Becker's ASC Review

24 GASTROENTEROLOGY 5 GI companies growing their ASC footprint in 2025 By Sophie Eydis G astroenterology is increasingly shiing to the outpatient setting, with physician groups and private equity platforms building large networks of ambulatory surgery centers. In 2025, a handful of GI organizations stand out for their growing ASC portfolios. Here are five GI companies to know, by ASC footprint, this year: 1. U.S. Digestive Health: Exton, Pa.-based U.S. Digestive Health, acquired by Optum's SCA Health in early 2025, operates one of the largest GI ASC portfolios in the country. e platform includes 24 ASCs, 40 practice sites and more than 250 providers across Pennsylvania and surrounding states. e Optum acquisition was among the biggest GI transactions of the year and positioned USDH as a key player in ASC-based digestive care. 2. GI Alliance: GI Alliance, based in Southlake, Texas, remains the largest GI platform in the U.S., with more than 1,000 physicians across more than 400 sites in 20 states. Its ASC footprint includes dozens of centers nationally, supported by strategic partnerships and acquisitions. Backed by Apollo Hybrid Value Fund, GI Alliance received a major boost in late 2024 when Cardinal Health acquired a $2.8 billion majority stake, giving it additional scale and resources to expand its ASC presence. 3. Gastro Health: Miami-based Gastro Health operates over 150 locations and more than 400 physicians, with a strong ASC and endoscopy center presence in Florida, Ohio and Virginia. e group, backed by Omers Private Equity, has made ASC expansion central to its growth model, emphasizing joint ventures and de novo development in competitive urban and suburban markets. 4. United Digestive: United Digestive, headquartered in Atlanta, manages more than 80 practice locations with 129 physicians across the southeast U.S. Its model is heavily ASC-focused, with a growing network of GI surgery centers developed through partnerships and acquisitions. e group, backed by Kohlberg & Co., has leaned on ASC joint ventures to expand its reach in Georgia and beyond. 5. Allied Digestive Health: Based in West Long Branch, N.J., Allied Digestive Health includes more than 200 providers across dozens of sites in New Jersey. e group was formed in 2015 by the merger of five practices and is backed by Assured Healthcare Partners. Its ASC footprint in New Jersey has steadily expanded, with affiliated endoscopy centers serving as the backbone of its regional care model. Together, these organizations operate dozens of GI ASCs nationwide, reflecting the specialty's shi toward lower-cost, outpatient settings — and signaling that ASC growth remains central to GI consolidation in 2025. n The state of private equity in GI in 2025 By Sophie Eydis P rivate equity's role in gastroenterology is shifting in 2025. While overall deal volume has slowed, acquisitions are getting larger, more strategic and increasingly subject to regulatory scrutiny. Here are 10 things to know so far this year: 1. GI PE deal volume nearly halved year over year, dropping from 26 in 2022 to 13 in 2023 – a slowdown that has carried into 2025 with fewer but larger transactions. 2. Three major platforms — GI Alliance, Gastro Health and United Digestive — continue to dominate PE deal activity in 2025. 3. Optum's SCA Health expanded in early 2025 with the acquisition of U.S. Digestive Health, a platform of more than 250 providers, 40 sites and 24 ASCs 4. About 1 in 10 gastroenterologists in the U.S. now practices within a private equity-backed group. 5. Over the past decade, the number of GI practices with three to nine physicians has declined 41%, a consolidation trend accelerated by PE-backed platforms in 2025. 6. In contrast, large practices with 500 or more physicians have increased 66%, signaling a rise of mega-groups often aligned with PE. 7. One PE-backed GI group quadrupled its physician count and expanded into six states within two years of acquisition by Webster Equity Partners. 8. Cardinal Health entered GI in late 2024 with a $2.8 billion majority stake acquisition in GI Alliance, a deal shaping the 2025 market by signaling new corporate entrants into the specialty. 9. Reimbursement for colonoscopy with biopsy has declined nearly 40% over the past 15 years, leaving many independent GI groups financially vulnerable to PE partnerships in 2025. 10. Lawmakers in Oregon and Pennsylvania advanced oversight efforts in 2025, with Oregon signing a strict healthcare PE bill into law and Pennsylvania's House passing legislation to expand review of medical practice acquisitions. n

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