Beyond Zero-Sum: A Practical GI Model Where Patients, Practices, and Payers All Win

In gastroenterology, everyone’s stretched thin. Patients wait months. Providers scramble. Payers see costs rise. Traditional approaches to fixing this, like shifting risk or enforcing narrow networks, often just move the problem around.

What if there was a better way?

We recently completed a study with a leading community GI group in Washington state to test a practical, scalable model for on-demand specialty care. The early results point to a new direction. This is not just virtual care. It's value-creating care.

The Problem

Digestive disorders lead to over 62 million emergency department visits annually in the U.S., with more than $37 billion in costs. Shortages in gastroenterology and growing demand leave many patients with few good options, defaulting to urgent care or the ED.

The Model

Our pilot involved a fully integrated GI telehealth solution.

• Staffed by GI-trained advanced practice providers
• Supervised by board-certified gastroenterologists
• Embedded within an existing community GI practice
• Accessed via the practice website, triage system, or call center

This wasn’t a bolt-on telehealth tool. It was part of the day-to-day care infrastructure.

The Results

Study period: January to September 2024
Location: Washington

Sample: 1,956 patients across 2,186 encounters

Fast, Appropriate Access

• Median wait time: 16.3 minutes
• Average visit length: 21 minutes
  96.2 percent of reviewed visits were appropriate for telehealth
  

Clinical Action

• 70.2 percent of visits resulted in diagnostic orders
  
  • Endoscopy: 38.1 percent
  • Labs: 36.4 percent
  • Imaging: 16.9 percent
    
    
• 90.1 percent of new patients received diagnostic orders
  
  • Endoscopy: 64.9 percent
    

Patient Behavior Shift

• Without the platform, 41.2 percent of patients said they would have gone to the ED (25.6 percent) or urgent care (29.5 percent)
• Actual acute referrals: 0.7 percent to ED, none to UC

Retention Through Access

• Net Promoter Score: 91 overall, 93 among established patients
• 26.5 percent of all patients, and 42.3 percent of new patients, would have gone to another GI practice if on-demand access wasn’t available

Downstream Savings

If just 10 percent of these visits avoided an ED trip (average cost: $2,909), the modeled savings exceeds $635,000. That does not include downstream care efficiencies or revenue from diagnostics and procedures.

Why It Matters

This model isn’t about checking a virtual care box. It gives patients the timely access they want, helps practices retain and convert demand, and relieves pressure on clinical teams. Everyone benefits. It’s not value-based care. It’s value-building care.

Read the full study
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