Pay cuts, payer AI and the staff who keep leaving: What we heard at MGMA's 100th annual conference

The Medical Group Management Association (MGMA) held its 100th annual conference Sept. 27-30 in San Antonio. Medicare's proposed 2027 fee schedule would cut the conversion factor again and pay half for a second service a physician bills the same day. Practice leaders at the conference also described Medicare Advantage plans downcoding claims and payers denying them faster than practices can appeal.

Medical Economics Senior Editor Richard Payerchin, Physicians Practice Managing Editor Keith Reynolds and Medical Economics Associate Editor Austin Littrell were in attendance.

This episode brings back highlights from interviews at and after the conference with MGMA's Anders Gilberg, Madison Hynes, Andrew Swanson, Julia Rosen and acting CEO Akash Madiah, along with Kem Tolliver of Medical Revenue Cycle Specialists, Taya Gordon of Atlas & Perpetua Healthcare Consulting, Doral Jacobsen of Prosper Beyond, Rachel Brace of BackPocket Talent, Dale Patterson, M.D., of Beacon Medical Group, health care attorney Tatiana Melnik and former NFL long snapper Jon Dorenbos.

Gilberg explains how MGMA is fighting the same-day cut and how practices can check whether their physicians are in the Ambulatory Specialty Model that starts Jan. 1. Speakers also cover longer patient wait times, physician pay rising as visits fall, renter and owner physicians and what physicians should know before using artificial intelligence (AI) scribes.

Register for the Physicians Practice Practice Academy Series: Protecting Your Practice's Revenue, a virtual event on Thursday, Oct. 29, from 12 to 4 p.m. ET.

Don't miss our recent episodes on interoperability, AI in hiring, practice revenue and direct primary care.

Music Credits:

Jazz Warm Lo-Fi by Nadezhda Pilitskaia - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 – 1:06 | Cold open. Kem Tolliver and Anders Gilberg on MGMA's centennial, and Doral Jacobsen on how much health care spending goes to administrative waste.

1:06 – 2:06 | Introduction. Austin Littrell previews the episode, built from interviews at and after the conference.

2:06 – 3:20 | 100 years of MGMA. From a 1926 meeting of 32 clinic managers to the association's largest conference since the pandemic, with acting CEO Akash Madiah on what he heard in the hallways and a look at the opening keynote from former INXS singer Ciaran Gribbin.

3:20 – 8:04 | What Washington has planned for 2027. A proposed 1.68% conversion factor cut, the same-day payment cut practices are fighting, the end of MIPS, the Ambulatory Specialty Model and the Jan. 1 electronic prior authorization deadline, with Gilberg, Taya Gordon and Tolliver.

8:04 – 11:43 | What happens to claims after they go out the door. Medicare Advantage growth and MGMA's draft bill to ban automatic downcoding, with Madison Hynes on why downcoding is so hard to track, Gordon on denials piling up in accounts receivable and Jacobsen on write-offs that should have been paid.

11:43 – 14:11 | Revenue practices have already earned. Rising costs, David Gans on productivity, Barbara Ireland's vaccine coding recovery, Andrew Swanson's one number to benchmark and Jacobsen on doing the homework before a payer negotiation.

14:11 – 18:05 | Who's leaving, and what it costs. Staff turnover data, Rachel Brace on what replacing an employee costs compared with a retention bonus, Swanson on longer patient wait times and Tolliver on why billers quit.

18:05 – 21:38 | Physicians who stay. Physician pay rising as visits fall, Swanson on why not to panic yet, Monique Delgado on physician-designed pay, Dale Patterson, M.D., on renter and owner physicians and Jon Dorenbos' advice for burned-out physicians.

21:38 – 24:28 | Where AI fits. Seema Verma on data strategy, Julia Rosen on starting with tools practices already own, Tatiana Melnik on AI scribe consent and Swanson on whether AI is replacing staff.

24:28 – 26:25 | One thing to do Monday. Madiah's two tips for administrators, and Tolliver on being surrounded by people who understand the work.

26:25 – End | Outro. Littrell reminds listeners about the Oct. 29 Practice Academy and wraps the episode.

Medical Economics was in San Antonio at the MGMA Annual Conference, Sept. 27-30, celebrating 100 years of MGMA, attending sessions and speaking with industry leaders. Follow our coverage on our MGMA conference page.