1. Innovations in patient experience
To increase their effectiveness and improve patient experience surrounding colonoscopy preparation, some practices have turned to new staffing models to provide a more hands-on approach.
“We have increased the number of nursing navigators helping patients who are directly scheduled for colonoscopies by their primary care physician. Nursing navigators are important to help patients with their prep, to answer questions and to standardize preoperative care. The goal is to improve prep quality, to help patients on anticoagulation — coordinating with PCPs and subspecialists — and to prepare patients who might be on GLP-1 agonists for weight loss with careful instructions about when to hold their medication,” Benjamin Levy, MD, a gastroenterologist at the University of Chicago Medicine, told Becker’s.
“The nursing navigators are a fantastic resource for patients,” he continued. “We are excited to expedite endoscopies that are ordered directly by primary care physicians and want to make patient experiences with the prep as wonderful as possible. Nursing navigators can identify any barriers to care, such as transportation. Nursing navigators have the potential to improve patient satisfaction and to reduce no-shows [or] cancellations at ASCs and hospitals.”
2. Developing technologies
Gastroenterology has seen a number of technological advances in the last year that could greatly enhance the precision of future colonoscopies.
“In 2025, we will see a dramatic expansion of intestinal ultrasound use for [inflammatory bowel disease] patients so that we can monitor disease activity in-clinic,” Dr. Levy said. “Intestinal ultrasound does not require fasting or a bowel prep. This will allow gastroenterologists to determine response to biologic therapies in-clinic, even before a colonoscopy is performed.”
AI may also be a key technology that gastroenterologists leverage for colonoscopies in the near future.
“2025 will be an important year for the rollout of artificial intelligence in gastroenterology, including AI-assisted endoscopic tools to help us identify polyps during gastroenterology procedures,” Dr. Levy said. “Increasingly, gastroenterologists will use AI dictation software in clinic, which will help improve the accuracy of notes, decrease the amount of time we spend typing, lower the potential for repetitive stress wrist/hand injuries for endoscopists and hopefully allow gastroenterologists to increase the number of patients we can see in clinic each day.”
3. Reimbursement challenges
According to a study led by Eric Shah, MD, at the University of Michigan in Ann Arbor, only 17% of patients pay nothing out-of-pocket for colonoscopies. Many leaders are concerned about how that could affect screening volumes.
High deductibles and out-of-pocket expenses, averaging $1,400 in 2024, can delay payments, according to a recent blog post from revenue-cycle management firm Sun Knowledge. Proactive patient communication about financial responsibilities improves collections and trust.
GI procedures require precise CPT codes. In 2025, CMS introduced 270 new codes, including updates for colonoscopies. Ongoing staff training and regular audits are key to maintaining accuracy and reimbursement, according to the post.
4. Legislation
In August, Illinois Gov. J.B. Pritzker signed new legislation mandating insurance coverage for all colonoscopies for patients who present symptoms of colon cancer or have a preexisting colon condition.
Manish Bhuva, MD, a gastroenterologist at Chicago-based GI Partners of Illinois, told Becker’s that the law could be a step in the right direction toward eliminating the financial barriers patients may face to getting a colonoscopy, but its true impact remains to be seen.
“I think it will definitely help. Any law that decreases patient costs will encourage people to get screened and follow up for symptoms or any prior colon history,” Dr. Bhuva said.”The law definitely reduces financial barriers, but we’ll have to see how it really affects underinsured or especially uninsured patients. With the upcoming Medicaid cuts being proposed, many of these patients may be sent to hospital outpatient departments and kept away from ASCs, since margins are already so thin with Medicaid patients.”
5. A need to increase screenings
While there are many promising developments surrounding colonoscopies in 2025, gastroenterologists still aim to increase the number of people who receive proper screenings as CRC rates continue to climb in the U.S. population.
“In addition, we hope to increase the percentage of patients nationally being screened for colorectal cancer,” Dr. Levy said. “We have many screening options today, including colonoscopies, which can prevent colorectal cancer by removing polyps, [fecal immunochemical test], Cologuard and the new Shield blood test, which received FDA approval in 2024. It’s important for us to continue educating patients to begin colorectal screening at age 45 due to the increasing number of early-onset colorectal cancers being diagnosed.”
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