MGMA Week in Review: Medicaid Cuts, Bathroom Cleanliness, and a Happy 4th of July!
Download MP3Well, hi, everyone, and welcome to the MGMA Weekend Review podcast, and happy fourth of July to you. For this special fourth of July episode, I'll just share who I am. I'm your host, Daniel Williams, along with cohost Colleen Luckett. We are editors and writers here at MGMA and love doing the podcast. So I'll just share with you each episode of Weekend Review.
Daniel Williams:We bring you some of the latest health care industry news, some policy updates when they occur, and some expert insights and just stories we find interesting and wanna share with you. So, Colleen, happy fourth of July.
Colleen Luckett:Thank you. You as well. Do you have any plans for the long weekend? May we get an extra day off, which is nice?
Daniel Williams:We are in the future. We're in our time machine. But True. I will tell you, we got two small dogs, and a lot of dogs react. You know?
Daniel Williams:They get a little nervous and scared. So usually
Colleen Luckett:Yes.
Daniel Williams:I like to hang with the dogs, get a couple of movies set up, and then we just kinda hang out together and and have a lot
Colleen Luckett:of fun. So yeah. That sounds awesome.
Daniel Williams:What about yourself?
Colleen Luckett:Yeah. We do the same. Hey. There's a new, I don't know if you guys watch it, but squid game, the last season is out on Netflix. We're watching that.
Colleen Luckett:That's probably what we'll be doing. Alrighty.
Daniel Williams:Let's take it to the, the news section section here. What is going on news wise?
Colleen Luckett:Alright. Well, just when you thought fourth of July fireworks were the biggest threat this week, especially to your little dogs, congress dropped a legislative sparkler of its own. And this one could burn through hospital budgets, access to care, and, yes, even your own medical group's bottom line. So a July 2 article, its chief health care executive, and it's titled Before Tax Bill Heads to Trump, Hospitals Hope to Limit Damage, details growing alarm among hospital leaders over a senate approved tax pass package that slashes nearly $1,000,000,000,000 from Medicaid, institutes work requirements, adds copays, and limits how states can secure federal Medicaid dollars. I'm sure most of our audience knows this.
Colleen Luckett:Hospital associations call the cuts unprecedented, warning of a domino effect from emergency room surges and longer wait times to reduced service lines, staff layoffs, and possible hospital closures, particularly in rural and underserved communities. Industry voices like Chip Khan of the Federation of American Hospitals and Rick Pollack of the stressed that these aren't distant hypotheticals. The congressional budget office projects that up to 11,800,000 people could lose Medicaid coverage within a decade, and an additional 5,000,000 could lose ACA related coverage if premium subsidies expire as planned. Even with a $50,000,000,000 rural hospital support fund tucked into the bill, leaders are calling it a short term patch for long term wounds. What this means for MGMA members.
Colleen Luckett:So expect a ripple effect beyond hospitals if local hospitals cut services, close units, or shut down. Expect a ripple effect beyond hospitals. If local hospitals cut services, close units, or shut down, referral pipelines shrink, ED overflow hits your clinics, and patient acuity rises in outpatient settings. Rural practices may see sudden spikes in uncompensated care, delayed diagnostics, or more patients arriving without coverage, especially in OB GYN, behavioral health, and chronic care management. Medical groups tied to hospital systems may be facing enterprise wise restructuring, capital freezes, or staff reallocations as systems tighten budgets to absorb the blow.
Colleen Luckett:And then practices should be reviewing payer mix projections, building contingency plans for Medicaid volume shifts, and advocating for state level mitigation strategies where possible. It's a tense moment, y'all. This is a story worth watching very closely. Medical groups that prepare now will be better positioned to weather the downstream impacts and protect access for the communities who rely on them. So, Daniel, over to you.
Daniel Williams:Yeah. And as Monty Python used to say, now for something completely different, I've got a story that might surprise some folk. It's about the bathroom. Yep. Physicians practice ran a piece called Bathrooms Are Us.
Daniel Williams:And while it may sound like a quirky headline, the story actually raises a really thoughtful point about patient perception and the spaces we often overlook. Here's the main idea. The bathroom is one of the only places in a medical office where the patient is alone, no staff, no distractions, and in that quiet moment, they tend to notice everything. A dusty vent, a leaky faucet, paper towels scattered on the floor, these can all shift the whole experience. As the article puts it, when the environment feels neglected, it calls the quality of care into question.
Daniel Williams:Think about it in this way, everybody. We've all gone into a restaurant. We're excited to eat the food. We go into the bathroom and we go, this is disgusting, and I don't think I wanna eat the food. If this is what the bathroom looks like, what is the food like?
Daniel Williams:Think about it from that perspective. So as one doctor featured in the piece shared how they started taking photos of their office restroom and reviewing them with staff to highlight discrepancies between their stated values like, We care about the details and what patients were actually seeing. That led to a simple solution, a rotating schedule where different team members checked the restroom twice a day. No fancy remodel needed, just a little ownership. The article also touched on how important the feeling of the space is.
Daniel Williams:Lighting, signage, updated fixtures, all of it contributes to a sense of comfort and dignity. If the bathroom looks like an afterthought, it does send a message. But when it's clean, safe, and thoughtfully maintained, it reinforces everything the practice is trying to convey out front. So, the takeaway is simple. The bathroom is part of the patient experience.
Daniel Williams:Think about it that way. And it might be worth asking, does it reflect the level of care your practice provides everywhere else? Colleen, with that said, back to you.
Colleen Luckett:That is something that is very important. I have not really put much into it. Maybe that was completely different. And speaking of the patient experience, so you know it's bad when even the automated hold music has a shorter wait time than your new patient slots. Our latest MGMA staff poll on July 1 checked in with practices across the country to see how long it's really taking to welcome new patients and what, if anything, is being done about it.
Colleen Luckett:Out of 269 respondents, forty percent said that wait times stayed the same. Twenty six percent said they got shorter. Good for you. But thirty one percent still reported that wait times have grown longer in 2025. That last number reflects a tough reality.
Colleen Luckett:Even modest improvements may not be keeping pace with rising demand, provider shortages, and operational constraints. Groups with worsening wait times cited retirements, staff shortages, and growing local populations. Many are trying to fix it, adding APPs, extending hours, and using tech tools. But others are still in the early stages of recruiting or haven't made changes yet. Those with stable or shorter wait times made tweaks like adjusting templates, using open access and online scheduling, hiring support staff, and implementing electronic check-in or more AI tools.
Colleen Luckett:The article for our stat polling also brings in national data from a May 2025 AMN health care study, which shows average new patient wait times have jumped to thirty one days, a 19% increase since 2022. Primary care, OBGYN, and dermatology all saw big delays, while orthopedic surgery was a rare bright spot, dropping to just twelve days on average. So what does all this mean for MGMA members? Well, for growth focused practices, wait times aren't just a scheduling headache. They're a strategic risk.
Colleen Luckett:Every day a new patient waits is a day they might walk. Staffing strategies, tech upgrades, and scheduling optimizations are no longer nice to haves. They're essential tools in the fight to protect referral pipelines, maintain access, and stay competitive. The bottom line is that front door matters. Keep it open, flexible, and moving, or risk becoming the healthcare version of a velvet rope club no one can get into.
Colleen Luckett:Well, as always, if you want your voice to help shape insights like these, please join the MGMA stat poll by texting stat, s t a t, to 33550, and you'll get those poll questions in your text messages weekly and be able to participate in our polls.
Daniel Williams:Alright. So for my last story of this July 4, I've got a story that looks into the future. Becker's Hospital Review just published a piece called Where Patient Volumes Are Headed, 10 Forecast for ten Years Out. And it is packed with insights about where health care is going and what it means for practices. First up, outpatient care is expected to grow eighteen percent over the next decade.
Daniel Williams:And wait for it, outpatient surgery alone is projected to increase by twenty percent. That's a major shift away from inpatient settings. So if your practice hasn't upped its outpatient game, now's the time to consider it. Inpatient volumes will still grow though, just more modestly, around five percent over ten years. But here's the kicker, patients will be sicker.
Daniel Williams:Sorry for the internal rhyme there, y'all. Lower patient count, higher acuity, so more complexity, more cost. Also, post acute care is going to blow up too, with an estimated 31% growth, especially in home health services, they're expecting a 24% growth. That tells me health care is not just moving out of hospitals, it's moving into homes. So here's something that touches a nerve.
Daniel Williams:Evaluation and management visits forecast to grow 16%. And by 02/1935, almost one fifth or 19% of these will be virtual visits. That's telehealth firmly cemented in the mix, not just a pandemic relic anymore. And a couple more nuggets worth noting. Emergency department volumes will inch up 5% driven by emergent visits, but urgent care stays flat.
Daniel Williams:Cancer outpatient volumes rise 18%, while inpatient oncology care holds steady. So oncology services need outpatient capacity. For pediatric patients, inpatient discharges go down 1%, while outpatient visits increase 8%. Basically, kids are showing up less in hospitals and more in clinic settings. Here are the key takeaways.
Daniel Williams:If you're managing a clinic or health system, lean into outpatient expansion, especially for surgery, chronic care, and cancer follow ups. With virtual visits rising, bolstering telehealth infrastructure isn't optional, it's essential. As post acute and home health explodes, partnering with home care or remote monitoring providers could be a big opportunity. And expect acutely ill patients, increase support for complexity and care coordination, even if volume isn't climbing as fast. That was a lot of numbers, but that is the data story behind the headline, Colleen.
Daniel Williams:Back to you.
Colleen Luckett:Thanks, Daniel. So ever feel like risk adjustment was designed by a committee that never met a provider or maybe by someone who's never even seen an EHR? Well, the American College of Physicians is feeling your pain, and they just proposed a fix. In a July 2 article from medical economics titled ACP Calls for Risk Adjustment Overhaul to Improve Health Equity, Cut Red Tape, author Austin Luttrell lays out the ACP's new policy push. Their paper published in the Annals of Internal Medicine calls the current risk adjustment landscape fragmented, inconsistent, and unnecessarily stressful for physicians.
Colleen Luckett:So to clean it up, ACP offers eight recommendations, including standardizing documentation rules across payers, investing in interoperable health IT using FHIR based tools, incorporating social drivers of health like housing and income, and putting an end to the annual redocumentation of chronic conditions. They're also raising red flags about coding manipulation and caution as AI enters the risk scoring world, calling for clear guardrails that support accuracy and equity. ACP president, doctor Jason Goldman, said the aim is simple. Reduce admin burden and make payment more reflective of real patient needs. So what does this mean for MGMA members?
Colleen Luckett:In a word, plenty. For practices navigating value based care, risk scoring affects everything from contract performance to revenue cycle management. Any move towards standardization and tech enabled efficiency could give medical groups a much needed breather and help shift the focus back where it belongs, on patient care. Well, that's a wrap for me. Daniel, back to you.
Daniel Williams:Alright, Colleen. And that is a wrap for us this week. Again, happy fourth of July to everyone. Whether you're out there watching all the big fireworks go off or barbecuing or hanging out with dogs or whatever you've got on the agenda. Hope you are safe, and have a wonderful long weekend.
Colleen Luckett:Happy fourth, everyone. See you next time.
