MGMA Week in Review: Medicaid Cuts, Bathroom Cleanliness, and a Happy 4th of July!

In this special Fourth of July edition of the MGMA Week in Review podcast, hosts Daniel Williams and Colleen Luckett share timely healthcare insights alongside some holiday cheer. They start with a major policy development: a Senate-approved tax bill that could cut nearly $1 trillion from Medicaid—posing serious implications for hospitals, rural providers, and medical groups. The episode also covers how bathroom cleanliness can shape patient perceptions, new MGMA poll results on wait times, and a forecast of where inpatient and outpatient care are headed over the next decade. The episode closes with an overview of a new ACP proposal to reform risk adjustment and promote health equity.

Timestamps
00:50 – Welcome and Happy 4th of July!
01:29 – 4th of July Plans and Weekend Fun
02:11 – Healthcare News: Legislative Updates (Chief Healthcare Executive)
05:06 – The Importance of Clean Bathrooms in Medical Offices (Physicians Practice)
07:37 – Patient Wait Times: A Growing Concern (MGMA Stat)
10:04 – Future of Healthcare: 10-Year Forecast (Becker's Hospital Review)
13:17 – Risk Adjustment Overhaul for Better Health Equity (Medical Economics)
14:58 – Closing Remarks and 4th of July Wishes

Additional Resources:

• MGMA Playbooks
• MGMA Events
• MGMA Consulting
• MGMA DataDive
• MGMA Stat
• MGMA Podcasts

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Episode Transcript

Daniel Williams (00:54):
Well, hi, everyone, and welcome to the
MGMA Weekend Review podcast, andhappy fourth of July to you. For
this special fourth of Julyepisode, I'll just share who I
am. I'm your host, DanielWilliams, along with cohost
Colleen Luckett. We are editorsand writers here at MGMA and
love doing the podcast. So I'lljust share with you each episode

(01:18):
of Weekend Review.
We bring you some of the latesthealth care industry news, some
policy updates when they occur,and some expert insights and
just stories we find interestingand wanna share with you. So,
Colleen, happy fourth of July.

Colleen Luckett (01:33):
Thank you. You as well. Do you have any plans
for the long weekend? May we getan extra day off, which is nice?

Daniel Williams (01:40):
We are in the future. We're in our time
machine. But True. I will tellyou, we got two small dogs, and
a lot of dogs react. You know?
They get a little nervous andscared. So usually

Colleen Luckett (01:50):
Yes.

Daniel Williams (01:51):
I like to hang with the dogs, get a couple of
movies set up, and then we justkinda hang out together and and
have a lot

Colleen Luckett (01:58):
of fun. So yeah. That sounds awesome.

Daniel Williams (02:00):
What about yourself?

Colleen Luckett (02:02):
Yeah. We do the same. Hey. There's a new, I
don't know if you guys watch it,but squid game, the last season
is out on Netflix. We'rewatching that.
That's probably what we'll bedoing. Alrighty.

Daniel Williams (02:11):
Let's take it to the, the news section section
here. What is going on newswise?

Colleen Luckett (02:17):
Alright. Well, just when you thought fourth of
July fireworks were the biggestthreat this week, especially to
your little dogs, congressdropped a legislative sparkler
of its own. And this one couldburn through hospital budgets,
access to care, and, yes, evenyour own medical group's bottom
line. So a July 2 article, itschief health care executive, and

(02:39):
it's titled Before Tax BillHeads to Trump, Hospitals Hope
to Limit Damage, details growingalarm among hospital leaders
over a senate approved tax passpackage that slashes nearly
$1,000,000,000,000 fromMedicaid, institutes work
requirements, adds copays, andlimits how states can secure
federal Medicaid dollars. I'msure most of our audience knows

(03:01):
this.
Hospital associations call thecuts unprecedented, warning of a
domino effect from emergencyroom surges and longer wait
times to reduced service lines,staff layoffs, and possible
hospital closures, particularlyin rural and underserved
communities. Industry voiceslike Chip Khan of the Federation

(03:22):
of American Hospitals and RickPollack of the stressed that
these aren't distanthypotheticals. The congressional
budget office projects that upto 11,800,000 people could lose
Medicaid coverage within adecade, and an additional
5,000,000 could lose ACA relatedcoverage if premium subsidies
expire as planned. Even with a$50,000,000,000 rural hospital

(03:46):
support fund tucked into thebill, leaders are calling it a
short term patch for long termwounds. What this means for MGMA
members.
So expect a ripple effect beyondhospitals if local hospitals cut
services, close units, or shutdown. Expect a ripple effect
beyond hospitals. If localhospitals cut services, close

(04:06):
units, or shut down, referralpipelines shrink, ED overflow
hits your clinics, and patientacuity rises in outpatient
settings. Rural practices maysee sudden spikes in
uncompensated care, delayeddiagnostics, or more patients
arriving without coverage,especially in OB GYN, behavioral
health, and chronic caremanagement. Medical groups tied

(04:29):
to hospital systems may befacing enterprise wise
restructuring, capital freezes,or staff reallocations as
systems tighten budgets toabsorb the blow.
And then practices should bereviewing payer mix projections,
building contingency plans forMedicaid volume shifts, and
advocating for state levelmitigation strategies where

(04:50):
possible. It's a tense moment,y'all. This is a story worth
watching very closely. Medicalgroups that prepare now will be
better positioned to weather thedownstream impacts and protect
access for the communities whorely on them. So, Daniel, over
to you.

Daniel Williams (05:06):
Yeah. And as Monty Python used to say, now
for something completelydifferent, I've got a story that
might surprise some folk. It'sabout the bathroom. Yep.
Physicians practice ran a piececalled Bathrooms Are Us.
And while it may sound like aquirky headline, the story

(05:26):
actually raises a reallythoughtful point about patient
perception and the spaces weoften overlook. Here's the main
idea. The bathroom is one of theonly places in a medical office
where the patient is alone, nostaff, no distractions, and in
that quiet moment, they tend tonotice everything. A dusty vent,

(05:49):
a leaky faucet, paper towelsscattered on the floor, these
can all shift the wholeexperience. As the article puts
it, when the environment feelsneglected, it calls the quality
of care into question.
Think about it in this way,everybody. We've all gone into a
restaurant. We're excited to eatthe food. We go into the
bathroom and we go, this isdisgusting, and I don't think I

(06:12):
wanna eat the food. If this iswhat the bathroom looks like,
what is the food like?
Think about it from thatperspective. So as one doctor
featured in the piece shared howthey started taking photos of
their office restroom andreviewing them with staff to
highlight discrepancies betweentheir stated values like, We

(06:33):
care about the details and whatpatients were actually seeing.
That led to a simple solution, arotating schedule where
different team members checkedthe restroom twice a day. No
fancy remodel needed, just alittle ownership. The article
also touched on how importantthe feeling of the space is.

(06:55):
Lighting, signage, updatedfixtures, all of it contributes
to a sense of comfort anddignity. If the bathroom looks
like an afterthought, it doessend a message. But when it's
clean, safe, and thoughtfullymaintained, it reinforces
everything the practice istrying to convey out front. So,

(07:15):
the takeaway is simple. Thebathroom is part of the patient
experience.
Think about it that way. And itmight be worth asking, does it
reflect the level of care yourpractice provides everywhere
else? Colleen, with that said,back to you.

Colleen Luckett (07:31):
That is something that is very
important. I have not really putmuch into it. Maybe that was
completely different. Andspeaking of the patient
experience, so you know it's badwhen even the automated hold
music has a shorter wait timethan your new patient slots. Our
latest MGMA staff poll on July 1checked in with practices across
the country to see how long it'sreally taking to welcome new

(07:54):
patients and what, if anything,is being done about it.
Out of 269 respondents, fortypercent said that wait times
stayed the same. Twenty sixpercent said they got shorter.
Good for you. But thirty onepercent still reported that wait
times have grown longer in 2025.That last number reflects a
tough reality.
Even modest improvements may notbe keeping pace with rising

(08:17):
demand, provider shortages, andoperational constraints. Groups
with worsening wait times citedretirements, staff shortages,
and growing local populations.Many are trying to fix it,
adding APPs, extending hours,and using tech tools. But others
are still in the early stages ofrecruiting or haven't made
changes yet. Those with stableor shorter wait times made

(08:40):
tweaks like adjusting templates,using open access and online
scheduling, hiring supportstaff, and implementing
electronic check-in or more AItools.
The article for our stat pollingalso brings in national data
from a May 2025 AMN health carestudy, which shows average new
patient wait times have jumpedto thirty one days, a 19%

(09:02):
increase since 2022. Primarycare, OBGYN, and dermatology all
saw big delays, while orthopedicsurgery was a rare bright spot,
dropping to just twelve days onaverage. So what does all this
mean for MGMA members? Well, forgrowth focused practices, wait
times aren't just a schedulingheadache. They're a strategic

(09:22):
risk.
Every day a new patient waits isa day they might walk. Staffing
strategies, tech upgrades, andscheduling optimizations are no
longer nice to haves. They'reessential tools in the fight to
protect referral pipelines,maintain access, and stay
competitive. The bottom line isthat front door matters. Keep it
open, flexible, and moving, orrisk becoming the healthcare

(09:44):
version of a velvet rope club noone can get into.
Well, as always, if you wantyour voice to help shape
insights like these, please jointhe MGMA stat poll by texting
stat, s t a t, to 33550, andyou'll get those poll questions
in your text messages weekly andbe able to participate in our
polls.

Daniel Williams (10:04):
Alright. So for my last story of this July 4,
I've got a story that looks intothe future. Becker's Hospital
Review just published a piececalled Where Patient Volumes Are
Headed, 10 Forecast for tenYears Out. And it is packed with
insights about where health careis going and what it means for

(10:26):
practices. First up, outpatientcare is expected to grow
eighteen percent over the nextdecade.
And wait for it, outpatientsurgery alone is projected to
increase by twenty percent.That's a major shift away from
inpatient settings. So if yourpractice hasn't upped its

(10:46):
outpatient game, now's the timeto consider it. Inpatient
volumes will still grow though,just more modestly, around five
percent over ten years. Buthere's the kicker, patients will
be sicker.
Sorry for the internal rhymethere, y'all. Lower patient
count, higher acuity, so morecomplexity, more cost. Also,

(11:12):
post acute care is going to blowup too, with an estimated 31%
growth, especially in homehealth services, they're
expecting a 24% growth. Thattells me health care is not just
moving out of hospitals, it'smoving into homes. So here's
something that touches a nerve.
Evaluation and management visitsforecast to grow 16%. And by

(11:37):
02/1935, almost one fifth or 19%of these will be virtual visits.
That's telehealth firmlycemented in the mix, not just a
pandemic relic anymore. And acouple more nuggets worth
noting. Emergency departmentvolumes will inch up 5% driven

(11:58):
by emergent visits, but urgentcare stays flat.
Cancer outpatient volumes rise18%, while inpatient oncology
care holds steady. So oncologyservices need outpatient
capacity. For pediatricpatients, inpatient discharges

(12:19):
go down 1%, while outpatientvisits increase 8%. Basically,
kids are showing up less inhospitals and more in clinic
settings. Here are the keytakeaways.
If you're managing a clinic orhealth system, lean into
outpatient expansion, especiallyfor surgery, chronic care, and

(12:41):
cancer follow ups. With virtualvisits rising, bolstering
telehealth infrastructure isn'toptional, it's essential. As
post acute and home healthexplodes, partnering with home
care or remote monitoringproviders could be a big
opportunity. And expect acutelyill patients, increase support

(13:03):
for complexity and carecoordination, even if volume
isn't climbing as fast. That wasa lot of numbers, but that is
the data story behind theheadline, Colleen.
Back to you.

Colleen Luckett (13:16):
Thanks, Daniel. So ever feel like risk
adjustment was designed by acommittee that never met a
provider or maybe by someonewho's never even seen an EHR?
Well, the American College ofPhysicians is feeling your pain,
and they just proposed a fix. Ina July 2 article from medical
economics titled ACP Calls forRisk Adjustment Overhaul to

(13:37):
Improve Health Equity, Cut RedTape, author Austin Luttrell
lays out the ACP's new policypush. Their paper published in
the Annals of Internal Medicinecalls the current risk
adjustment landscape fragmented,inconsistent, and unnecessarily
stressful for physicians.
So to clean it up, ACP offerseight recommendations, including

(13:59):
standardizing documentationrules across payers, investing
in interoperable health IT usingFHIR based tools, incorporating
social drivers of health likehousing and income, and putting
an end to the annualredocumentation of chronic
conditions. They're also raisingred flags about coding
manipulation and caution as AIenters the risk scoring world,

(14:22):
calling for clear guardrailsthat support accuracy and
equity. ACP president, doctorJason Goldman, said the aim is
simple. Reduce admin burden andmake payment more reflective of
real patient needs. So what doesthis mean for MGMA members?
In a word, plenty. For practicesnavigating value based care,
risk scoring affects everythingfrom contract performance to

(14:44):
revenue cycle management. Anymove towards standardization and
tech enabled efficiency couldgive medical groups a much
needed breather and help shiftthe focus back where it belongs,
on patient care. Well, that's awrap for me. Daniel, back to
you.

Daniel Williams (14:59):
Alright, Colleen. And that is a wrap for
us this week. Again, happyfourth of July to everyone.
Whether you're out therewatching all the big fireworks
go off or barbecuing or hangingout with dogs or whatever you've
got on the agenda. Hope you aresafe, and have a wonderful long
weekend.

Colleen Luckett (15:19):
Happy fourth, everyone. See you next time.