MGMA Week in Review: Medicare Fee Schedule Changes, Digital Forms Frustration, and The Pitt’s Emmy Nominations
Download MP3Well, hi, everyone, and welcome to the MGMA week in review podcast. Daniel Williams here along with cohost Colleen Luckett. We're editors and writers at MGMA, and we're your cohost for the MGMA Week in Review where each week we bring you the latest health care industry news, policy updates, expert insights, and stories from the field that we find interesting. So, Colleen, hello.
Colleen Luckett:Hello. Hello, everyone out there. Up first, if your week's been a balancing act between staff shortages, payer negotiations, and about 47 open browser tabs. You're not alone, my friends. But here's something you'll want to keep on your radar.
Colleen Luckett:The Centers for Medicare and Medicaid Services just dropped the proposed 2026 Medicare physician fee schedule, if you haven't seen it yet. It's packing some big changes that could ripple through your practice operations, especially if you're focused on chronic care, telehealth, or skin substitutes, interestingly. So here's the rundown from medical economics on July 14 is when they published this. So chronic disease and specialty care are center stage. A new ambulatory specialty model will launch in 2027, holding specialists accountable for performance and costs, starting with heart failure and low back pain.
Colleen Luckett:Think fewer hospitalizations, more early detection, and incentives for tech savvy team based care. Next up, physician payment updates include separate conversion factors for QPs and non QPs. Both groups get a bump around 3.8%, but the biggest shift, CMS is pushing for empirical data over outdated survey methods to set values, possibly a nod to more realistic reimbursement metrics in the future. Prevention and wellness take the spotlight as well. CMS wants to move from reactive to proactive care by eliminating 10 underperforming quality measures and adding five new ones focused on disease prevention, like diabetes prescreening.
Colleen Luckett:The Medicare diabetes prevention program could soon offer more coaching and support at no cost to patients. Telehealth flexibility from the COVID era may become permanent. Yay. And CMS is also looking to expand digital mental health device coverage, a win for hybrid and virtual care models. And and about those skin substitutes, Medicare spending exploded from 256,000,000 in 2019 to a whopping $10,000,000,000 in 2024.
Colleen Luckett:CMS is aiming to slash costs up to 90% by cracking down on pricing abuses and tying payment to clinical evidence. According to Doctor. Oz and RFK Jr, the goal is modernizing Medicare, reducing waste, and, quote, protecting hometown doctors. Interpret that as you will, but either way, this proposed rule will have real implications for practice leaders trying to stay afloat in today's health care economy. CMS is accepting comments for sixty days.
Colleen Luckett:So if you've got thoughts, and you probably do, now's the time to weigh in for a deeper dive and links to the full article. Of course, always check out our show notes for the link to the full article at Medical Economics. Okay, Daniel, over to you.
Daniel Williams:Colleen, thank you so much for that. And for our next story, I wanna share an article I came across on physician's practice. This one stood out to me, and I wanted to share it with y'all. It's called Every Patient Deserves Your First Time Energy. It was written by Doctor.
Daniel Williams:Neil Baum. Now the idea here is pretty simple, but definitely worth saying out loud. No matter how many times you've explained something, whether it's directions to the restroom, post op instructions,
Colleen Luckett:or
Daniel Williams:how a procedure works, every patient deserves to feel like it's your first time saying it. Doctor Baum compares it to being on stage. He tells a story about doing 30 magic shows over three days at a trade show. Even though he said the same lines over and over, each audience saw him for the first time, so he made sure to bring that fresh energy every single time. And it's the same in health care.
Daniel Williams:I like how he puts it, Repetition is your burden, not the patient's. They don't know you've had that same conversation 10 times already that morning. Another cool example in the piece, he mentions a colleague who uses a pre recorded video to explain medical procedures so the patient can get consistent information, but there's still that face to face follow-up where the doctor's showing up fully present. He even brings in Joe DiMaggio, how he played every game like someone in the crowd might be seeing him for the first and only time. Same mindset applies here.
Daniel Williams:Bottom line, whether it's the first question or the one hundredth, the patient deserves that same focus and energy. Easy thing to forget in a busy practice, but worth coming back to. Alright, Colleen. What's next?
Colleen Luckett:Wow. I can really relate to that. When I was teaching full time, you are on a stage, and it is exhausting. So I can't really relate to that message, but it's important. Alright.
Colleen Luckett:Up next, our MGMA members know better than anyone that real life emergency medicine isn't always what you're TV, but a new hit drama is changing that narrative. And I have a fun story for you all. So in the article called The Pit scores 13 Emmy nominations in a Pittsburgh hospital played a key role, published July 16 in chief healthcare executive by Ron Southwick. We learn how The Pit, HBO Max's breakout hospital drama earned 13 Emmy nods this week, including best drama and best actor for Noah Wiley. Remember that guy from ER?
Colleen Luckett:He's back in the hospital. So what makes this show different? Authenticity. The production team worked closely with Allegheny General Hospital, part of Highmark Health, to film key scenes and accurately depict the intensity of a busy urban trauma center. Staff gave real world input, helped shape the tone of the series, and even coordinated the logistics of a rooftop helicopter scene, which by pure luck had zero landings that day.
Colleen Luckett:Highmark's Dan Laurent says the hospital typically turns down filming requests, but the show's vision to honor frontline workers and portray emergency care with realism won them over. The result, a drama praised by both critics and clinicians. You can read the full article over at chief health care executive, and we'll also, of course, drop the link in our show notes as usual. And keep your eyes peeled season two of The Pit premieres in January 2026. And who knows?
Colleen Luckett:Maybe next awards season, we'll see one of our own MGMA members getting their fifteen minutes of fame. Just don't forget all of us little people when you hit the big time, guys. Okay, Daniel. Back to you.
Daniel Williams:Alright. Thank you so much. And I have had that bookmarked to watch that show for a while. And now that I see the praise it's getting, I'm definitely gonna check that out. So thank you So so for our next story, we're looking at new data from SMART Communications 2025 Healthcare Benchmark Report on Customer Experience and Communications.
Daniel Williams:There's some good news for healthcare leaders here. Healthcare consumers reported the biggest jump in satisfaction with communications compared to other industries. According to the report, 62% of consumers overall rate healthcare, banking, and insurance communications as good or excellent. And, healthcare actually saw a 75% improvement since 2018, and that's ahead of banking and insurance. So, some real progress being made.
Daniel Williams:That said, there are still major pain points. One is forms. That's right, forms. Digital forms, intake forms, enrollment forms. Anytime a patient has to fill something out, it's a form and we don't like it.
Daniel Williams:I'm speaking for patients here. And when that process is slow or confusing, people check out. According to the report, sixty six percent of all consumers abandon a process if the form is too difficult, and that number jumps up for younger folks. Seventy three percent of millennials, seventy one percent of Gen Z say they've bailed mid form having a 20 year old. I believe it.
Daniel Williams:What people want is speed and simplicity. Nine out of 10 respondents said that's essential. And here's something else. 63% of consumers prefer guided, interactive digital forms over those static PDFs. And 77% now expect more companies to offer digital data intake as standard.
Daniel Williams:Print and Scan just isn't cutting it anymore. The report also highlights an omni channel gap. Only 54% of consumers say they're satisfied with their omni channel health care experience. That means communication across email, text, portals just having to bounce back and forth. And they say the consistency isn't always there and that it erodes trust.
Daniel Williams:In fact, 60% said they'd trust health care companies more if experiences were consistent across all channels. So, some quick takeaways. One, forms aren't just paperwork. They're that patient's first impression. If the process is frustrating, it can cost you patience.
Daniel Williams:Two, health care has made real progress in consumer engagement, but omnichannel consistency is a big opportunity. Three, digital forms, digital first forms, communications aren't a luxury anymore. They're really that baseline expectations that patients have. So again, that's from SMART Communications 2025 Healthcare Benchmark Report. We'll have that linked in the episode description if you wanna check it out in full.
Daniel Williams:I love that, Colleen. So now I'm gonna just turn it over to you.
Colleen Luckett:Yeah. That is timely. We had a internal training here at MGMA, and my team actually brought that up, like, all the paperwork we have to get through. So we are definitely thinking about that over here, ways to help you all out on that. For our last segment, I wanna leave you all with something a little closer to home.
Colleen Luckett:It's a must read article from the July issue of MGMA Connection magazine. It's called From Bogota to the Boardroom. It's written by the incredible Paola Turci, who is a health care revenue cycle executive and proud Colombian immigrant. In this piece, she shares her career journey with honesty, vulnerability, and deep insight. She reflects on what it means to lead as a woman and an immigrant.
Colleen Luckett:Navigating systems not with her in mind, battling impostor syndrome. Oh, I know that one. And building her own board of directors for support along the way. This piece is a powerful reminder that leadership is about lifting others as you climb, staying grounded in your values, and showing up with both head and heart. If you've ever felt like the only one in the room, or if you're helping to build rooms that are more inclusive and equitable, Paola's story will speak directly to you.
Colleen Luckett:Beyond her executive role, Paola also helps lead MGMA's Women Healthcare Leaders Resource Group here, a space where women can connect, grow, and support one another in the industry. All of these resource groups will also be hosting sessions at our MGMA Leaders Conference in Orlando this fall, and their next virtual events and meetings will take place in November. So keep an eye out. We will drop the link to all resource groups in our show notes. You can check those out and see if there's one that you wanna join.
Colleen Luckett:And you can read Paola's full article now at ngma.com/articles. And I'm telling you guys, it's one of the most personal and powerful pieces that we published this year in my opinion, and I really hope you'll take a moment to check it out. Okay, Daniel. That is it for me. Over to you.
Daniel Williams:Alright. And that is it for this week's MGMA week in review. Everybody, thank you so much for being podcast listeners. Please, we've said this before, but if you have a story you want us to read, if you wanna write an article like Paula did, if you wanna be on a podcast, send us a note. We'll provide all the links to that in our episode show notes.
Daniel Williams:So until then, have a great weekend.
