Join Daniel Williams and Colleen Luckett, editors at MGMA, as they dive into the latest healthcare news and insights. From the impact of executive orders on global health to the imperative for streamlining revenue cycles, this episode covers a range of topics that are shaping the future of the industry.

Key Highlights:

• President Trump's Executive Order on WHO
• Healthcare's 2025: Revenue Cycle Imperative
• Maternal Health Awareness Day Interview
• MGMA Stat (Cyber Attacks)
• Cyber Security Playbook
• Self Monitoring Devices

Conclusion:
In this episode, Daniel and Colleen explore the evolving landscape of healthcare, from global health policies to revenue cycle optimization and patient engagement. Stay tuned for more insights and resources to help you navigate the ever-changing healthcare industry.

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.

In this episode of the MGMA Business Solutions Podcast, host Daniel Williams welcomes Frank Herrington, Senior Director of Sales at MGMA Best Price. MGMA BestPrice is an exclusive group purchasing organization (GPO) that provides MGMA members access to discounted pricing on essential medical, surgical, pharmaceutical, and business services. Frank shares how MGMA members of all sizes can benefit from the program and the significant savings opportunities available.

Key Takeaways:

• MGMA BestPrice is a free, no-risk program that leverages the collective buying power of MGMA members to negotiate lower pricing on a wide range of products and services. "MGMA BestPrice provides contract pricing for medical, pharmaceutical, surgical equipment, office supplies, IT products, travel services, shipping, shredding, and more," Frank highlights. "It helps organizations reduce costs and improve operational efficiency."
• MGMA BestPrice works with a variety of medical practices, from primary care to specialty groups, as well as ambulatory surgery centers and other healthcare organizations. "By joining MGMA BestPrice, medical practices can save up to 20% on essential products and services," Frank says. "The best part is that practices don't need to change their distribution representatives or ordering process."
• MGMA BestPrice provides dedicated customer support, including a personalized account manager to guide members through the implementation and onboarding process. Frank advises, "If you're on the fence about joining MGMA BestPrice, the best thing to do is to reach out to one of the representatives, and we can perform a cost study analysis for the prospective member."
• MGMA BestPrice has saved members over $14 million in the last year, with one member expected to save close to $1 million over the next seven years.

Resources:

• To learn more or sign up for MGMA BestPrice, visit MGMABestPrice.org or call 844-234-6462.

In this episode of the MGMA Week in Review podcast, hosts Daniel Williams, senior editor at MGMA, and Colleen Luckett, editor and writer at MGMA, discuss the latest healthcare news and trends. They cover the Supreme Court's review of the Affordable Care Act's preventive services mandate, the rise of virtual nursing, and the growing use of AI in healthcare decision-making.

Key Takeaways:

• The Supreme Court has agreed to review a challenge to the ACA's requirement for insurers to cover specific preventive services at no cost, which could limit access to crucial services like cancer screenings and HIV prevention medications.
• Virtual nursing programs are becoming a game-changer in healthcare staffing, with the potential to significantly shift traditional nurse-patient ratios and provide more flexibility for experienced nurses.
• AI tools have surpassed EHR usability as the top tech priority for medical leaders i n 2025, with key goals including automating documentation, improving patient interactions, and enhancing operational efficiency.
• The use of AI by insurance companies to decide which medical treatments to approve is raising concerns, with examples of patients being denied necessary care and the error rates of these systems being as high as 90%.
• A new AI algorithm called RADAR, developed by Linus Health, has shown impressive accuracy in identifying undiagnosed cognitive impairments like Alzheimer's and dementia, potentially transforming value-based care.

Resources Mentioned:

• Axios article on the Supreme Court's review of the ACA's preventive services mandate
• Becker's Hospital Review article on virtual nursing
• MGMA Stat poll on tech priorities for medical leaders in 2025 
• Med City News article on the use of AI by insurance companies
• Healthcare IT News on AI that identifies undiagnosed cognitive impairment 
• MGMA's updated physician fee schedule tool

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.

In this episode of the MGMA Business Solutions podcast, we welcome back Dr. Alex Ding, Associate VP for Physician Strategy and Medical Affairs at Humana. Dr. Ding dives into the findings of the MGMA-Humana AI Adoption Report, discussing how artificial intelligence is transforming healthcare by reducing clinician burnout, improving operational efficiency, and enhancing patient outcomes. Join us for a thought-provoking conversation on AI's evolving role in healthcare, its ethical implications, and the opportunities it creates for practices embracing value-based care.

Key Takeaways:

1. AI Adoption and Early Success:
   • AI is in its early stages for many organizations, with about one-third of practices adopting tools focused on operational efficiency and clinical support.
   • Practices in value-based care settings show greater adoption rates.
   • Access the MGMA-Humana AI Adoption Report here.
2. Reducing Burnout with Ambient AI:
   • Ambient AI, such as virtual scribes, is helping alleviate clinician burnout by streamlining documentation processes.
   • Over two-thirds of surveyed organizations using AI cite this as a primary application.
3. Ethical and Governance Considerations:
   • Lack of formal governance structures and education remains a barrier to AI adoption.
   • Organizations need ethical and technical training for successful, compliant implementation.
4. AI in Revenue Cycle Management (RCM):
   • AI tools are improving processes like coding, claims, and predictive analytics, particularly in population health management.
5. Supporting Underserved Populations:
   • AI identifies care gaps and enables proactive interventions for high-risk populations, allowing clinicians to focus on patient relationships.

Resources:

• Read the Full MGMA-Humana AI Adoption Report
• Explore MGMA’s AI Resources by visiting our homepage and clicking Ask AI
• Visit Humana's website to learn more about their plans and coverage
• Connect with Dr. Alex Ding on LinkedIn

Closing:
Thank you for tuning in to this episode of MGMA Business Solutions. For more insights into the role of AI in healthcare, be sure to explore the links in the show notes. Until next time, keep innovating and enhancing healthcare practices!

In this episode of the Ask MGMA podcast, hosts Daniel Williams and Cristy Good discuss strategies for sizing a central billing office (CBO) to ensure efficient accounts receivable (AR) management and claims processing. Christy, an MGMA expert, shares key insights and best practices to help medical practices determine the right staffing, technology, and processes to optimize their CBO operations.

Key Takeaways:

1. Assessing Current Volume and Complexity

• Evaluate historical data on claim volume and billing procedures to determine appropriate staffing levels.

2. Leveraging Technology

• Integrate billing and coding software with the practice's EHR system to streamline claims processing and reduce errors.

3. Training and Monitoring Staff

• Provide ongoing training to billing and coding personnel to stay up-to-date on regulatory changes and ensure quality control.

4. Pre-Submission Claim Scrubbing

• Implement a robust pre-submission claims review process to catch and correct errors before submission.

5. Regular Audits

• Perform both internal and external audits to validate coding standards and payer requirements.

6. Effective Patient Communication

• Develop clear financial policies and scripts to help patients understand their financial responsibilities.

7. Outsourcing Considerations

• Evaluate the benefits of outsourcing billing and coding functions, especially for smaller practices.

8. Adjusting Strategies for Seasonal Changes

• Adapt Central Business Office (CBO) staffing and processes to accommodate fluctuations in patient volume and claim complexity throughout the year.

Resources and Call to Action:
For more information and support in optimizing your practice's central billing office, visit MGMA.com and explore our wide range of resources, including:

• MGMA Consulting services for customized guidance
• MGMA Benchmarking data for industry insights
• MGMA Coding and Billing Toolkit for regulatory updates

If you have a specific question or challenge, use the "Ask MGMA" feature on MGMA.com to connect with our experts, like Cristy Good, who can provide personalized assistance.

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.

Welcome to the MGMA Week in Review podcast, where we dive into the latest news and insights impacting healthcare leaders. In this episode, we cover a powerful call to protect Medicaid, a guide on behavioral finance for physicians and dentists, the rise of no-show fees, states' moves to reform certificate of need laws, and the data dilemma costing health systems millions.

Main Items and Resources:

• Families USA and 344 Organizations Urge Congress to Protect Medicaid (MedCity News)

• Behavioral Finance: A Guide for Physicians and Dentists as Business Owners (Physicians Practice)

• No-Show Fees Gain Traction in Medical Practices (MGMA.com/Stat)

• States Move to Curb Certificate of Need Laws to Boost Hospital Bed Capacity (Healthcare Dive)

• The Data Dilemma: How Fragmented and Inaccurate Data is Costing Health Systems Millions (HealthLeaders)

Additional Resources:

• MGMA Data Dive

• MGMA Events

• Oncology Patient No-Show Policy, member-exclusive tool 

Connect with Us!
If you'd like to share your thoughts, ask a question or appear on a podcast, contact us at 
[email protected]
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Thanks for being an MGMA Podcast Listener!

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.

In this episode of the MGMA Insights Podcast, host Daniel Williams sits down with Dr. Ruth Gotian, a leading expert in mentorship and the Chief Learning Officer at Weill Cornell Medicine. Dr. Gotian discusses the transformative impact of mentorship, the key elements of successful mentoring relationships, and how organizations can build thriving mentorship programs.

Key Takeaways:

The Benefits of Mentorship

• Mentored individuals earn more, get promoted more often, and experience lower rates of burnout compared to those without mentors.
• Mentorship can increase self-efficacy, leading to greater confidence in pursuing new opportunities.
• Mentoring relationships can enhance loyalty and retention within an organization.

Rethinking the Traditional Mentor-Mentee Dynamic

• The traditional view of a mentor as a senior, experienced individual is outdated. The contemporary approach is to build a diverse team of mentors, including peers and even those junior to you.
• Successful mentoring relationships are built on mutual curiosity, a desire to learn from each other, and a reciprocal exchange of knowledge and perspectives.
• Mentors should not aim to create "mini-me's" but rather help mentees become the best version of themselves.

Organizational Support for Mentorship

• Organizations can foster a culture of mentorship by providing the necessary infrastructure, training for both mentors and mentees, and opportunities for organic connections to form.
• Effective mentorship programs should have a clear ownership structure and ensure that mentors are rewarded for their time and contributions.
• Measuring the success of a mentorship program should go beyond just tracking metrics like promotions and revenue. It should also consider factors like employee motivation, productivity, and retention.

Resources:

• Purchase Dr. Ruth Gotian's latest books, The Success Factor and Mentoring: A Complete Guide to Effective Mentoring from the Financial Times Guides series.
• Visit Ruth Gotian's website or connect with Ruth Gotian on LinkedIn

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.

In this episode of the MGMA Insights Podcast, host Daniel Williams welcomes back Liz Mahan, the Director of Professional Development and Solutions at the Association for Advancing Physician and Provider Recruitment (AAPPR). Mahan dives deep into AAPPR's 2024 Benchmarking Report, exploring the key trends and challenges facing physician and provider recruitment in the coming years. From the ongoing physician shortage to the evolving needs of the next generation of healthcare providers, this episode offers insights and practical strategies for medical practice leaders and MGMA members.

Key Takeaways:

• The Physician Shortage Persists: Mahan emphasizes that the physician shortage is not going away anytime soon, and organizations need to be proactive in their recruitment and retention efforts.
• Shifting Priorities for Younger Providers: Newer generations of physicians and providers are seeking more flexibility, work-life balance, and a strong cultural fit, requiring recruiters to adapt their strategies.
• Importance of Proactive Planning: Mahan stresses the need for organizations to regularly update their medical staff development plans and stay attuned to community needs to ensure they are meeting the evolving demands of their patient populations.
• Recruitment Professionals Face Challenges: The 2024 Benchmarking Report reveals a 20% turnover rate among recruitment professionals, highlighting the importance of investing in and supporting these critical team members.
• Branding and Influence are Key: Mahan highlights how successful recruitment in the future will require recruiters to think like marketers and influencers, leveraging their organization's brand and culture to attract the right candidates.

Resources:

• Visit the AAPPR website to connect with and learn from physician and provider recruitment leaders.
• Purchase AAPPR's 2024 Benchmarking Report to unlock comprehensive insights that can give your organization a competitive recruiting advantage. 
• Connect with Liz Mahan on LinkedIn

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.

In this episode of the MGMA Insights Podcast, host Daniel Williams speaks with Regina Rogoff, the retired CEO of People’s Community Clinic in Austin, Texas. With over 20 years of healthcare leadership and a prior career in legal aid, Regina has dedicated her professional life to serving underserved communities. The discussion highlights Regina’s transformative leadership at People’s Community Clinic, her insights into challenges and successes in healthcare management, and her plans for retirement.

Resources and Links

• Learn More About People’s Community Clinic
  Visit People’s Community Clinic to explore their mission, programs, and impact.
• Regina Rogoff’s Retirement Announcement
  Read the Austin American-Statesman article: Regina Rogoff Retiring from People’s Community Clinic
• 2014 Best CEO Award – Nonprofit
  View details of Regina’s recognition: Austin Business Journal Best CEO Awards

Closing

This episode honors the legacy of Regina Rogoff, a leader who has dedicated her career to creating meaningful change in healthcare and legal services. Thank you to Regina for her decades of service and to our listeners for joining us. For more inspiring stories and insights, stay connected to the MGMA Insights Podcast or send us a note if you want to be interviewed at [email protected]. 

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.

In this episode of the MGMA Insights podcast, Daniel Williams sits down with Dr. Anjali Rajpal, a leading cosmetic dentist and founder of Beverly Hills Dental Arts. Dr. Rajpal shares her journey into healthcare, her passion for art and mindfulness, and how she is redefining the patient experience through a holistic, patient-centered approach.

Main Points:

• Dr. Rajpal's Path to Dentistry: Blending Medicine, Art, and a Passion for Hands-On Work
• Creating a Unique Dental Practice: Incorporating Art, Mindfulness, and a Soothing Environment
• Prioritizing Patient-Centered Care: Building Trust, Leveraging Technology, and Minimizing Pharmaceutical Interventions
• The Power of Mindfulness: Dr. Rajpal's Personal Journey and Integrating it into Her Practice
• Deepak Chopra's Influence: Insights from Serving on a Panel with the Renowned Mindfulness Advocate

Sources and Resources Mentioned:

• Beverly Hills Dental Arts
• Deepak Chopra
• Cedars Sinai Medical Center

Watch the interview on YouTube here

This episode is brought to you by Zoll Data Systems, software and data solutions for healthcare financial professionals. Zoll AR Boost is the comprehensive automated RCM optimization suite that automatically finds, corrects and verifies patient and payer information to capture more revenue, reduce administrative burden, and improve the patient financial experience. The number one Black Book-rated insurance discovery tool can discover active, billable coverage for more than 40 percent of claims. Visit https://www.zolldata.com/healthcare-financial-data/arboost to learn about the complete Solution suite.