exposure therapy, according to the findings in BMC Gastroenterology.
Microbiome-focused Vedanta expands new fundraise to launch 2 studies (Endpoints News)
The company wrapped up a $68 million Series D raise Wednesday morning, which included the $25 million equity investment Pfizer plunked down back in January.
Fiber Dose Boosts FMT Effects in Clinical Trial (Gastroenterology & Endoscopy News)
Fiber supplementation appeared to modulate the response to fecal microbiota transplantation in patients with severe obesity and metabolic syndrome, researchers have found.
Q&A: Multitarget FIT bests regular FIT in adenoma detection (Healio)
Multitarget FIT yielded better diagnostic accuracy in the detection of advanced adenomas compared with basic FIT, according to research published in Annals of Internal Medicine.
Physicians Turning to Side Gigs for Extra Pay (Medscape)
To gauge the prevalence of side gigs among physicians, Medscape surveyed more than 2500 practicing doctors in the United States about their side gigs ― what they do, what they earn, and what they hope to gain.
GIs should wear ‘internal medicine hats’ to care for IBD across all ages (Healio)
The range of IBD across the ages highlights the importance of wearing our internal medicine hats when caring for these patients.
FDA OKs Odevixibat for Pruritus Associated With Rare Liver Disease (Medscape)
The FDA has approved odevixibat (Bylvay, Albireo Pharma), the first treatment for pruritus associated with all types of progressive familial intrahepatic cholestasis (PFIC).
Effect of a deep learning-based system on the miss rate of gastric neoplasms during upper GI endoscopy (The Lancet)
The use of an AI system during upper gastrointestinal endoscopy significantly reduced the gastric neoplasm miss rate. AI-assisted endoscopy has the potential to improve the yield of gastric neoplasms by endoscopists.
Mary Thomson, MD: The Future of NASH Care (HCPLive)
Thomson, a lead author on TARGET-NASH, recently told HCPLive® that statin use is underutilized in this patient population, largely due to the risks associated with the treatment for additional liver damage.
Low-FODMAP, gluten-free diet improves IBS symptoms (Healio)
Patients with IBS had improved symptom severity and normalized gut microbiota while following a low-FODMAP diet combined with a gluten-free diet.
Metabolic Syndrome Linked to Internal Hemorrhoids in Older Patients (Gastroenterology & Endoscopy News)
Older people with metabolic syndrome appear to be at a significantly greater risk for developing internal hemorrhoids and diverticular complaints, researchers have found.

More Hot headlines in GI
CMaine GI practice adds 5th physician to meet growing demand
(Becker’s GI & Endoscopy)

New-Onset IBD and IL-17 Inhibitors: What Is the Risk? (MedPage Today)

Largo Medical 1st in U.S. to offer new AI for colonoscopies (ABC Action News)

Rectal Diclofenac Likely Comparable to Rectal Indomethacin for Post-ERCP Pancreatitis (Medscape)

WHO Report Targets AI in Health, Cautions Against Health Disparities (HealthITAnalytics)

New Drug Delivery System Promises More-Targeted Delivery of IBD Drugs (Medscape)

Untreated Eosinophilic Esophagitis Is a Progressive Disorder (Gastroenterology & Endoscopy News)

Addressing post-COVID-19 gastrointestinal symptoms (Baylor College of Medicine)

Capital Digestive Care partners with Colliers International and Facility Logix to relocate and expand its clinical laboratory (Daily Journal)

Black patients with liver disease may face obstacles to transplants
(Cornell Chronicle)

Benefits From Moving More, Sitting Less for CRC Survivors (Medscape)

Walmart files to provide healthcare in 37 states as it pushes deeper into telehealth (Becker’s Hospital Review)

Videos: Interviews with GI Leaders  (NextServices)

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COVID-19: The Way Forward for Gastroenterology Practices
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16 Jul 2021

Curated GI articles July 15th, 2021: Gastro Health vs. GI Alliance vs. PE GI Solutions: 7 comparisons to know

Curated GI articles July 15th, 2021:
Gastro Health vs. GI Alliance vs. PE GI Solutions: 7 comparisons to know
Gastro Health vs. GI Alliance vs. PE GI Solutions: 7 comparisons to know (Becker’s GI & Endoscopy)
Private equity-backed Gastro Health, GI Alliance and PE GI Solutions are major players in the gastroenterology industry. Here’s how the companies stack up across seven areas.
How digital pathways are changing healthcare (pharmaphorum)
Digital technologies are proving their value by allowing for better care, improved adherence and a more connected ecosystem between doctors, patients and pharma.
AGA Updates Recs For Refractory H. pylori Infection (Gastroenterology & Endoscopy News)
Patients who fail an initial regimen should receive an empirical trial of an appropriately tailored second regimen instead of going directly to susceptibility testing.
Women in Healthcare Are Paid Far Less Than Men, Study Shows (The Swaddle)
A new study found a “pronounced gender pay gap” in healthcare (includes gastroenterology), indicating the medical field isn’t immune from the disparities in pay across gender prevalent in society.
Private equity-backed GI practices: 6 recent updates (Becker’s GI & Endoscopy)
From securing a $90 million investment to expanding to Colorado, Southlake, Texas-based GI Alliance and Miami-based Gastro Health have had a busy month. Here are six recent updates from private equity-backed GI practices.
Obesity links to increased risk for Crohn’s disease (Healio)
Obesity correlated with an increased risk for older-age onset Crohn’s disease but not ulcerative colitis, according to research published in Clinical Gastroenterology and Hepatology.
PPIs Could Be Bad News for Oral Cancer Therapies (Medscape)
GIs may want to be mindful of prescribing PPIs for patients with cancer because they may adversely affect concomitant oral therapies.
Ryan Ungaro, MD: Managing IBD During COVID-19 (HCP Live)
A trio of clinicians recently came together to present data and expertise on a variety of issues related to inflammatory bowel disease (IBD) treatments.
Geisinger partners with EarlySign for AI algorithms to spot chronic disease (Healthcare IT News)
A multi-year agreement with the machine learning company will start with a tool to identify high-risk GI patients, eventially expanding to other high-burden diseases.
The effectiveness of using an abdominal binder during colonoscopy (Taylor & Francis Online)
In this study, the effectiveness of using an abdominal binder (AB) during colonoscopy on procedure time and colonoscopy outcomes was investigated.
Medicare Proposes Direct Payments to PAs, Telehealth Expansion (Medscape)
Medicare intends next year to allow physician assistants (PAs) to begin directly billing for their work and to expand coverage of telehealth services.
Double trouble: a pandemic of obesity and COVID-19 (The Lancet)
Obesity has emerged as a strong risk factor for severe disease during the COVID-19 pandemic; several studies have shown that individuals with COVID-19 and obesity have an increased risk of severe disease.
CMS aims to end coinsurance when CRC screenings become diagnostic tests by 2030 (Becker’s GI & Endoscopy)
CMS plans to phase out coinsurance for colorectal cancer screenings when physicians identify a polyp for removal, which currently are categorized as diagnostic tests.
COVID-19 in gastroenterology and hepatology: Where will we be? (Wiley Online Library)
The COVID-19 pandemic showed us there is a great potential to optimize our communication with patients and to increase efficacy of triage when faced with limited endoscopy services.
Trial Data May Signal Paradigm Shift In GERD, Esophageal Illnesses (Gastroenterology & Endoscopy News)
Many esophageal diseases, including gastroesophageal reflux, appear to be driven by a dysregulated esophageal microbiome, new research indicates.
Q&A: Addressing the unmet need for equitable health care access (Healio)
Despite representing 13% of the general population, Black physicians are few in the field of gastroenterology and hepatology (> 4%) and accounted for less than 7% of the medical student population.
Latest Multi-Society Reprocessing Guidelines Aim to Follow the Evidence (Gastroenterology & Endoscopy News)
Increased research on reprocessing of endoscopes triggered by infectious outbreaks related to contaminated duodenoscopes since 2014 provided data for the guidelines authors to develop a comprehensive document.
Malnutrition persistent in patients with COVID-19 at 3- and 6-months post-infection (Healio)
3,229 of the hospitalized patients with COVID-19 had GI manifestations and 715 patients had 788 distinct GI manifestations and 3 and/or 6 months outpatient follow up data post-discharge.
Did Getting a Colonoscopy Lead to Cleaner Living? (MedPage Today)
Individuals who underwent endoscopic screenings said they started to live a healthier lifestyle afterwards, especially for those with severe findings, researchers found.
Severe food avoidance, restriction reduces quality of life in IBS (Healio)
Patients with IBS who engaged in severe food avoidance and restriction experienced more severe IBS symptoms and a reduced quality of life, according to study results.
Can Gut Changes Predict Celiac Disease? (Medscape)
Changes in the gut microbiome are present in infants at risk of developing celiac disease (CD) long before they actually develop the disease, a finding that may pave the way for novel treatment and prevention strategies.
Disease Surveillance With Every Flush: Introducing the Smart Toilet (Gastroenterology & Endoscopy News)
Toilets enabled with AI can analyze stool samples for signs of acute or chronic gastrointestinal disease, such as bleeding, infections or even inflammatory bowel disease.
Fecal Transplantation, Boosted by Fiber, Improves Insulin in Obesity (Medscape)
New research shows that a noninvasive approach ― with an oral capsule formulation ― combined with fiber supplementation significantly improved insulin sensitivity among those with severe obesity and metabolic syndrome.
Geneoscopy Enrolls First Patients in CRC-PREVENT U.S. Pivotal Trial (PR Newswire)
Initial clinical study demonstrated high sensitivity of its multifactor RNA-FIT assay compared with colonoscopy findings, demonstrating 95% sensitivity for colorectal cancer and 62% sensitivity for advanced adenomas.
NEC’s AI Supports Doctors to Determine If Colorectal Lesions Are Potentially Neoplastic (Business Wire)
The Cx20 software connects and interacts with existing endoscopic equipment and automatically notifies users if a lesion is possibly neoplastic based on images captured during endoscopy procedures.
Will PPE Practices in Endoscopy Change Permanently After COVID-19? (Gastroenterology & Endoscopy News)
Will endoscopists keep their new habits when it comes to personal protective equipment (PPE) once the COVID-19 pandemic has ended? A survey of Canadian clinicians suggests they will.
Phoenix hospital adds AI-powered colonoscopy system (Becker’s GI & Endoscopy)
The Cancer Treatment Centers of America Phoenix implemented Medtronic’s GI Genius. The artificial intelligence device helps detect polyps during colonoscopies.
FDA advisory committee unanimously agrees donor liver portable system is safe, effective (Healio)
The FDA voted unanimously that a portable system for near-normothermic continuous perfusion of donor livers with perfusate was safe and effective.

More Hot headlines in GI
Coming of age: AI in GI endoscopy, impact on optical diagnosis and training
(ESGE Endoscopy)

Unlocking the ‘gut microbiome’ – and its massive significance to our health
(The Guardian)

UnitedHealth reports $4.3B in profit in Q2, down from massive Q2 2020 haul
(Fierce Healthcare)

Update 2021: COVID-19 from the perspective of gastroenterology (PubMed)

52 Women-Led Startups Driving The Future Of HealthTech And FemTech (Forbes)

[Podcast] To End Burnout, Doctors Must Change the Culture of Medicine (Medscape)

The Most Famous Artist Mints First NFT from Human Fecal Matter to Fund Gut-Brain Research Grant (PR Newswire)

ProciseDx Raises $13M to Commercialize Point-of-Care Platform, GI Tests (GenomeWeb)

[VIDEO] Older IBD patients use more aminosalicylate monotherapy (Healio)

Microsoft taps Teladoc to integrate telehealth into Teams app (Fierce Healthcare)

Managing Fatigue in IBD Patients Is Crucial for Quality of Life (MedPage Today)

CMS announces new director for Center of Medicare (Healthcare Finance)

CrossBridge Health acquires Geisinger-developed PACER software (PR Newswire)

Health systems-backed Truveta closes $95M to fund its data analysis platform
(Fierce Healthcare)

Gut Microbiome Affected by Genetics More Than Once Thought (Genetic Engineering & Biotechnology News)

Should we trust big tech with our health data? (BBC)

FDA: Johnson & Johnson COVID-19 vaccine tied to Guillain-Barré syndrome (Healio)

Dr. Atul Gawande is Biden’s pick for global health position (Becker’s Hospital Review)

Videos: Interviews with GI Leaders  (NextServices)

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09 Jul 2021

Curated GI articles July 8th, 2021: Penfund announces $85 million investment in Gastro Health

Curated GI articles July 8th, 2021:
Penfund announces $85 million investment in Gastro Health
(Webinar) Scope Forward: The Future of GI is Now in Your Hands (Sonic Incytes)
Join Praveen and gastroenterologist Dr. Bradley Sklar to discover insights and practical advice for the industry to thrive, not just survive in the coming decade.
Gastro Health Expands Presence in Ohio (Gastro Health)
Gasto Health has partnered with a group of 17 hospital-based gastroenterologists who will now become part of Gastro Health – Ohio, also known as Ohio GI.
South Suburban Gastroenterology Joins GI Alliance (PR Newswire)
GI Alliance expands in Illinois and the Greater Chicago Area through a partnership with South Suburban Gastroenterology. GI Alliance now represents over 1,000 providers across ten states.
Penfund Announces US$85 million Investment in Gastro Health (GlobeNewswire)
An independent provider of junior capital to North American middle market companies, announced the completion of a second lien debt and equity co-investment in Gastro Health, LLC.
FOMAT Medical Research Partners With Santa Maria Gastroenterology Medical Group (KPVI)
The partnership broadens the reach of medical research across Central California, making hard-to-reach clinical trials readily available for hundreds of thousands of patients.
Lessons Learned on Gastroenterology Future During COVID-19 Pandemic (HCPLive)
A team, led by Fernando Magro, University of Porto, evaluated how the COVID-19 pandemic impacted the quality of health care services for gastroenterology patients.
15 insights on GI net worth, debt & compensation (Becker’s GI & Endoscopy)
Fifty percent of gastroenterologists who took financial hits because of the pandemic expect their income to return to normal in this year.
Twitter Found to Be Key GI Educational Tool (Gastroenterology & Endoscopy News)
Twitter is fast becoming a central way of imparting knowledge in gastroenterology for students and veteran practitioners alike, according to findings from a survey.
Hepatic Steatosis Is Associated with Increased Disease Severity and Liver Injury in COVID-19 (PubMed)
A study indicated hepatic steatosis (HS) was associated with increased disease severity and transaminitis in COVID-19. HS may be relevant in predicting risk of complications related to COVID-19.
Chemotherapy destabilizes gut microbiome in cancer patients (News-Medical.Net)
New research in BMC Cancer has shown myelosuppressive chemotherapy destabilizes gut microbiome in patients with solid organ cancers.
Clostridioides difficile: 2 Sets of Guidelines Disagree (Medscape)
With two sets of recommendations being published within a month of each other, clinicians may find themselves trying to reconcile some of the conflicts between the two guidelines.
Endoscopic sleeve gastroplasty may be safe for managing weight loss in NASH (Healio)
Endoscopic sleeve gastroplasty in patients with nonalcoholic steatohepatitis vs. life-style intervention alone was safe and effective for achieving weight loss correlated with significant improvements.
Minnesota GI company building ASC (Becker’s GI & Endoscopy)
MNGI Digestive Health is building a new clinic and ASC in Vadnais Heights, Minnesota. The project is slated to open in April 2022.
Q&A: LinZess reduces bloating, pain in patients with IBS-C (Healio)
Compared with placebo, LinZess significantly decreased abdominal symptoms such as bloating, discomfort and pain in patients with IBS-C, according to results published in the AJG.
One GI Symptom Stuck Around Months After Severe COVID (MedPage Today)
While most GI symptoms resolved for patients hospitalized with COVID-19, inability to gain weight persisted for months, researchers found in a retrospective study.
Probiotic ‘yeast robots’ may one day treat IBD (Medical News Today)
Researchers have developed a multifunctional “designer” probiotic to treat various facets of IBD. It reduces inflammation, reverses tissue damage, and restores the gut microbiome in a mouse model.
Olympus Supports New Recommendation to Begin Colorectal Cancer Screenings at Age 45 
(PR Newswire)
Olympus announced its support of the new recommendation issued by the United States Preventive Services Task Force to begin colorectal cancer screenings for all individuals beginning at age 45.
Antibiotic Linked to Rise in Early-Onset Colon Cancer? (Medscape)
Exposure to antibiotics appears to be associated with the development of colon cancer, particularly in younger people, and could be contributing to the increase in early onset colorectal cancer (CRC).
Single-use endoscopy: 3 leading physicians weigh in (Becker’s Hospital Review)
Traditionally, health systems have invested in reusable endoscopy equipment, but an industrywide transition toward single-use endoscopes is gaining momentum.
New Jersey Center Implements Innovative Program For Pancreatic Cyst Surveillance (Gastroenterology & Endoscopy News)
Saint Barnabas Medical Center, N.J., has pioneered one of the first cloud-based data management platforms in the nation to identify, track and monitor patients with pancreatic cysts.
Colon Cancer Is Rising in Younger Adults. Do Sugary Drinks Play a Role? (The New York Times)
As consumption of sugar-laden drinks rose in the 1980s and ’90s, so did colorectal cancer rates among younger adults, a study in nurses found.
Study links low UVB light exposure with increased CRC risk (Becker’s GI & Endoscopy)
Areas where people have lower ultraviolet B light exposure often report higher colorectal cancer rates, according to a study published July 5 in BMC Public Health.
FIT after negative colonoscopy may reduce the risk of incident CRC: Study (Medical Dialogues)
Subsequent FIT must be scheduled after negative colonoscopy to detect missed neoplasms, thereby reducing the risk of incidence, of CRC finds a recent study.
3 biggest threats to ASCs (Becker’s ASC Review)
The power of hospital consolidation and recruiting staff continue to threaten ASC profitability in 2021. Here are the three biggest external risks to ASCs.
Progress Made in Characterizing The Microbiome of Patients With SIBO (Gastroenterology & Endoscopy News)
A sophisticated characterization of the small-bowel microbiome could aid the search for treatments for small intestinal bacterial overgrowth (SIBO).
COVID-19 Drives Digital Health Transformation, Health IT Innovation (EHR Intelligence)
COVID-19 has advanced the digital health transformation, bringing executives to drive health IT innovation with urgency for business resilience.

More Hot headlines in GI
Impact of the National Endoscopy Database (NED) on colonoscopy withdrawal time (PubMed)

July Issue of Issue of The American Journal of Gastroenterology Includes Analysis of Psychological Comorbidities and Irritable Bowel Syndrome Prognosis (Newswise)

Exact Sciences schedules second quarter 2021 earnings call (Yahoo Finance)

We’re Going to Need Smaller Scopes (and Lots of Them) (Gastroenterology & Endoscopy News)

What GI companies did in Q2: 19 notes (Becker’s GI & Endoscopy)

Black Patients with Liver Disease May Face Obstacles to Placement on the Liver Transplant Waitlist (Weill Cornell Medicine)

Advances in Nonalcoholic Fatty Liver Disease Unveiled at International Liver Congress (Managed Healthcare Executive)

If You Invested $1000 in Exact Sciences a Decade Ago, This is How Much It’d Be Worth Now (Yahoo Finance)

Novome announces phase 1 trial of GEMM cell therapy (Healio)

Osso VR takes in $27M to train surgeons using simulations (Fierce Healthcare)

Apple’s VP of health says the company works ‘like an orchestra’ (Apple Insider)

VIDEO: Telemedicine shaped future of health care during COVID-19 (Healio)

Saltzer Health names administrator of ASC, GI center (Becker’s ASC Review)

Digital health funding rockets up to $14.7B, speeding past 2020’s investment (Fierce Healthcare)

Hepatitis B does not link to increased risk for liver injury, death in COVID-19 (Healio)

Amazon is trying to persuade Aetna and other health plans to cover its medical-care service (Business Insider)

Videos: Interviews with GI Leaders  (NextServices)

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COVID-19: The Way Forward for Gastroenterology Practices
COVID-19 is a double whammy of both clinical and business disruption. This ebook will help you explore possible scenarios and be a guide in your plans for the future.
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