MGMA Week in Review: ACA Mandate Upheld, Clinician Retention Challenges, and Cybersecurity Priorities
Download MP3Hi, everyone, and welcome to the MGMA Weekend Review podcast. I'm one of our hosts here today, Daniel Williams, a senior editor at MGMA and joined by co host Colleen Luckett and editor and writer here at MGMA and as we do with each week, we're going to bring you the latest health care industry news. Some of it today right off the press. We'll also bring you if there are any policy updates, expert insights, and just stories that we enjoy seeing from the field to keep medical practice leaders informed and inspired. Colleen, what is happening since we last spoke?
Colleen Luckett:Yeah. First, I wanna say welcome back from Spain. Thank you.
Daniel Williams:I'm tan, aren't I? I have a little bit of a tan.
Colleen Luckett:Yeah. I
Daniel Williams:actually got very sunburned. I went to a beach and it was a lot of fun. It was very interesting.
Colleen Luckett:Yeah. That's nice. I'm very jealous, but yeah, welcome back. And I hear you have a lot of work to do, we will leave you alone for a little while. All right.
Colleen Luckett:First to the news. And yes, I have some breaking news here. And this first one made me let out a huge sigh of relief as a patient. It's the kind that makes your blood pressure drop by at least five points. Now I know I wasn't the only one on this one, but medical group leaders everywhere can finally stop bracing for another preventable crisis because the Supreme Court just didn't gut a key part of the Affordable Care Act.
Colleen Luckett:So in her June 27 article for Health Care Dive titled Supreme Court Upholds ACA Preventive Services Mandate, Reporter Emily Olsen breaks down exactly what happened and why this ruling matters so much, although we know. On Friday, the Supreme Court ruled six to three to uphold a key provision of the Affordable Care Act that requires private insurers to cover a wide range of preventive services without cost sharing. That means cancer screenings, prenatal visits, STI testing, and medications to prevent HIV like PrEP remain fully covered. No deductibles, no co pays, no surprise bills. The case at the heart of it, Kennedy v.
Colleen Luckett:Braidwood Management Inc, was brought by two Christian owned businesses who argued that the US Preventive Services Task Force, which recommends what services insurers must cover, was unconstitutional. Their claim was the task force members hadn't been appointed by the president or confirmed by the senate. But justice Brett Kavanaugh, writing for the majority said, nope. The task force members are inferior officers. They're appointed and supervised by the secretary of health and human services who who is answerable to the president.
Colleen Luckett:That chain of command meets the constitution's appointments clause, plain and simple. So joining Kavanaugh and the majority were justices Roberts, Barrett, and the court's three liberal judges. Meanwhile, justices Thomas, Alito, and Gorsuch dissented, claiming the HHS had invented a brand new legal theory to justify the appointments. The supreme court's final word now clears that confusion. The ACA's mandate stands, the task force structure holds, and preventive care coverage stays intact.
Colleen Luckett:Whew. For medical groups, this ruling avoids a major operational headache. No reconfiguring coverage, no guessing games on benefits, and no scrambling to explain to your patients why their screenings just got more expensive. So, yes, breathe that sigh of relief. We all deserve it.
Colleen Luckett:Okay, Daniel, over to you.
Daniel Williams:Yeah. Thank you so much, Colleen. For our second story, I wanna dig into some fresh research that's really caught my eye. We're gonna have a full podcast on this about a month or so from now, but a sneak peek for today. So a new research study came out.
Daniel Williams:It's a clinician workforce survey. It's from locumtenens.com and the advisory board. And here's the headline: Even satisfied clinicians are planning to leave their jobs. You heard it. So based on their research, 76% of clinicians say they're satisfied where they are, but almost 30% of those same folks are thinking about switching jobs in the next two years.
Daniel Williams:And it's not just the younger crowd either. Nearly half of clinicians 40 are eyeing the exit, but so are a third or more of clinicians in their 50s and 60s. In short, job satisfaction doesn't guarantee retention anymore and organizations that assume otherwise might be in for a surprise. So let's dig a little deeper into this survey. It also looked at what clinicians actually value in a job, and compensation is still number one across the board.
Daniel Williams:But here's where it gets interesting. When you combine non comp factors like schedule flexibility, work life balance, and benefits, those actually outweigh compensation alone. For example, nearly sixty percent of clinicians said they preferred full time work, but they want control over when that work happens. Not necessarily fewer hours, just different hours. And when asked about work life balance, the top responses were all about time.
Daniel Williams:Time for family, time off, time to actually rest. Another finding that jumped out to me, no employer type comes out as a clear winner. Corporate groups score highest on pay and work life balance. Independent practices lead on clinician loyalty and work environment. Hospitals sit squarely in the middle.
Daniel Williams:But regardless of where they work, more than forty percent of clinicians are considering a change. That's a big red flag. And interestingly, clinicians placed through staffing firms scored their work environment an average of 14% higher than those who weren't. So, there might be something to learn from how these matches are being made. Bottom line, if you're trying to attract or retain clinicians, it's not just about throwing more money at the problem.
Daniel Williams:Today's workforce is looking for flexibility, balance, and a culture that actually walks the talk. Compensation will get them in the door, but it won't keep them there. Colleen, back to you.
Colleen Luckett:And now let's talk about another hot topic that's been keeping practice leaders up at night, encounter volume. Because let's face it, managing fluctuating patient visits today feels like trying to hit a moving target in a windstorm with one eye closed. According to the June 24 MGMA stat poll, forty eight percent of medical groups reported an increase in patient encounters compared to 2024. Another 26% said volumes stayed about the same, while 26% saw a decrease. The responses came from 254 practices across the country offering a solid snapshot of what's driving volume shifts and what's stalling them.
Colleen Luckett:For those with rising encounters, the big factors included better scheduling processes, extended hours, improved access, and expanded care teams, including PAs and NPs. Some practices saw a boost from strategic marketing or a growing patient population due to hospital referrals or community outreach. But for practices with flat or declining volumes, staffing shortages were the recurring villain. Other obstacles included provider PTO, aging clinician departures, EHR transitions, bad weather, fewer new patients, and, of course, the ever persistent issue of patient no shows. Pediatric practices especially noted a shift from sick visits to more mental health care driven by a lack of specialty support.
Colleen Luckett:And then there's telehealth still hanging in the balance. With parity protections only guaranteed through September, some practices are already seeing hesitation and decreased volume in virtual care. The article also dives into specialty specific strategies to help stabilize encounter volume. So primary care groups are leaning into open access scheduling, chronic care codes, and AI scribes to free up provider time. Surgical practices are optimizing scheduling, streamlining discharges, and integrating robotics and PAs to boost throughput.
Colleen Luckett:Nonsurgical specialties are deploying ambient AI and expanding remote monitoring to increase revenue without additional in person visits, and multispecialty groups are focusing on internal referrals, centralized scheduling, and cross training staff to better manage demand across departments. The big takeaway, whether you're running a solo practice or a large multispecialty group, success in 2025 means getting strategic. That means smarter scheduling, greater staffing flexibility, and, yes, embracing the tech that gives providers back their time. If you're looking for more detailed benchmarks and insights, MGMA members can check out the 2025 provider compensation and productivity data report we just released, which ties encounter trends directly to work RVUs, comp models, and collections. And as always, if you want your voice to help shape insights like this, join the MGMA stat poll by texting s t a t to 33550, and you'll get those poll questions in your text messages weekly.
Colleen Luckett:Okay, Daniel. Back to you.
Daniel Williams:Colleen, thanks for that. Now, our next story dives into why a non punitive workplace culture isn't just a nice to have. It's essential for patient safety according to three top CMOs featured in a recent Health Leaders piece. Here's the core insight. When staff feel safe to report safety concerns without fear of blame or retaliation, that's when real improvements happen.
Daniel Williams:Doctor. Jennifer Kalil from Vertuo says if caregivers worry they'll be penalized for flagging a medication error, staffing issue, or faulty equipment, they simply won't speak up. And Doctor. Kevin Post at Avira took it further. Quote, they can speak up for the safety of patients and their coworkers without fearing retaliation.
Daniel Williams:In their view, leadership must actively cultivate that environment and then reward people for stepping forward. Let's break down the mechanics. Providence's Sylvain Trepanier, a DNP, notes that in a non punitive culture, people actually report errors they were involved in. Rarely are they hidden. Then the team focuses on process failures, not individual blame.
Daniel Williams:That shift is huge. It turns errors into learning opportunities. At Avera, for example, their Good Catch award recognizes team members who identify near misses before harm occurs. That's not just a pat on the back. It's a signal that vigilance is valued and shared across the system.
Daniel Williams:But what does this look like day to day? First, leaders need to be visible, on the floor, in the trenches. Khalil emphasizes the importance of thanking people for speaking up and then following through when those concerns lead to real change. That kind of full circle feedback builds trust. And structurally, systems need to be in place to review and share those near miss learnings across the organization.
Daniel Williams:Think anonymous reporting, cross team communication, and a rhythm of regular reflection. And it's worth saying, this kind of cultural shift doesn't happen overnight. It requires long term commitment from leadership, not just CMOs, but department heads, nurse managers, HR, all the way up to the c suite. It's about creating psychological safety at every level. You can't fake it if your team sees retaliation or even silence after someone reports a concern, the trust breaks.
Daniel Williams:On the flip side, when leaders respond with curiosity instead of blame, it builds a loop of continuous improvement. That's when safety, retention, and morale all move in the right direction. With that said, Colleen, back to you.
Colleen Luckett:If your practice or health system is still thinking that patching is enough to keep cybersecurity threats out, you will want to listen up to this last story. Dominique Sorrentino, web editor for State Tech Magazine, gives it to us straight in his article titled exploitation trends underscore the need for layered cybersecurity and health care published on June 26 in HealthTech. According to Sorrentino's reporting, new data from SonicWall's 2025 threat brief shows that attackers are getting faster, smarter, and more opportunistic. While remote code execution flaws accounted for 40% of vulnerabilities, they were only responsible for 19 of actual attacks. Meanwhile, less obvious threats like elevation of privilege bugs were the most exploited, driving 38% of real world incidents.
Colleen Luckett:Why? Because attackers aren't wasting time. They're going for what's easiest to exploit, not necessarily what's most obvious on paper. SonicWall's research also revealed that security feature bypass methods made up just 8% of known vulnerabilities but nearly a third of real world exploits. Translation, volume doesn't equal priority.
Colleen Luckett:It's not about how many vulnerabilities you patch. It's about which ones are likely to be exploited. Douglas McKee, SonicWall's executive director of Threat Research, put it plainly. He said patching alone isn't enough. He emphasized that organizations need a, quote, smarter, faster approach, one that layers protections and aligns with how attackers actually operate today.
Colleen Luckett:That means detecting and stopping privilege escalation attempts, neutralizing malware hidden in office docs. Yes. Still a thing. Blocking exploits before they reach end users, integrating protections across endpoints, email, and network infrastructure. So what's the takeaway for our health care leaders?
Colleen Luckett:Don't just rely on CVEs or common vulnerabilities and exposures, severity scores, or patch volumes. Build layered defenses. Prioritize based on real world exploitability. And treat threat intelligence as a living, breathing necessity, not a check the box task. In other words, don't just patch and then throw salt over your monitor while whispering, please don't crash three times.
Colleen Luckett:It's time to patch and prepare. And that's a wrap for me today, Daniel. Back to you.
Daniel Williams:Alright. And that is gonna do it for this episode of MGMA's Weekend Review Podcast. We say it every week, but thank you so much for being MGMA podcast listeners, and please send us a note. I'll put our emails in the episode show notes. Send us a note and let us know if you have a story you want us to share or if you want to appear on an MGMA podcast.
Daniel Williams:Until then, have a great weekend.
Colleen Luckett:Bye, everyone. See you next time.
