MGMA Week in Review: AI Denials, Financial Strategies for Physicians, and Productivity Trends in 2024
Download MP3Well, hi, everyone. Daniel Williams here, senior editor at MGMA and one of the cohost here of the MGMA Week in Review podcast. We're back again this week along with, co host Colleen Luckett, who's an editor and writer at MGMA. Colleen, hello. What's going on?
Colleen Luckett:Hey, everyone. Oh, it's been a busy week for us this week, but, hey, the sun is shining again this week. I noticed well, it was. And then For a minute. Now it looks it looks cloudy again, but, but, yeah, it's been nice weather this week.
Daniel Williams:Waiting for wonderful. This far.
Colleen Luckett:Yeah.
Daniel Williams:I think I mentioned last week that I am we're recording a little bit early y'all. So if any of the news changes that we share with you right now, it's because we're recording on Wednesday. I am leaving for San Diego tomorrow, and I'll be there for I know. I'll be there four days, but enough about that. Let's do it get on with the news.
Daniel Williams:What what's going on? What you got?
Colleen Luckett:Well, AI and health care is the one we got up first. So, yeah, it's, it's great for reading X rays, not so great for reading the room, apparently. Turns out when doctors say they want AI to streamline care, they don't mean streamlining denials of care. And that's the growing concern among physicians according to a new article from chief health care executives. It was published on February 26 written by Ron Southwick.
Colleen Luckett:The article titled most doctors fear insurers using AI to deny coverage highlights a recent American Medical Association survey showing that three in five doctors or 61% fear that insurance companies are using AI not to improve care, but to increase denials of preapproval or treatment. AMA president doctor Bruce a Scott says insurers are leveraging AI to automatically reject claims in bold, often without proper human review. He warrants that medical decisions should be made by doctors and patients, not by unregulated AI systems. Seems reasonable. Physicians have long been frustrated with prior authorization, of course, and AI is only making things worse.
Colleen Luckett:According to the AMA survey, more than ninety percent of doctors say prior authorization delays care, while twenty nine percent report serious adverse events, and twenty three percent say these delays have led to patient hospitalizations. And while doctors aren't entirely opposed to AI, two thirds say they already use it in some form, 49% want more oversight on how insurers are applying it in preapprovals. Hospitals are also reporting an uptick in wrongful claim denials directly linked to AI driven decision making. The bottom line is this. Physicians say AI is turning prior authorization into an even bigger headache contributing to burnout and delaying patient care.
Colleen Luckett:And as always, we'll drop the link to this article on the show notes, so check that out for more information. Okay, Daniel. Over to you.
Daniel Williams:Alright. Let's talk money, specifically smart tax moves for physicians. This week, medical economics published an article titled five tax strategies to help physicians achieve financial independence. This was written by Gretchen Clyburn, who is a CFP, and this article is packed with solid advice for doctors looking to keep more of their hard earned income. Clyburn breaks down some savvy strategies that can make a big difference when it comes to financial independence.
Daniel Williams:First up, Roth IRAs. A lot of physicians think they make too much money to contribute, but Clyburn points out a workaround, the backdoor Roth IRA. Here's how it works. You contribute to a traditional IRA, which doesn't have income limits, then convert it to a Roth IRA. If done right, you might not even owe taxes on the conversion.
Daniel Williams:It's a great way to build tax free income for retirement, but the key is making sure you don't have existing pretax IRA balances that could complicate things. Then there's real estate investing, but with a twist. If your spouse qualifies as a real estate professional under IRS rules, it could open up some serious tax advantages. Basically, this allows you to use rental property losses to offset your active income like your salary. But fair warning, the IRS has strict requirements for this, so you'll wanna work with a tax pro to make sure you're playing by the rules.
Daniel Williams:Then there's charitable giving. It also gets a smart tax strategy update. Instead of writing checks, Clyburn suggests donating appreciated stock to a donor advised fund. This lets you avoid capital gains, taxes, and get a deduction for the full market value of the stock. And if you're 70 or older, another option is making qualified charitable distributions directly from your IRA, meaning you donate pretax dollars and lower your taxable income.
Daniel Williams:Another great tool, health savings accounts or HSAs. Clyburn calls them a triple threat because contributions are tax deductible, the money grows tax free, and withdrawals for medical expenses aren't taxed either. Her advice, treat it like an investment, not just a spending account. Let it grow for retirement instead of using it for small medical expenses now. Finally, there's tax loss harvesting, a strategy that's all about playing smart with your investments.
Daniel Williams:If you sell a stock at a loss, you can use that loss to offset other taxable gains, lowering your tax bill in the process. Just be careful of the wash sale rule, which prevents you from repurchasing the same investment within thirty days if you wanna claim the tax benefit. Bottom line, these strategies aren't just about saving on taxes now. They're about setting yourself up for long term financial independence. As Clyburn puts it, the key is to have a plan that aligns with your financial goals.
Daniel Williams:So talk to a tax pro, take advantage of these strategies, and make your money work for you. What do you have there?
Colleen Luckett:Alright. So my last segment was all about how insurers are using AI to put up more roadblocks, but what an AI and automation could actually remove barriers in this, area instead of create them? Well, that's exactly what an article from Med City News published on February 25 by Gary Hamilton explores. This one is titled automating insurance verification, a game changer for previsit payment collection, and it highlights how automating insurance verification is streamlining previsit payment collection, cutting down on administrative headaches for staff while improving financial transparency for patients. For years, manual insurance verification has been a major bottleneck in health care.
Colleen Luckett:It's slow, prone to errors, and a leading cause of claim denials and unexpected patient bills. In fact, a survey by Experian found that three out of four providers have seen an increase in claim denials with 45% linked to missing or inaccurate intake data, issues that manual processes struggle to fix. The solution, automated eligibility verification tools. By running real time insurance checks before a patient even steps into the office, these sit down these systems provide accurate cost estimates upfront, helping practices collect payments earlier and reduce administrative burden. They also flag missing or incorrect information immediately so staff can fix problems in real time, often with built in two way texting features for quick patient updates.
Colleen Luckett:Beyond the operational benefits, automation also improves patient and staff satisfaction. Patients get fewer surprise bills while staff spend less time chasing payments and fixing errors. With a smoother check-in process and less friction over billing, practices can focus on delivering better patient care rather than battling insurance red tape. So while AI might be a problem in some areas of health care, this is one case where automation is actually working in provider's favor. It's a reminder that, you know, technology isn't inherently good or bad.
Colleen Luckett:It's all about how we use it. Okay, Daniel. Back to you.
Daniel Williams:Alright. So let's talk about something every medical practice needs, but often puts off an employee handbook. So physician's practice recently published an article titled, how to write an employee handbook for practice staff. And it's really got some great tips on why this document is essential and how to get it right. A solid handbook isn't just a stack of rules.
Daniel Williams:It's a way to set expectations, protect your practice legally, and keep things running smoothly. First things first, your handbook is not a contract. This is a big one. The article stresses that you need to make it crystal clear that your handbook does not create a binding agreement. Most practices are at will employers, meaning either you or your employees can end the working relationship at any time.
Daniel Williams:To avoid any confusion, you should include a big bold disclaimer right up front that says just that. Another key takeaway, keep it up to date. Laws change, policies shift, and you don't want an outdated handbook causing problems. The article recommends reviewing and revising it at least once a year to stay compliant with federal and state regulations. Plus, updating your staff on new policies make sure everyone's on the same page.
Daniel Williams:Now what exactly goes in the handbook? The article suggests covering the basics, attendance expectations, vacation policies, sick leave, confidentiality agreements, and anything else that defines workplace behavior. Think of it as the ultimate FAQ for your staff. The more details you include, the fewer misunderstandings you'll have down the road. One thing that really stood out, get legalize on it.
Daniel Williams:The article recommends having an attorney review your handbook to make sure you're in line with employment laws. It's a simple step that can save you some major headaches later. At the end of the day, a well crafted employee handbook is your playbook for running a smooth, professional, and legally protected practice. If you haven't updated yours in a while or don't have one at all, I hope that's not the case. Now is the time to get started.
Daniel Williams:So, Colleen, yeah, let's take a look at that employee handbook next week.
Colleen Luckett:Yeah. Time time to update, I see. Alright. Well, for our I'm gonna leave everyone with some good news. According to this week's NGMA sub poll, most medical practices still managed to hit their productivity goals in 2024.
Colleen Luckett:Hooray. So, our poll this week found that 69% of medical group leaders reported their physicians and advanced practice providers or APPs either met or exceeded productivity goals in 2024. So met was 45% of you said that, and exceeded was 24%. And this is despite ongoing staffing shortages and patient access challenges. However, 30% of practices did fall short of expectations, citing, of course, the usual suspects, burnout, administrative burdens, and staffing gaps as the key hurdles.
Colleen Luckett:This poll included 218 responses from our medical group leaders. So what drove productivity in 2024? So practices that exceeded goals credited better scheduling, expanded staffing, and strategic use technology like AI, virtual scribes, and telehealth. High patient demand also played a role, but leaders acknowledged the need to balance efficiency with staff well-being to avoid burnout. And practices that met goals saw success through stable staffing, selective AIUs, and schedule refinements rather than major workflow overhauls.
Colleen Luckett:Expanding specialty services and chronic care programs also helped boost revenue and sustained financial performance. And those practices that fell short struggled with staffing shortages, provider attrition, and insurance related disruptions. Some faced higher patient resistance to seeing APPs, while others noted that work life life balance initiatives, while beneficial, led to fewer available pry provider hours. So the key takeaway is medical group productivity hinges on staffing stability, optimized scheduling, and financial alignment. AI and automation help, but they don't solve systemic issues like provider burnout and administrative burdens.
Colleen Luckett:And lastly, patient demand remains high, but so do barriers like no shows, insurance denials, and access challenges. Hey. For more data driven insights to help your health help your health care organization, check out MGMA's data guide provider compensation report, which can help you with benchmarking staff salaries, productivity, and incentives. And as usual, we'll drop the link to that information along with this week's stat poll article in the show notes. And, hey, would you like to share your insights on medical leadership and industry trends for our polls?
Colleen Luckett:Sign up for MGMA stat by texting s t a t stat to 33550, or visit mgma.com/mgma-stat to participate in our weekly polls. Alright. That's it for me, Daniel.
Daniel Williams: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 the episode show notes. So until then, thank you all again for being MGMA podcast listeners.
Colleen Luckett:And, Daniel, have a great time in San Diego. I'll see you next week.
Daniel Williams:Thank you. Bye now.
