MGMA Week in Review: Cybersecurity Updates, Patient Loyalty, and Shifts in Incentive Pay
Download MP3Well, hi, everyone. Daniel Williams here, senior editor at MGMA and host of the MGMA Podcast Network. We're back with another MGMA week in review podcast along with cohost Colleen Luckett, an editor and writer at MGMA. And we've been chatting offline, having a little fun catching up, so we're gonna share some of that with y'all. Colleen, what do you have first to share with us?
Colleen Luckett:Yeah. Well, I may have mentioned this last week, Daniel, but in in any case, I attended the Colorado HIMSS advocacy day breakfast last week. It was held in our own swanky historic Brown Palace Hotel in Downtown Denver. And if you're not already familiar, HIM stands for the Healthcare Information and Management System Society. They just had their big annual conference in Vegas.
Colleen Luckett:Chris Herritt, my boss, attended, and this was a little Colorado breakfast. And it was held on March 17. Yes. That was Saint Patrick's Day. And let's just say, if you were hoping for a feel good parade on cybersecurity updates, this is not going to be that.
Colleen Luckett:Now while there were festive green outfits, including a speaker from local government in a truly unforgettable shamrock blazer, the mood was anything but celebratory for the Guardians of Healthcare strengthening cybersecurity in an evolving Threat Landscape panel that took place later in the morning. So I wrote a recap of the panel in my latest, in this latest MGMA Insights article I did. It's titled Cybersecurity in Healthcare. No luck required, just relentless vigilance. And friends, I don't scare easily psychological horror and crime drama to my favorite genres for books and movies, but this one got under my skin.
Colleen Luckett:I just wanted to give you all a few important insights from the panel. So moderated by Stephanie Broderick from clinical architecture, the panel brought together some true cyber sentinels. Howard Hale, VP and CTO, Intermountain Health Richard Stainings, chief chief security strategist from Silera, and Rick Baum, chief information security officer at Point Solution Security, and a self proclaimed professional hacker. They were not pulling any punches on that morning from ransom ransomware attacks, paralyzing entire revenue cycles, to AI generated deep fakes of your CEO calling the help desk for a password reset. The message was clear.
Colleen Luckett:Cybersecurity isn't just an IT problem anymore. It is a leadership problem. A patient safety problem. A we could lose everything problem. One of the key takeaways, health care is a massive target because it's essential, and our systems, particularly third party vendors, are deeply interconnected and under defended.
Colleen Luckett:That was the really scary part. The Change Healthcare breach wasn't just a fluke. It was a warning. And as Rick Baum bluntly put it, the next change healthcare is coming is coming. So what does this mean for you, our members, in outpatient and medical group practice settings?
Colleen Luckett:Well, even if you're not part of a hospital system, you're likely working with these third party vendors. Do you know how secure they are? Do you have contingency plans if they go down? Something to really think about. Also, the panel emphasized that availability is now the top concern, not confidentiality.
Colleen Luckett:So if your EMR is encrypted by ransomware, if your e prescribing system is offline, or if your devices stop working, patient care halts. And that is bad, as you know. Finally, and this one's personal for practices. Your staff, especially at the front desk or call center, are the new frontline. Social engineering attacks powered by AI are designed to sound like your boss.
Colleen Luckett:So penetration testing, your help desk isn't a luxury anymore. It is a necessity. The good news, you, our MGMA members, don't have to figure this out alone. We have a cybersecurity and medical practices playbook we just put out. We have podcast episodes from Daniel's team.
Colleen Luckett:We've got courses and insight articles all designed to help you secure your systems, train your staff, and stay a step ahead of those bad guys. And I rounded up a strong collection of them for your convenience. You can find them at the bottom of my recap article. Again, it's called cybersecurity and health care. No luck required.
Colleen Luckett:Just relentless vigilance, and it's live now on mgma.com. We'll also link it in the show notes below, of course, but don't read it before bed unless you wanna lose sleep like I did after listening to that panel. Okay. Over to you, Daniel.
Daniel Williams:Alright. Thanks for sharing that. What a great panel discussion. So our next story, it comes from medical economics. It's written by Austin Lattrell.
Daniel Williams:It was published on March 26, and this is something that really caught my attention. It's a new study published in the Annals of Family Medicine, and it suggests something that I did not know. Patients are, in fact, willing to wait a little bit longer to see their own doctor. As long as it's their own doctor who they trust, they're willing to see them. So there are some caveats here.
Daniel Williams:It's special, especially when the visit involves something more personal or complex. We're talking chronic condition management, mental health care, or anything that requires a sensitive exam. The survey included more than 2,300 primary care patients, and it does make one thing very clear: continuity of care still matters. In fact, ninety four percent of those surveyed said they have a personal primary care physician, and seventy one percent said it was extremely important to them that that was so. Now, that's a powerful reminder in an era filled with urgent care clinics, minute clinics, and same day telehealth appointments.
Daniel Williams:For a lot of people, trust beats convenience. Now, when it comes to things like follow-up visits for mental health or chronic illness, more than half a patient said they only wanted to see their doctor. But that loyalty starts to shift when symptoms are more acute. For example, only about seven percent said they'd wait for their own doc when dealing with something urgent. Makes sense?
Daniel Williams:When you're sick sick, you won't help fast fast, so that's something to keep in mind. The survey even laid out hypothetical scenarios. Would you rather see your own primary care physician in three to four weeks or someone else within twenty four to forty eight hours? If the issue was sensitive, something like a pelvic or prostate exam, sixty eight percent said they'd hold out for their physician. For mental health concerns, fifty nine percent said the same.
Daniel Williams:That trust and relationship, especially in vulnerable situations, was worth the wait. And there was there were some interesting demographic details in the mix too. Patients with less education were actually more likely to want to wait to see their own doctor, even for new symptoms. Women were also more likely to prefer continuity when it came to annual checkups. And for chronic health conditions, folks with higher self reported health risk measured by the What Matters Index were more likely to want to stick with their personal provider.
Daniel Williams:So what's this mean for practices? It's merely a reminder that while improving access and quick scheduling is important, practices shouldn't lose sight of the value patients place on long term relationships with their providers. Building that trust isn't just good for outcomes. It's something that patients are actually willing to wait for. So Colleen, turn it over to you.
Colleen Luckett:I can totally relate to that. I actually saw my primary care physician yesterday, and I had waited for a little while. But I was thinking that, like, at our age, at my age, like, symptoms could be any number, like a hundred thousand different things. And so having that continuity of care and someone who really knows you, that is very important. Cool article.
Colleen Luckett:Thanks. So let's move on to the next segment here. So is the momentum behind incentive based pay for advanced practice providers starting to lose steam? In our March 25 poll, we asked medical group leaders how they currently compensate their APPs, and the results show a pretty even split. 44% said they use salary plus incentives, but another 44% said they stick to straight salary or hourly pay.
Colleen Luckett:Just 6% reported using an RVU model, and 3% used volume based compensation, and another 3% said other, the mystery people. That's a bit of a shift from our August poll when more than half, 51%, of respondents were using salary plus incentives. So we're seeing a modest retreat from incentive laden models. Now, before we jump to conclusions, it's worth noting that a number of leaders using salary only approaches said they're still considering adding incentives in the future, especially tied to productivity or value based care. But others were clear.
Colleen Luckett:They're sticking with simple salary models for now. And honestly, with rising operational costs and constant pressure on margins, that predictability can be a big win. It's also worth noting, fixed salary models may actually help with recruitment. In our June poll, 63% of practices said they were planning to add new APP roles. And with the ongoing hiring boom, less administrative complexity and quicker onboarding can be real advantages, especially for smaller groups with limited resources.
Colleen Luckett:Hey. If you've got a success story or best practice to share around APP compensation, we would love to hear from you. We would actually love to publish you in our next issue of Connection magazine or on the Week in Review podcast right here. You can reach out to me at c luckett, c l u c k e t t at m g m a dot org or Daniel at d williams, d w I l l I a m s at mgma dot org. And if you're not already part of the MGMA stat community, you should be.
Colleen Luckett:You can join by texting stat, s t a t, to 33550 or by accessing our sign up form online at MGMA.com/MGMA-stat. It's quick, easy, and your insights really help shape the future of health care leadership. Daniel, back to you.
Daniel Williams:All right. Thanks for that story, Colleen. Now we talked about continuity of care a moment ago. Let's talk about the flip side, discontinuity of care and when that comes from the practice. So what am I getting at?
Daniel Williams:Well, this is a story that comes from Physicians' Practice written by Keith A. Reynolds, published on March 25. And let's be honest here, discontinuity or dismissing a patient from your practice is one of those things that no one wants to deal with, but sometimes it just has to happen. Maybe it's chronic no shows, maybe it's verbal abuse, or a complete breakdown. In that word again, trust.
Daniel Williams:Whatever the reason, the article lays it out clearly. If you're going to do it, you've got to do it the right way, legally, ethically, and professionally. Reynolds walks through the situation where dismissal is appropriate, and there are more than you'd think. We're talking things like noncompliance, threatening behavior, repeated violations of office policies, or even refusal to pay for services. But here's the key.
Daniel Williams:It's not just about why you're letting a patient go. It's how you do it that really matters. Step one: document everything. You need a paper trail showing you gave the patient clear communication and reasonable chances to correct the issue. This isn't just about covering yourself.
Daniel Williams:It's also about showing that you've acted in good faith throughout. Then comes the formal written notice. That's your official breakup letter. It needs to explain without inflammatory language that the patient provider relationship is ending, and it should include a thirty day window during which you'll still provide emergency care, giving that patient time to find a new provider. And here's something that might surprise some folks: You don't have to give a specific reason for dismissal in the letter, especially if it's a high conflict situation.
Daniel Williams:The goal is to stay neutral, professional, and most importantly, avoid escalating things. The article also emphasizes avoiding discriminatory language or actions. You've got to be especially cautious when dealing with patients in protected classes. Think disability, race, gender, age, or a mental health status. A poorly handled dismissal can lead to legal blowback and damage your practice's reputation.
Daniel Williams:And finally, offer referrals. Even if the relationship has gone south, helping the patient transition out shows professionalism and keeps the focus where it should be on patient care, even as you're parting ways. So, yeah, it's not easy, but it's necessary. And when handled well, dismissing a patient can protect your team, your other patients, and the overall healthier practice. Colleen, I'm gonna turn it over to you.
Colleen Luckett:Sure. We're gonna finish this episode off with some hospital overcrowding issues. So if you thought hospital overcrowding peaked during COVID, think again. A new forecast says we may just be getting warmed up. So while your clinic might not have patients parked in the hallway yet, this story has major implications for outpatient care.
Colleen Luckett:The Association of Healthcare Journalists published a piece on March 17 by Mary Chris Jaklavik entitled it's titled More Hospitals Will Get Dangerously Overcrowded, Researchers Project. The article breaks down findings from a new research letter in JAMA Network Open showing that national hospital occupancy has climbed to a post pandemic average of seventy five percent compared to about sixty four percent before COVID hit. The big takeaway, this increase isn't due to a massive surge in hospitalizations. It's largely because we now have fewer staffed hospital beds. In fact, researchers found a 16% drop in bed supply nationwide.
Colleen Luckett:And if current trends hold, we could hit a critical 85% occupancy rate by 02/1932. Now, why does this matter to outpatient leaders like you all at NGMA? Well, first, hospital capacity often leads systems to double down on ambulatory services. That could mean more mergers, partnerships, or even acquisitions involving local practices. If hospitals can't keep patients in beds, they'll try to keep them out of beds, and that's where outpatient care steps in.
Colleen Luckett:Second, staffing. If hospitals start throwing around big sign on bonuses to solve their bottlenecks, physician practices could find themselves in an even tougher talent war. Recruiting and retaining staff could get more competitive than ever, especially in markets with major health systems. And finally, collaboration. This is a moment for outpatient practices to lean into preventive care, care coordination, and discharge planning.
Colleen Luckett:By working more closely with local hospitals, you can play a key role in reducing readmissions and helping manage complex patients outside the four walls of the hospital. Again, this article is by Mary Chris Jaklavik for the Association of Healthcare Journalists. It was published on March 17, and we've got the link for you in the show notes. And that does it for me today, Daniel.
Daniel Williams:Alright. And that's gonna do it for this episode. Again, as Colleen was saying, we'll have all of these links for you in the episode show notes, and we'll provide other resources for you as well. So I'll just say thank you all for being MGMA podcast listeners.
Colleen Luckett:Thanks, everyone. See you next time.
