The Biologic Bottleneck in Gastroenterology Practices—and Why It’s Getting Worse

Biologic therapies have transformed the treatment landscape for inflammatory bowel disease (IBD), Crohn’s disease, ulcerative colitis, and other complex gastrointestinal conditions. These therapies offer targeted, disease-modifying benefits that improve remission rates and quality of life.

Yet for many gastroenterology practices, the rapid growth in biologic utilization has created a new reality: operational bottlenecks that strain staff, slow access to care, and limit a practice’s ability to scale.

What was once a manageable service line has evolved into a high-impact, strategic growth opportunity that benefits from modern, scalable operational support.

What to Know

• Biologic utilization in gastroenterology continues to rise, increasing pressure on in-office infusion and injection workflows.
• Common bottlenecks include limited infusion capacity, staffing shortages, and payer authorization delays.
• These constraints impact patient access, continuity of care, and practice revenue.
• Scalable, in-office biologic support models can help practices expand capacity without overwhelming internal teams.

Why the Biologic Bottleneck Is Accelerating

Multiple factors are converging to accelerate biologic-related operational pressure across gastroenterology practices.

1. Growing Dependence on Biologic Therapies

Biologics are now the standard of care for many moderate-to-severe GI conditions. As earlier use becomes more common and patients remain on therapy longer, overall treatment volume continues to rise.

For practices, this means:

• More patients requiring induction and maintenance dosing
• Higher frequency of infusions or injections
• Greater administrative and clinical workload tied to each patient

Traditional staffing and infrastructure models were not designed for this level of sustained biologic volume.

2. Limited Infusion and Treatment Capacity

Many gastroenterology practices operate with:

• A small number of infusion chairs
• Shared clinical space
• Restricted scheduling windows for biologic administration

When chair availability is maxed out, practices face difficult choices:

• Delay treatment starts
• Refer patients externally
• Limit new biologic initiations

All three options can negatively affect patient experience and continuity of care.

3. Staffing Strain and Burnout

Biologic administration is labor-intensive. It requires:

• Trained infusion nurses or medical assistants
• Ongoing patient monitoring
• Documentation and coordination with providers

At the same time, healthcare staffing shortages persist nationwide. Practices often ask existing staff to absorb additional responsibilities, leading to:

• Overtime and burnout
• Increased turnover
• Inconsistent coverage

Staffing instability further compounds scheduling and capacity challenges.

4. Authorization and Reimbursement Delays

Payer requirements for biologics are increasingly complex. Prior authorizations, step-therapy documentation, and benefit verification can take days or weeks, resulting in treatment start delays and administrative overload.

Even when clinical capacity exists, administrative friction alone can create a bottleneck.

The Downstream Impact

When gastroenterology practices cannot accommodate the rising volume of biologics, the downstream effects are significant.

Patients experience longer wait times, referrals to external infusion centers, and gaps in therapy; barriers that can worsen disease control and increase flare risk. At the same time, delays in initiation and maintenance dosing undermine optimal clinical outcomes.

For practices, each delayed or referred-out case translates into lost medical benefit revenue, underutilized in-house services, and missed opportunities to strengthen long-term patient relationships, ultimately limiting operational efficiency and scalable growth.

Why Traditional Fixes Fall Short

Common attempts to solve the bottleneck include:

• Adding chairs
• Hiring more staff
• Extending hours

While helpful, these approaches require significant capital, long lead times, and ongoing management. For many practices, they are not sustainable solutions.

What’s needed is a smarter operational model, not simply more internal burden.

Rethinking Biologic Administration with Altus Biologics

Altus Biologics partners with gastroenterology practices to help modernize and scale in-office biologic administration without overwhelming existing teams.

Rather than forcing practices to build everything internally, Altus provides structured, scalable support that directly addresses the core bottlenecks.

How Altus Biologics Helps

Expanded In-Office Capacity

Altus helps practices establish or optimize biologic administration workflows that increase treatment throughput without requiring major facility expansion.

Clinical Staffing Support

Dedicated, trained personnel assist with biologic administration, patient monitoring, and workflow execution, reducing pressure on internal staff.

Authorization and Access Coordination

Altus supports benefit verification and authorization processes to help minimize delays and improve time-to-treatment.

Operational Standardization

Practices benefit from consistent protocols, documentation workflows, and scheduling structures that reduce variability and inefficiency.

Scalable Growth Model

As biologic volume increases, practices can expand capacity incrementally rather than through disruptive, high-risk investments.

From Bottleneck to Competitive Advantage

The biologic bottleneck in gastroenterology is not a temporary surge; it is a structural shift driven by modern standards of care. Practices that rely solely on legacy operational models will continue to feel increasing strain.

By rethinking how biologic therapies are delivered and leveraging scalable in-office support, gastroenterology practices can turn a growing challenge into a sustainable growth opportunity.

Altus Biologics exists to make that transition possible.

Frequently Asked Questions

Why are biologic bottlenecks worse now than in the past?

Because more patients are starting biologics earlier, staying on therapy longer, and requiring ongoing maintenance dosing, dramatically increasing volume.

Does Altus Biologics replace the practice’s clinical team?

No. Altus supplements and supports existing teams, helping them operate more efficiently and at higher capacity.

Is Altus Biologics only for large practices?

No. Both independent and multi-site gastroenterology practices can benefit from our scalable support.

How quickly can practices experience operational improvements with Altus Biologics?

Many practices experience improvements in scheduling efficiency, staffing relief, and time-to-treatment within the first few months.