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18 GASTROENTEROLOGY The GI trends shaping 2024 By Amelia Ickes F rom private equity's growing presence in the specialty to changes in the use of anesthesia, here are three trends shaping the gastroenterology field in 2024. Changes in anesthesia Beginning Jan. 1, Blue Cross Blue Shield Massachusetts stopped its coverage of monitored anesthesia for certain gastrointestinal patients undergoing endoscopic, bronchoscopic or interventional pain procedures. e insurer no longer considers monitored anesthesia "medically necessary" through this new policy except for cases wherein a patient receives documentation that specific risk factors or significant medical conditions are present from the operating physician or anesthesiologist/certified registered nurse anesthetist. Meanwhile, the shortage of anesthesiologists continues to affect the ASC and GI industries, with the Association of American Medical Colleges predicting a shortage of 12,500 anesthesiologists by 2033. Compensation updates Gastroenterologists were among the highest paid physician specialties in 2023, coming in at No. 11 in Doximity's "2023 Physician Compensation Report." e specialty earned an average annual salary of $496,667, while the highest paid specialty — neurosurgery — earned $788,313 on average each year. Additionally, a 2024 Stark law compensation update has made it so that ASCs, physician groups and hospitals can provide non- monetary compensation to physicians up to an amount of $507 throughout the calendar year. Rise of private equity Private equity firms' interest in gastroenterology practices across the country has continued to grow over the last few years, with the number of private equity- backed gastrointestinal groups increasing by 28% to 68 in 2021. Meanwhile, independent gastroenterologists are turning to private equity firms to stabilize their finances as the industry continues to consolidate — a trend which was further exacerbated by the COVID-19 pandemic. n Private practice gastroenterologists earn big compared to employed counterparts By Patsy Newitt G astroenterologists working at physician-owned entities outearn their hospital and management service counterparts, according to Healthcare Appraisers' 2023 GI "Industry Outlook" report, published in September. Here are four more notes: 1. Median compensation for gastroenterologists working at hospital-owned groups or MSOs increased 4% from 2018 to 2023, while the figure for physician- owned groups increased 15%. 2. Hospital-owned group compensation declined from 2018 to 2023 at both the 75th and 90th percentile. 3. Median compensation for all gastroenterologists increased 9% during that period. 4. The report noted that physicians take pay reductions during MSO transactions, and the increase in those transactions in the last five years could be driving the compensation decline. n Image Credit: Adobe Stock