April 18, 2025 • 13 mins
In this episode of the MGMA Weekend Review, hosts Daniel Williams and Colleen Luckett discuss the latest healthcare industry news, including the impact of private equity on medical trainees, strategies to keep physicians offline during vacations, challenges in physician compensation, and the potential impact of new tariffs on medical practices. They emphasize the importance of proactive policy changes and operational adjustments to navigate these evolving challenges.
00:00 Introduction and Welcome
00:55 Private Equity's Impact on Medical Trainees (Health Affairs)
03:49 Physicians and EHR During Vacation (Health Leaders Media)
06:59 Navigating Physician Compensation (MGMA Stat)
09:33 Trump Tariffs and Healthcare (Medical Economics)
12:40 Conclusion and Farewell
Additional Resources:
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Daniel Williams (00:06):
Hi, everyone. I'm Daniel Williams, senior
editor at MGMA and host of theMGMA Podcast Network, along with
co host Colleen Luckett, editorand writer at MGMA. We are back
with another MGMA Weekend ReviewPodcast and just excited to
bring y'all the latest healthcare industry news, occasionally
(00:29):
some policy updates, a lot ofexpert insights, and
occasionally stories fromColleen and me that we like to
share with you all. So, with allthat said, Colleen, hey, happy
day to you. How are you doing?
Colleen Luckett (00:43):
Thanks. Happy day to you. Yeah. We were we
were just having some Zoomissues today. There was an
outage.
Yeah. We feel your pain ifanyone else was
Daniel Williams (00:52):
I know.
Colleen Luckett (00:52):
Feeling that today, but we're back. So Yeah.
Yeah. So I am gonna start with alittle bit of private equity
story. So this week, a group ofmedical students, yes, the ones
still somehow surviving oncaffeine and sheer sheer will,
published a must read piece athealth affairs titled private
(01:12):
equity's impact on medicaltrainees.
It's all about how privateequity ownership is reshaping
not just physician practices andpatient care, but the training
environment for the nextgeneration of providers. So
what's the diagnosis? Let's justsay it's grim. Private Equity
now owns 65% of acquiredpractices and nearly 30% of for
(01:35):
profit hospitals, and its shortterm profit driven model model
is colliding hard with the longterm mission of medical
education. Medical trainees arecaught in the middle, fewer
teaching opportunities, pressureto prioritize profit over
evidence based care, and eventhreats to residency stability
and loan forgiveness.
(01:56):
Some residents are beingreplaced by nonphysicians to cut
costs. Others have faced suddenrelocations, like when Hanama
University Hospital shut down,leaving 550 residents scrambling
mid training. Even visa issuesand accreditation loss are on
the table in these chaotictransitions. The authors argue
that these business practicesare not only negatively
(02:17):
impacting patient outcomes,they're demoralizing future
physicians and could worsen theprojected shortage of up to
86,000 physicians by 2036. Well,their call to action is policy
change from ending noncompetesand boosting Medicare payments
to supporting small practicesand reviving legislation like
(02:38):
the shot like the Stop WallStreet Looting Act.
And the authors say we needproactive structural reforms,
not just Band Aids after thedamage is already done. So,
again, that's private equity'simpact on medical Trainees in
Health Affairs Forefrontnewsletter. It was published on
April 14. Read it with a doubleespresso. It's that urgent.
(03:00):
Okay, Daniel, over to you.
Daniel Williams (03:02):
That's so funny that you mentioned double
espresso. Full disclosure,Colleen and everyone, I've been
a tea drinker for like twentyyears. And this weekend, I just
wanted to mix things up and I'veshifted to coffee. And yeah. Oh,
it's all over.
Literally bouncing off the wallsyesterday. I was just could not.
(03:26):
Wow. My energy levels downyesterday and now I feel like
I'm paying for it. I think Ifeel like I'm crashing.
So
Colleen Luckett (03:35):
I'm You know, I'm a little jealous of that
first coffee hit, though,because I've been a coffee
drinker forever. So that musthave been kind of fun yes
yesterday.
Daniel Williams (03:44):
Oh, boy. Did it get me. Yes. So to our next
story. All right, everybody.
I want to talk about somethingthat'll hit close to home for a
lot of you managing medicalpractices. Your doctor can't
seem to log off, even onvacation. There's a new Health
Leaders article that's got atitle you might appreciate, How
(04:06):
to Keep Physicians Out of theEHR During Their Time Off.
That's right, not just afterhours. We're talking PTO, beach
time, long weekends, and guesswhat?
A whole lot of physicians arestill in their inbox. A study
published in JAMA Network Openfollowed 56 primary care
(04:27):
physicians and found out that onaverage they were spending over
sixteen minutes per day in theEHR during vacation. Some were
logging thirty plus minutes aday. But here's the kicker. The
EHR activity was highest on thefirst and last days of vacation
(04:47):
because nothing says relaxinggetaway like answering MyChart
messages from a hotel room.
A physician from Vertua MedicalGroup summed it up nicely. They
actually call this pajama time,that nightly scramble to catch
up on documentation, medrefills, and patient messages
(05:09):
after hours. So what arepractices like Virtua doing
about it? First, coveragesystems. When a doc's out,
there's a structured plan inplace.
No more guilt about who'shandling the inbox. Next, taming
the inbox in basket. Only themessages that truly need a
(05:30):
physician's eyes get through.The rest routed to the right
team member. And this one'swild.
They've hired in basketologists.These are nurse practitioners
dedicated to scrubbing the inbasket so docs don't get bogged
down in stuff someone else fromthe team can handle. On the tech
(05:53):
side, Ardent Health is rollingout ambient AI tools, think real
time conversation capture duringthe visit, that takes the
documentation off thephysician's plate. Their CMIO,
Doctor. Bradley Hoyt, saidthey've seen a 50% cut in pajama
time and a 41% drop indocumentation time.
(06:17):
Not bad, right? So here's thetakeaway for practice leaders.
If your docs are coming backfrom vacation looking more tired
than when they left, you've gota workflow problem and not a
time off problem. Buildcoverage, rethink the inbox, and
maybe ask yourself, could AIactually give my team more human
(06:39):
time? Alright, Colleen.
What's next?
Colleen Luckett (06:43):
Well, I was thinking I need one of those in
how do you even say inbasketologists?
Daniel Williams (06:48):
I think so.
Colleen Luckett (06:49):
I'm one of those people who never deletes
her emails drive, you know, OCDpeople insane, bro. Leva. Yeah.
Well, let's move on to the nextstory. So if you've ever tried
figuring out physiciancompensation without a dedicated
team, you know it's like tryingto assemble IKEA furniture
without the instructions.
(07:10):
Sure. You might get it done, butsomeone's definitely going to
lose a screw. And I guess we cansay that figuratively or
literally on that one. Thisweek's MDMA stat article is
titled, do you have dedicatedresources for physician
compensation decisions? It's bymy boss, Chris Harrop.
It dives into how practices arenavigating one of the most
(07:32):
critical and complex aspects ofmedical group management, paying
physicians fairly while keepingthe lights on. According to our
April 15 stat poll, only 30% 36%of medical groups have a
dedicated team or committee forphysician compensation. A solid
61% of you do not. And thenthere are those 3% who are not
(07:54):
sure, which kinda sounds liketheir compensation model lives
on someone's Google Drive underfinal final updated v three. I
have a few of those, I think.
For those of for those withformal teams, many meet monthly
or quarterly, usually led by a csuite leader like the CEO or
CFO, sometimes sharing the reinswith the medical director.
Without a formal group, compdecisions are typically handled
(08:17):
by a combo of the exec team,physician partners, or board
members. The article also breaksdown how compensation strategies
vary across practice teams. Soprivate practices lean on
collaborative decisions betweenphysician owners and admins.
Midsized groups often usestructured executive governance,
and system owned outpatientclinics tend to have full
(08:40):
fledged comp committees withcompliance and compensation
experts in the mix.
So what's trending? We're seeinga shift toward more physician
input to team based incentives.And, hey, no surprises here, an
increased role for AI inmodeling, forecasting, and even
assigning work RVUs. In fact,half of medical groups now
(09:02):
include quality metrics in theircompensation models, which is
trending up from last year. Youcan read the full article at
MGMA.com, MGMA hyphen stat.
And as always, if you want tohelp shape future MGMA
resources, please sign up forMGMA stat by texting 233550 or
(09:25):
you can fill out the form on thewebsite. Okay, Daniel, back to
you.
Daniel Williams (09:29):
All right. This will be just a wonderful topic
for everybody. We're going totalk about tariffs. If you
haven't heard about it in thejust general news, but there is
a message here because it canimpact medical practices,
especially if you're handlingthe business side, the
(09:50):
acquisition side. So there's areally interesting piece that
was released this week frommedical economics.
It's called Trump Tariff ImpactsWhy Businesses Need a Response
Plan Now. So here's the deal.And this changes day to day. So
even as I'm reading this, I'mgoing, now is that the
(10:11):
percentage that I saw earliertoday? Because some of the
percentages are changing.
However, this says thatpresident Trump has proposed
massive new tariffs, 10% acrossthe board, own all imports, and
a whopping six this says 60% ongoods from China. But, Colleen,
that may have changed since thewe last even this person wrote
Colleen Luckett (10:33):
this one. Minutes.
Daniel Williams (10:35):
So here's the deal. As many of you may know,
president Trump has proposedmany new tariffs across the
board. Some of those have comedown. Some, as far as with
China, are continuing to rise.So what's the goal?
Reshoring Americanmanufacturing. The likely
outcome? Disruptions and costincreases, especially for small
(10:58):
and mid sized businesses thatrely on global supply chains. So
you may be wondering again, howdoes this hit healthcare? Well,
think about it from thisperspective.
Think about medical equipment,IT systems, exam room supplies,
even furniture. If and whenthose particular tariffs go into
(11:19):
effect, the cost of running apractice could spike and
quickly. And we all know thatrising overhead without
increased reimbursement is arecipe for burnout and margin
panic. The article quotes a fewexperts who basically say, don't
wait. Now's the time to do thefollowing.
Audit your current vendors andcontracts. Look at what products
(11:44):
are sourced internationally.Build contingency plans for
price fluctuations ordisruptions. And maybe even
negotiate long term pricing nowwhile things are stable ish.
What stood out to me was asimple truth.
Even if the tariffs don'tmaterialize in the way we
(12:06):
thought they might, theuncertainty alone is a risk. And
healthcare businesses alreadystretched thin can't afford to
be reactive. You gotta have aplan. So whether you're leading
a specialty group or a solopractice, this is your reminder
to loop in your operations andfinance folks. Review what's
(12:27):
coming in and from where, andstart thinking strategically
before the ripple hits yourbottom line.
Alright. That's your quick econpulse check, everyone. Alright,
everybody. Thanks, Colleen. Thatis gonna do it for this episode
of MGMA Week in Review.
If you liked what you heard, besure to follow and subscribe to
(12:48):
the MGMA Podcast Networkwherever you get your podcast.
You'll find links in the shownotes to today's full stories as
well as additional resources formedical practice leaders. Thanks
for listening everybody andwe'll see you next time.
Colleen Luckett (13:06):
Bye.
Hi, everyone. I'm Daniel Williams, senior
editor at MGMA and host of theMGMA Podcast Network, along with
co host Colleen Luckett, editorand writer at MGMA. We are back
with another MGMA Weekend ReviewPodcast and just excited to
bring y'all the latest healthcare industry news, occasionally
(00:29):
some policy updates, a lot ofexpert insights, and
occasionally stories fromColleen and me that we like to
share with you all. So, with allthat said, Colleen, hey, happy
day to you. How are you doing?
Colleen Luckett (00:43):
Thanks. Happy day to you. Yeah. We were we
were just having some Zoomissues today. There was an
outage.
Yeah. We feel your pain ifanyone else was
Daniel Williams (00:52):
I know.
Colleen Luckett (00:52):
Feeling that today, but we're back. So Yeah.
Yeah. So I am gonna start with alittle bit of private equity
story. So this week, a group ofmedical students, yes, the ones
still somehow surviving oncaffeine and sheer sheer will,
published a must read piece athealth affairs titled private
(01:12):
equity's impact on medicaltrainees.
It's all about how privateequity ownership is reshaping
not just physician practices andpatient care, but the training
environment for the nextgeneration of providers. So
what's the diagnosis? Let's justsay it's grim. Private Equity
now owns 65% of acquiredpractices and nearly 30% of for
(01:35):
profit hospitals, and its shortterm profit driven model model
is colliding hard with the longterm mission of medical
education. Medical trainees arecaught in the middle, fewer
teaching opportunities, pressureto prioritize profit over
evidence based care, and eventhreats to residency stability
and loan forgiveness.
(01:56):
Some residents are beingreplaced by nonphysicians to cut
costs. Others have faced suddenrelocations, like when Hanama
University Hospital shut down,leaving 550 residents scrambling
mid training. Even visa issuesand accreditation loss are on
the table in these chaotictransitions. The authors argue
that these business practicesare not only negatively
(02:17):
impacting patient outcomes,they're demoralizing future
physicians and could worsen theprojected shortage of up to
86,000 physicians by 2036. Well,their call to action is policy
change from ending noncompetesand boosting Medicare payments
to supporting small practicesand reviving legislation like
(02:38):
the shot like the Stop WallStreet Looting Act.
And the authors say we needproactive structural reforms,
not just Band Aids after thedamage is already done. So,
again, that's private equity'simpact on medical Trainees in
Health Affairs Forefrontnewsletter. It was published on
April 14. Read it with a doubleespresso. It's that urgent.
(03:00):
Okay, Daniel, over to you.
Daniel Williams (03:02):
That's so funny that you mentioned double
espresso. Full disclosure,Colleen and everyone, I've been
a tea drinker for like twentyyears. And this weekend, I just
wanted to mix things up and I'veshifted to coffee. And yeah. Oh,
it's all over.
Literally bouncing off the wallsyesterday. I was just could not.
(03:26):
Wow. My energy levels downyesterday and now I feel like
I'm paying for it. I think Ifeel like I'm crashing.
So
Colleen Luckett (03:35):
I'm You know, I'm a little jealous of that
first coffee hit, though,because I've been a coffee
drinker forever. So that musthave been kind of fun yes
yesterday.
Daniel Williams (03:44):
Oh, boy. Did it get me. Yes. So to our next
story. All right, everybody.
I want to talk about somethingthat'll hit close to home for a
lot of you managing medicalpractices. Your doctor can't
seem to log off, even onvacation. There's a new Health
Leaders article that's got atitle you might appreciate, How
(04:06):
to Keep Physicians Out of theEHR During Their Time Off.
That's right, not just afterhours. We're talking PTO, beach
time, long weekends, and guesswhat?
A whole lot of physicians arestill in their inbox. A study
published in JAMA Network Openfollowed 56 primary care
(04:27):
physicians and found out that onaverage they were spending over
sixteen minutes per day in theEHR during vacation. Some were
logging thirty plus minutes aday. But here's the kicker. The
EHR activity was highest on thefirst and last days of vacation
(04:47):
because nothing says relaxinggetaway like answering MyChart
messages from a hotel room.
A physician from Vertua MedicalGroup summed it up nicely. They
actually call this pajama time,that nightly scramble to catch
up on documentation, medrefills, and patient messages
(05:09):
after hours. So what arepractices like Virtua doing
about it? First, coveragesystems. When a doc's out,
there's a structured plan inplace.
No more guilt about who'shandling the inbox. Next, taming
the inbox in basket. Only themessages that truly need a
(05:30):
physician's eyes get through.The rest routed to the right
team member. And this one'swild.
They've hired in basketologists.These are nurse practitioners
dedicated to scrubbing the inbasket so docs don't get bogged
down in stuff someone else fromthe team can handle. On the tech
(05:53):
side, Ardent Health is rollingout ambient AI tools, think real
time conversation capture duringthe visit, that takes the
documentation off thephysician's plate. Their CMIO,
Doctor. Bradley Hoyt, saidthey've seen a 50% cut in pajama
time and a 41% drop indocumentation time.
(06:17):
Not bad, right? So here's thetakeaway for practice leaders.
If your docs are coming backfrom vacation looking more tired
than when they left, you've gota workflow problem and not a
time off problem. Buildcoverage, rethink the inbox, and
maybe ask yourself, could AIactually give my team more human
(06:39):
time? Alright, Colleen.
What's next?
Colleen Luckett (06:43):
Well, I was thinking I need one of those in
how do you even say inbasketologists?
Daniel Williams (06:48):
I think so.
Colleen Luckett (06:49):
I'm one of those people who never deletes
her emails drive, you know, OCDpeople insane, bro. Leva. Yeah.
Well, let's move on to the nextstory. So if you've ever tried
figuring out physiciancompensation without a dedicated
team, you know it's like tryingto assemble IKEA furniture
without the instructions.
(07:10):
Sure. You might get it done, butsomeone's definitely going to
lose a screw. And I guess we cansay that figuratively or
literally on that one. Thisweek's MDMA stat article is
titled, do you have dedicatedresources for physician
compensation decisions? It's bymy boss, Chris Harrop.
It dives into how practices arenavigating one of the most
(07:32):
critical and complex aspects ofmedical group management, paying
physicians fairly while keepingthe lights on. According to our
April 15 stat poll, only 30% 36%of medical groups have a
dedicated team or committee forphysician compensation. A solid
61% of you do not. And thenthere are those 3% who are not
(07:54):
sure, which kinda sounds liketheir compensation model lives
on someone's Google Drive underfinal final updated v three. I
have a few of those, I think.
For those of for those withformal teams, many meet monthly
or quarterly, usually led by a csuite leader like the CEO or
CFO, sometimes sharing the reinswith the medical director.
Without a formal group, compdecisions are typically handled
(08:17):
by a combo of the exec team,physician partners, or board
members. The article also breaksdown how compensation strategies
vary across practice teams. Soprivate practices lean on
collaborative decisions betweenphysician owners and admins.
Midsized groups often usestructured executive governance,
and system owned outpatientclinics tend to have full
(08:40):
fledged comp committees withcompliance and compensation
experts in the mix.
So what's trending? We're seeinga shift toward more physician
input to team based incentives.And, hey, no surprises here, an
increased role for AI inmodeling, forecasting, and even
assigning work RVUs. In fact,half of medical groups now
(09:02):
include quality metrics in theircompensation models, which is
trending up from last year. Youcan read the full article at
MGMA.com, MGMA hyphen stat.
And as always, if you want tohelp shape future MGMA
resources, please sign up forMGMA stat by texting 233550 or
(09:25):
you can fill out the form on thewebsite. Okay, Daniel, back to
you.
Daniel Williams (09:29):
All right. This will be just a wonderful topic
for everybody. We're going totalk about tariffs. If you
haven't heard about it in thejust general news, but there is
a message here because it canimpact medical practices,
especially if you're handlingthe business side, the
(09:50):
acquisition side. So there's areally interesting piece that
was released this week frommedical economics.
It's called Trump Tariff ImpactsWhy Businesses Need a Response
Plan Now. So here's the deal.And this changes day to day. So
even as I'm reading this, I'mgoing, now is that the
(10:11):
percentage that I saw earliertoday? Because some of the
percentages are changing.
However, this says thatpresident Trump has proposed
massive new tariffs, 10% acrossthe board, own all imports, and
a whopping six this says 60% ongoods from China. But, Colleen,
that may have changed since thewe last even this person wrote
Colleen Luckett (10:33):
this one. Minutes.
Daniel Williams (10:35):
So here's the deal. As many of you may know,
president Trump has proposedmany new tariffs across the
board. Some of those have comedown. Some, as far as with
China, are continuing to rise.So what's the goal?
Reshoring Americanmanufacturing. The likely
outcome? Disruptions and costincreases, especially for small
(10:58):
and mid sized businesses thatrely on global supply chains. So
you may be wondering again, howdoes this hit healthcare? Well,
think about it from thisperspective.
Think about medical equipment,IT systems, exam room supplies,
even furniture. If and whenthose particular tariffs go into
(11:19):
effect, the cost of running apractice could spike and
quickly. And we all know thatrising overhead without
increased reimbursement is arecipe for burnout and margin
panic. The article quotes a fewexperts who basically say, don't
wait. Now's the time to do thefollowing.
Audit your current vendors andcontracts. Look at what products
(11:44):
are sourced internationally.Build contingency plans for
price fluctuations ordisruptions. And maybe even
negotiate long term pricing nowwhile things are stable ish.
What stood out to me was asimple truth.
Even if the tariffs don'tmaterialize in the way we
(12:06):
thought they might, theuncertainty alone is a risk. And
healthcare businesses alreadystretched thin can't afford to
be reactive. You gotta have aplan. So whether you're leading
a specialty group or a solopractice, this is your reminder
to loop in your operations andfinance folks. Review what's
(12:27):
coming in and from where, andstart thinking strategically
before the ripple hits yourbottom line.
Alright. That's your quick econpulse check, everyone. Alright,
everybody. Thanks, Colleen. Thatis gonna do it for this episode
of MGMA Week in Review.
If you liked what you heard, besure to follow and subscribe to
(12:48):
the MGMA Podcast Networkwherever you get your podcast.
You'll find links in the shownotes to today's full stories as
well as additional resources formedical practice leaders. Thanks
for listening everybody andwe'll see you next time.
Colleen Luckett (13:06):
Bye.
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