February 28, 2025 • 15 mins
In this episode of the MGMA Week in Review podcast, hosts Daniel Williams and Colleen Luckett discuss key healthcare topics, including AI-driven insurance denials, financial strategies for physicians, automation in insurance verification, the importance of employee handbooks, physician productivity trends, and provider compensation insights.
Episode Breakdown
00:00 Introduction and Greetings
01:10 AI in Healthcare: Concerns and Impacts (Chief Healthcare Executive)
03:10 Smart Tax Strategies for Physicians (Medical Economics)
06:42 Automation in Insurance Verification (MedCity News)
08:46 Creating an Effective Employee Handbook (Physicians Practice)
11:22 MGMA Stat Poll: Productivity Insights (MGMA Stat)
14:16 Conclusion and Wrap-Up
Additional Resources Mentioned
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Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Daniel Williams (00:52):
Well, hi, everyone. Daniel Williams here,
senior editor at MGMA and one ofthe cohost here of the MGMA Week
in Review podcast. We're backagain this week along with, co
host Colleen Luckett, who's aneditor and writer at MGMA.
Colleen, hello. What's going on?
Colleen Luckett (01:14):
Hey, everyone. Oh, it's been a busy week for us
this week, but, hey, the sun isshining again this week. I
noticed well, it was. And thenFor a minute. Now it looks it
looks cloudy again, but, but,yeah, it's been nice weather
this week.
Daniel Williams (01:29):
Waiting for wonderful. This far.
Colleen Luckett (01:30):
Yeah.
Daniel Williams (01:31):
I think I mentioned last week that I am
we're recording a little bitearly y'all. So if any of the
news changes that we share withyou right now, it's because
we're recording on Wednesday. Iam leaving for San Diego
tomorrow, and I'll be there forI know. I'll be there four days,
but enough about that. Let's doit get on with the news.
(01:54):
What what's going on? What yougot?
Colleen Luckett (01:56):
Well, AI and health care is the one we got up
first. So, yeah, it's, it'sgreat for reading X rays, not so
great for reading the room,apparently. Turns out when
doctors say they want AI tostreamline care, they don't mean
streamlining denials of care.And that's the growing concern
among physicians according to anew article from chief health
(02:19):
care executives. It waspublished on February 26 written
by Ron Southwick.
The article titled most doctorsfear insurers using AI to deny
coverage highlights a recentAmerican Medical Association
survey showing that three infive doctors or 61% fear that
insurance companies are using AInot to improve care, but to
(02:41):
increase denials of preapprovalor treatment. AMA president
doctor Bruce a Scott saysinsurers are leveraging AI to
automatically reject claims inbold, often without proper human
review. He warrants that medicaldecisions should be made by
doctors and patients, not byunregulated AI systems. Seems
reasonable. Physicians have longbeen frustrated with prior
(03:04):
authorization, of course, and AIis only making things worse.
According to the AMA survey,more than ninety percent of
doctors say prior authorizationdelays care, while twenty nine
percent report serious adverseevents, and twenty three percent
say these delays have led topatient hospitalizations. And
while doctors aren't entirelyopposed to AI, two thirds say
(03:26):
they already use it in someform, 49% want more oversight on
how insurers are applying it inpreapprovals. Hospitals are also
reporting an uptick in wrongfulclaim denials directly linked to
AI driven decision making. Thebottom line is this. Physicians
say AI is turning priorauthorization into an even
bigger headache contributing toburnout and delaying patient
(03:49):
care.
And as always, we'll drop thelink to this article on the show
notes, so check that out formore information. Okay, Daniel.
Over to you.
Daniel Williams (03:57):
Alright. Let's talk money, specifically smart
tax moves for physicians. Thisweek, medical economics
published an article titled fivetax strategies to help
physicians achieve financialindependence. This was written
by Gretchen Clyburn, who is aCFP, and this article is packed
(04:18):
with solid advice for doctorslooking to keep more of their
hard earned income. Clyburnbreaks down some savvy
strategies that can make a bigdifference when it comes to
financial independence.
First up, Roth IRAs. A lot ofphysicians think they make too
much money to contribute, butClyburn points out a workaround,
(04:39):
the backdoor Roth IRA. Here'show it works. You contribute to
a traditional IRA, which doesn'thave income limits, then convert
it to a Roth IRA. If done right,you might not even owe taxes on
the conversion.
It's a great way to build taxfree income for retirement, but
the key is making sure you don'thave existing pretax IRA
(05:04):
balances that could complicatethings. Then there's real estate
investing, but with a twist. Ifyour spouse qualifies as a real
estate professional under IRSrules, it could open up some
serious tax advantages.Basically, this allows you to
use rental property losses tooffset your active income like
(05:26):
your salary. But fair warning,the IRS has strict requirements
for this, so you'll wanna workwith a tax pro to make sure
you're playing by the rules.
Then there's charitable giving.It also gets a smart tax
strategy update. Instead ofwriting checks, Clyburn suggests
donating appreciated stock to adonor advised fund. This lets
(05:50):
you avoid capital gains, taxes,and get a deduction for the full
market value of the stock. Andif you're 70 or older, another
option is making qualifiedcharitable distributions
directly from your IRA, meaningyou donate pretax dollars and
lower your taxable income.
(06:11):
Another great tool, healthsavings accounts or HSAs.
Clyburn calls them a triplethreat because contributions are
tax deductible, the money growstax free, and withdrawals for
medical expenses aren't taxedeither. Her advice, treat it
like an investment, not just aspending account. Let it grow
(06:32):
for retirement instead of usingit for small medical expenses
now. Finally, there's tax lossharvesting, a strategy that's
all about playing smart withyour investments.
If you sell a stock at a loss,you can use that loss to offset
other taxable gains, loweringyour tax bill in the process.
(06:53):
Just be careful of the wash salerule, which prevents you from
repurchasing the same investmentwithin thirty days if you wanna
claim the tax benefit. Bottomline, these strategies aren't
just about saving on taxes now.They're about setting yourself
up for long term financialindependence. As Clyburn puts
(07:13):
it, the key is to have a planthat aligns with your financial
goals.
So talk to a tax pro, takeadvantage of these strategies,
and make your money work foryou. What do you have there?
Colleen Luckett (07:28):
Alright. So my last segment was all about how
insurers are using AI to put upmore roadblocks, but what an AI
and automation could actuallyremove barriers in this, area
instead of create them? Well,that's exactly what an article
from Med City News published onFebruary 25 by Gary Hamilton
explores. This one is titledautomating insurance
(07:50):
verification, a game changer forprevisit payment collection, and
it highlights how automatinginsurance verification is
streamlining previsit paymentcollection, cutting down on
administrative headaches forstaff while improving financial
transparency for patients. Foryears, manual insurance
verification has been a majorbottleneck in health care.
(08:10):
It's slow, prone to errors, anda leading cause of claim denials
and unexpected patient bills. Infact, a survey by Experian found
that three out of four providershave seen an increase in claim
denials with 45% linked tomissing or inaccurate intake
data, issues that manualprocesses struggle to fix. The
solution, automated eligibilityverification tools. By running
(08:33):
real time insurance checksbefore a patient even steps into
the office, these sit down thesesystems provide accurate cost
estimates upfront, helpingpractices collect payments
earlier and reduceadministrative burden. They also
flag missing or incorrectinformation immediately so staff
can fix problems in real time,often with built in two way
texting features for quickpatient updates.
(08:56):
Beyond the operational benefits,automation also improves patient
and staff satisfaction. Patientsget fewer surprise bills while
staff spend less time chasingpayments and fixing errors. With
a smoother check-in process andless friction over billing,
practices can focus ondelivering better patient care
rather than battling insurancered tape. So while AI might be a
(09:19):
problem in some areas of healthcare, this is one case where
automation is actually workingin provider's favor. It's a
reminder that, you know,technology isn't inherently good
or bad.
It's all about how we use it.Okay, Daniel. Back to you.
Daniel Williams (09:33):
Alright. So let's talk about something every
medical practice needs, butoften puts off an employee
handbook. So physician'spractice recently published an
article titled, how to write anemployee handbook for practice
staff. And it's really got somegreat tips on why this document
is essential and how to get itright. A solid handbook isn't
(09:57):
just a stack of rules.
It's a way to set expectations,protect your practice legally,
and keep things runningsmoothly. First things first,
your handbook is not a contract.This is a big one. The article
stresses that you need to makeit crystal clear that your
handbook does not create abinding agreement. Most
(10:18):
practices are at will employers,meaning either you or your
employees can end the workingrelationship at any time.
To avoid any confusion, youshould include a big bold
disclaimer right up front thatsays just that. Another key
takeaway, keep it up to date.Laws change, policies shift, and
(10:41):
you don't want an outdatedhandbook causing problems. The
article recommends reviewing andrevising it at least once a year
to stay compliant with federaland state regulations. Plus,
updating your staff on newpolicies make sure everyone's on
the same page.
Now what exactly goes in thehandbook? The article suggests
(11:05):
covering the basics, attendanceexpectations, vacation policies,
sick leave, confidentialityagreements, and anything else
that defines workplace behavior.Think of it as the ultimate FAQ
for your staff. The more detailsyou include, the fewer
misunderstandings you'll havedown the road. One thing that
(11:27):
really stood out, get legalizeon it.
The article recommends having anattorney review your handbook to
make sure you're in line withemployment laws. It's a simple
step that can save you somemajor headaches later. At the
end of the day, a well craftedemployee handbook is your
playbook for running a smooth,professional, and legally
(11:50):
protected practice. If youhaven't updated yours in a while
or don't have one at all, I hopethat's not the case. Now is the
time to get started.
So, Colleen, yeah, let's take alook at that employee handbook
next week.
Colleen Luckett (12:05):
Yeah. Time time to update, I see. Alright. Well,
for our I'm gonna leave everyonewith some good news. According
to this week's NGMA sub poll,most medical practices still
managed to hit theirproductivity goals in 2024.
Hooray. So, our poll this weekfound that 69% of medical group
(12:26):
leaders reported theirphysicians and advanced practice
providers or APPs either met orexceeded productivity goals in
2024. So met was 45% of you saidthat, and exceeded was 24%. And
this is despite ongoing staffingshortages and patient access
challenges. However, 30% ofpractices did fall short of
(12:47):
expectations, citing, of course,the usual suspects, burnout,
administrative burdens, andstaffing gaps as the key
hurdles.
This poll included 218 responsesfrom our medical group leaders.
So what drove productivity in2024? So practices that exceeded
goals credited betterscheduling, expanded staffing,
(13:08):
and strategic use technologylike AI, virtual scribes, and
telehealth. High patient demandalso played a role, but leaders
acknowledged the need to balanceefficiency with staff well-being
to avoid burnout. And practicesthat met goals saw success
through stable staffing,selective AIUs, and schedule
refinements rather than majorworkflow overhauls.
(13:30):
Expanding specialty services andchronic care programs also
helped boost revenue andsustained financial performance.
And those practices that fellshort struggled with staffing
shortages, provider attrition,and insurance related
disruptions. Some faced higherpatient resistance to seeing
APPs, while others noted thatwork life life balance
(13:50):
initiatives, while beneficial,led to fewer available pry
provider hours. So the keytakeaway is medical group
productivity hinges on staffingstability, optimized scheduling,
and financial alignment. AI andautomation help, but they don't
solve systemic issues likeprovider burnout and
administrative burdens.
(14:12):
And lastly, patient demandremains high, but so do barriers
like no shows, insurancedenials, and access challenges.
Hey. For more data driveninsights to help your health
help your health careorganization, check out MGMA's
data guide provider compensationreport, which can help you with
benchmarking staff salaries,productivity, and incentives.
(14:34):
And as usual, we'll drop thelink to that information along
with this week's stat pollarticle in the show notes. And,
hey, would you like to shareyour insights on medical
leadership and industry trendsfor our polls?
Sign up for MGMA stat by textings t a t stat to 33550, or visit
mgma.com/mgma-stat toparticipate in our weekly polls.
(15:01):
Alright. That's it for me,Daniel.
Daniel Williams (15:03):
Alright. And that is gonna be a wrap for this
week's MGMA weekend review. As,Colleen said, we'll have all
these resources and more in theepisode show notes. So until
then, thank you all again forbeing MGMA podcast listeners.
Colleen Luckett (15:21):
And, Daniel, have a great time in San Diego.
I'll see you next week.
Daniel Williams (15:25):
Thank you. Bye now.
Well, hi, everyone. Daniel Williams here,
senior editor at MGMA and one ofthe cohost here of the MGMA Week
in Review podcast. We're backagain this week along with, co
host Colleen Luckett, who's aneditor and writer at MGMA.
Colleen, hello. What's going on?
Colleen Luckett (01:14):
Hey, everyone. Oh, it's been a busy week for us
this week, but, hey, the sun isshining again this week. I
noticed well, it was. And thenFor a minute. Now it looks it
looks cloudy again, but, but,yeah, it's been nice weather
this week.
Daniel Williams (01:29):
Waiting for wonderful. This far.
Colleen Luckett (01:30):
Yeah.
Daniel Williams (01:31):
I think I mentioned last week that I am
we're recording a little bitearly y'all. So if any of the
news changes that we share withyou right now, it's because
we're recording on Wednesday. Iam leaving for San Diego
tomorrow, and I'll be there forI know. I'll be there four days,
but enough about that. Let's doit get on with the news.
(01:54):
What what's going on? What yougot?
Colleen Luckett (01:56):
Well, AI and health care is the one we got up
first. So, yeah, it's, it'sgreat for reading X rays, not so
great for reading the room,apparently. Turns out when
doctors say they want AI tostreamline care, they don't mean
streamlining denials of care.And that's the growing concern
among physicians according to anew article from chief health
(02:19):
care executives. It waspublished on February 26 written
by Ron Southwick.
The article titled most doctorsfear insurers using AI to deny
coverage highlights a recentAmerican Medical Association
survey showing that three infive doctors or 61% fear that
insurance companies are using AInot to improve care, but to
(02:41):
increase denials of preapprovalor treatment. AMA president
doctor Bruce a Scott saysinsurers are leveraging AI to
automatically reject claims inbold, often without proper human
review. He warrants that medicaldecisions should be made by
doctors and patients, not byunregulated AI systems. Seems
reasonable. Physicians have longbeen frustrated with prior
(03:04):
authorization, of course, and AIis only making things worse.
According to the AMA survey,more than ninety percent of
doctors say prior authorizationdelays care, while twenty nine
percent report serious adverseevents, and twenty three percent
say these delays have led topatient hospitalizations. And
while doctors aren't entirelyopposed to AI, two thirds say
(03:26):
they already use it in someform, 49% want more oversight on
how insurers are applying it inpreapprovals. Hospitals are also
reporting an uptick in wrongfulclaim denials directly linked to
AI driven decision making. Thebottom line is this. Physicians
say AI is turning priorauthorization into an even
bigger headache contributing toburnout and delaying patient
(03:49):
care.
And as always, we'll drop thelink to this article on the show
notes, so check that out formore information. Okay, Daniel.
Over to you.
Daniel Williams (03:57):
Alright. Let's talk money, specifically smart
tax moves for physicians. Thisweek, medical economics
published an article titled fivetax strategies to help
physicians achieve financialindependence. This was written
by Gretchen Clyburn, who is aCFP, and this article is packed
(04:18):
with solid advice for doctorslooking to keep more of their
hard earned income. Clyburnbreaks down some savvy
strategies that can make a bigdifference when it comes to
financial independence.
First up, Roth IRAs. A lot ofphysicians think they make too
much money to contribute, butClyburn points out a workaround,
(04:39):
the backdoor Roth IRA. Here'show it works. You contribute to
a traditional IRA, which doesn'thave income limits, then convert
it to a Roth IRA. If done right,you might not even owe taxes on
the conversion.
It's a great way to build taxfree income for retirement, but
the key is making sure you don'thave existing pretax IRA
(05:04):
balances that could complicatethings. Then there's real estate
investing, but with a twist. Ifyour spouse qualifies as a real
estate professional under IRSrules, it could open up some
serious tax advantages.Basically, this allows you to
use rental property losses tooffset your active income like
(05:26):
your salary. But fair warning,the IRS has strict requirements
for this, so you'll wanna workwith a tax pro to make sure
you're playing by the rules.
Then there's charitable giving.It also gets a smart tax
strategy update. Instead ofwriting checks, Clyburn suggests
donating appreciated stock to adonor advised fund. This lets
(05:50):
you avoid capital gains, taxes,and get a deduction for the full
market value of the stock. Andif you're 70 or older, another
option is making qualifiedcharitable distributions
directly from your IRA, meaningyou donate pretax dollars and
lower your taxable income.
(06:11):
Another great tool, healthsavings accounts or HSAs.
Clyburn calls them a triplethreat because contributions are
tax deductible, the money growstax free, and withdrawals for
medical expenses aren't taxedeither. Her advice, treat it
like an investment, not just aspending account. Let it grow
(06:32):
for retirement instead of usingit for small medical expenses
now. Finally, there's tax lossharvesting, a strategy that's
all about playing smart withyour investments.
If you sell a stock at a loss,you can use that loss to offset
other taxable gains, loweringyour tax bill in the process.
(06:53):
Just be careful of the wash salerule, which prevents you from
repurchasing the same investmentwithin thirty days if you wanna
claim the tax benefit. Bottomline, these strategies aren't
just about saving on taxes now.They're about setting yourself
up for long term financialindependence. As Clyburn puts
(07:13):
it, the key is to have a planthat aligns with your financial
goals.
So talk to a tax pro, takeadvantage of these strategies,
and make your money work foryou. What do you have there?
Colleen Luckett (07:28):
Alright. So my last segment was all about how
insurers are using AI to put upmore roadblocks, but what an AI
and automation could actuallyremove barriers in this, area
instead of create them? Well,that's exactly what an article
from Med City News published onFebruary 25 by Gary Hamilton
explores. This one is titledautomating insurance
(07:50):
verification, a game changer forprevisit payment collection, and
it highlights how automatinginsurance verification is
streamlining previsit paymentcollection, cutting down on
administrative headaches forstaff while improving financial
transparency for patients. Foryears, manual insurance
verification has been a majorbottleneck in health care.
(08:10):
It's slow, prone to errors, anda leading cause of claim denials
and unexpected patient bills. Infact, a survey by Experian found
that three out of four providershave seen an increase in claim
denials with 45% linked tomissing or inaccurate intake
data, issues that manualprocesses struggle to fix. The
solution, automated eligibilityverification tools. By running
(08:33):
real time insurance checksbefore a patient even steps into
the office, these sit down thesesystems provide accurate cost
estimates upfront, helpingpractices collect payments
earlier and reduceadministrative burden. They also
flag missing or incorrectinformation immediately so staff
can fix problems in real time,often with built in two way
texting features for quickpatient updates.
(08:56):
Beyond the operational benefits,automation also improves patient
and staff satisfaction. Patientsget fewer surprise bills while
staff spend less time chasingpayments and fixing errors. With
a smoother check-in process andless friction over billing,
practices can focus ondelivering better patient care
rather than battling insurancered tape. So while AI might be a
(09:19):
problem in some areas of healthcare, this is one case where
automation is actually workingin provider's favor. It's a
reminder that, you know,technology isn't inherently good
or bad.
It's all about how we use it.Okay, Daniel. Back to you.
Daniel Williams (09:33):
Alright. So let's talk about something every
medical practice needs, butoften puts off an employee
handbook. So physician'spractice recently published an
article titled, how to write anemployee handbook for practice
staff. And it's really got somegreat tips on why this document
is essential and how to get itright. A solid handbook isn't
(09:57):
just a stack of rules.
It's a way to set expectations,protect your practice legally,
and keep things runningsmoothly. First things first,
your handbook is not a contract.This is a big one. The article
stresses that you need to makeit crystal clear that your
handbook does not create abinding agreement. Most
(10:18):
practices are at will employers,meaning either you or your
employees can end the workingrelationship at any time.
To avoid any confusion, youshould include a big bold
disclaimer right up front thatsays just that. Another key
takeaway, keep it up to date.Laws change, policies shift, and
(10:41):
you don't want an outdatedhandbook causing problems. The
article recommends reviewing andrevising it at least once a year
to stay compliant with federaland state regulations. Plus,
updating your staff on newpolicies make sure everyone's on
the same page.
Now what exactly goes in thehandbook? The article suggests
(11:05):
covering the basics, attendanceexpectations, vacation policies,
sick leave, confidentialityagreements, and anything else
that defines workplace behavior.Think of it as the ultimate FAQ
for your staff. The more detailsyou include, the fewer
misunderstandings you'll havedown the road. One thing that
(11:27):
really stood out, get legalizeon it.
The article recommends having anattorney review your handbook to
make sure you're in line withemployment laws. It's a simple
step that can save you somemajor headaches later. At the
end of the day, a well craftedemployee handbook is your
playbook for running a smooth,professional, and legally
(11:50):
protected practice. If youhaven't updated yours in a while
or don't have one at all, I hopethat's not the case. Now is the
time to get started.
So, Colleen, yeah, let's take alook at that employee handbook
next week.
Colleen Luckett (12:05):
Yeah. Time time to update, I see. Alright. Well,
for our I'm gonna leave everyonewith some good news. According
to this week's NGMA sub poll,most medical practices still
managed to hit theirproductivity goals in 2024.
Hooray. So, our poll this weekfound that 69% of medical group
(12:26):
leaders reported theirphysicians and advanced practice
providers or APPs either met orexceeded productivity goals in
2024. So met was 45% of you saidthat, and exceeded was 24%. And
this is despite ongoing staffingshortages and patient access
challenges. However, 30% ofpractices did fall short of
(12:47):
expectations, citing, of course,the usual suspects, burnout,
administrative burdens, andstaffing gaps as the key
hurdles.
This poll included 218 responsesfrom our medical group leaders.
So what drove productivity in2024? So practices that exceeded
goals credited betterscheduling, expanded staffing,
(13:08):
and strategic use technologylike AI, virtual scribes, and
telehealth. High patient demandalso played a role, but leaders
acknowledged the need to balanceefficiency with staff well-being
to avoid burnout. And practicesthat met goals saw success
through stable staffing,selective AIUs, and schedule
refinements rather than majorworkflow overhauls.
(13:30):
Expanding specialty services andchronic care programs also
helped boost revenue andsustained financial performance.
And those practices that fellshort struggled with staffing
shortages, provider attrition,and insurance related
disruptions. Some faced higherpatient resistance to seeing
APPs, while others noted thatwork life life balance
(13:50):
initiatives, while beneficial,led to fewer available pry
provider hours. So the keytakeaway is medical group
productivity hinges on staffingstability, optimized scheduling,
and financial alignment. AI andautomation help, but they don't
solve systemic issues likeprovider burnout and
administrative burdens.
(14:12):
And lastly, patient demandremains high, but so do barriers
like no shows, insurancedenials, and access challenges.
Hey. For more data driveninsights to help your health
help your health careorganization, check out MGMA's
data guide provider compensationreport, which can help you with
benchmarking staff salaries,productivity, and incentives.
(14:34):
And as usual, we'll drop thelink to that information along
with this week's stat pollarticle in the show notes. And,
hey, would you like to shareyour insights on medical
leadership and industry trendsfor our polls?
Sign up for MGMA stat by textings t a t stat to 33550, or visit
mgma.com/mgma-stat toparticipate in our weekly polls.
(15:01):
Alright. That's it for me,Daniel.
Daniel Williams (15:03):
Alright. And that is gonna be a wrap for this
week's MGMA weekend review. As,Colleen said, we'll have all
these resources and more in theepisode show notes. So until
then, thank you all again forbeing MGMA podcast listeners.
Colleen Luckett (15:21):
And, Daniel, have a great time in San Diego.
I'll see you next week.
Daniel Williams (15:25):
Thank you. Bye now.
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