Looking to 2026, Gastro Health Chief Medical Officer Eugenio Hernandez, MD, is most concerned about how federal payment changes, coverage shifts and physician recruitment costs will squeeze margins, particularly the passage of the One Big Beautiful Bill Act.
Editor’s note: This interview was edited lightly for clarity and length.
Question: Looking ahead to 2026, what margin pressures are concerning you the most, and what are you relying on to protect sustainability?
Dr. Eugenio Hernandez: I think the biggest one is going to be the One Big, Beautiful Bill Act — what it does in terms of [relative value units] and RVU calculations for procedure lists like ours. I think that’s going to be a potential concern.
Medicaid coverage is another factor. Our practice isn’t dependent on Medicaid — we have very little Medicaid as part of our business, but there is some. So I’m watching what’s going to happen there, and the uncertainty around the exchange plans and the Affordable Care Act — what changes are going to occur, how many people are going to become uninsured or underinsured. That’s less patient volume that we will see.
In terms of labor costs, I think those have stabilized. The big changes that we saw post-COVID, I think the market is starting to stabilize in that regard. So we’re seeing less of that.
We’ve done pretty well in terms of costs. I think we leverage the folks that we have, and we’re very technology-driven, so we’ve been able to use that to our advantage with costs.
The other thing that is impacting margin is physician cost. As there are fewer physicians available in the recruiting pool, there’s more competition, which means the cost of recruiting has gone up for all of us, as we run in competition with hospital systems and other groups.
So I think those are going to be the main drivers for 2026: labor — labor costs, more on the physician side — and still some uncertainties regarding the government and what we’re going to see in that regard.
Q: How are you preparing for the cuts in the One Big, Beautiful Bill Act, and what’s your strategy there?
WH: We’re already baking in an assumed Medicare cut into our budget. So we’re already building that in.
And then I think the main thing that we’re looking at for 2026 — the big buzzword for us, or buzz words — is “patient access.” We’re really trying to see how we can maximize access for our patients.
That doesn’t mean telling our physicians that they need to see more patients. It’s about really making it easier for patients to access appointments. I can only speak to the seven states that we’re in, but I would venture to say that, probably universally, it’s hard for patients to get appointments with gastroenterologists, especially in larger cities and municipalities, just because of the demand.
So what we’re trying to do is really leverage our AI capabilities, and also our APPs, to practice at the top of their license. Patient access is the big one for us, because that really drives our ability to sustain our financial model and compensation for our doctors and, most specifically, to serve our patients.
So that’s our big strategy for ’26 — patient access.
