Virtual Gastrointestinal Care Solutions

Gastrointestinal (GI) conditions impact one in five adults in the United States, causing a range of symptoms that negatively impact patients’ physical and mental health, quality of life, and productivity. These disorders account for $112 billion in total healthcare spending per year—driven by diagnostic imaging, scoping, specialty medications, emergency department visits, and hospitalizations.

For many patients with GI conditions, access to recommended, multidisciplinary care is limited. Gastroenterologists have the third longest wait times for specialists in the United States, and nearly all multidisciplinary programs are located within academic medical centers.

Virtual GI solutions aim to provide expanded access to multidisciplinary GI care, with the goals of both improving symptom control and quality of life and reducing the total cost of care. Virtual solutions include:

• Wraparound solutions complement patients’ existing GI treatment by offering them a virtual program that includes support services as well as engagement with coaches, dietitians, and mental health providers. These solutions generally operate independently of patients’ GI specialists, primary care providers, or other clinicians.
• Clinician-led solutions are designed to offer comprehensive GI care that includes gastroenterologists and other clinicians integrated with a suite of support services, to deliver a virtual multidisciplinary care model. These solutions rely on clinical teams to develop and modify treatment plans—including prescribing and adjusting medications—and directly oversee nutrition, behavioral health, and other support services.

Report contributors and reviewers provided important expertise and insight throughout our process. Those who directly contributed to the report have no relevant conflicts of interest to disclose.​

PHTI’s assessment found that virtual GI solutions improve clinical and economic outcomes for patients with IBS and IBD.

Wraparound solutions deliver clinically meaningful improvements in symptoms and quality of life for patients with IBS. However, the limited available evidence examining wraparound solutions for patients with IBD shows no clinical benefit over usual care. Wraparound solutions substantially decrease net healthcare spending for patients with IBS and result in greater per user savings than clinician-led solutions for IBS.

Clinician-led solutions appear to deliver comparable clinical outcomes to in-person multidisciplinary care for patients with IBD, including improved quality of life, based on the limited evidence available. These solutions also offer support services, like gut-brain hypnotherapy and nutrition counseling, which achieve clinically meaningful improvements for patients with IBS that are on par with those achieved by wraparound solutions. Despite having a higher price, clinician-led solutions may also reduce utilization for patients with IBS and IBD, resulting in lower net healthcare spending. The potential for savings is greatest when these solutions are targeted to patients with moderate-to-severe IBD, as well as those with IBS.

• Strengthen evidence generation to clarify where virtual GI solutions deliver the greatest value, including comparative studies that assess durability of impact, effectiveness across disease stages, and performance among diverse and underserved patient populations.
• Generate evidence on the durability of outcomes and the role of patient adherence, including longer-term follow-up to assess sustained clinical improvement and the relationship between engagement, treatment duration, and long-term economic impact.
• Leverage virtual GI solutions to expand access to specialty care, particularly in regions with limited gastroenterology capacity, while pairing access expansion with targeted outreach and enrollment strategies to ensure that solutions reach the patients most likely to benefit.
• Align payment models with sustained clinical and economic outcomes, prioritizing validated clinical measures, durability of benefit, and reductions in avoidable utilization over short-term engagement or enrollment-based metrics.