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Welcome to the MGMA Podcast Network, your gateway to insightful discussions and expert analysis on key topics in healthcare management. Dive into a diverse array of shows tailored to meet the interests and needs of healthcare professionals like you.

Explore the experiences and perspectives of trailblazing women in healthcare on "Women in Healthcare," or discover innovative strategies and solutions for your practice on "Business Solutions." Stay updated on the latest industry trends and news with "Week in Review," and gain valuable insights from industry leaders and MGMA members on "Member Spotlight." Don't miss our flagship show, "MGMA Insights," where we delve deep into the most pressing issues facing healthcare organizations today.

Whether you're seeking inspiration, practical advice, or in-depth analysis, the MGMA Podcast Network is your trusted companion on your journey towards excellence in healthcare management. Tune in and join the conversation today!

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#780
Wednesday · 27 min
AI vs. AI: The Next Generation of Revenue Cycle Management — A Conversation with ModMed's Rob Ware
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams has a conversation with Rob Ware, senior vice president and general manager of revenue cycle management at ModMed, about how artificial intelligence is reshaping medical billing and financial operations. Ware explains why revenue cycle management has reached an inflection point, how organizations can respond as payers adopt increasingly sophisticated technology, and what practice leaders should examine before adding another solution to their technology stack. Episode takeaways Revenue cycle management is moving beyond rules and individual expertise. Billing has traditionally depended on experienced professionals navigating an enormous and constantly changing mix of payers, plans, codes and requirements. Machine learning and AI can evaluate more of those variables at once, giving organizations an opportunity to make revenue cycle performance more consistent and scalable. Smaller amounts of revenue can no longer be dismissed. Rising operating costs, stagnant reimbursement and expanding administrative requirements have narrowed practice margins. Under those conditions, improving net collection rate by even one or two percentage points can have a meaningful financial impact. Practices increasingly need to “fight AI with AI.” Payers are using automation and AI to apply edits, conduct initial claim reviews and accelerate denial decisions. Practices need tools capable of identifying changing denial patterns quickly, rather than relying exclusively on monthly or quarterly reports that describe problems after they have already affected cash flow. Technology purchases should begin with a specific source of pain. Before selecting a solution, leaders should determine whether their primary leakage comes from charge capture, prior authorization, coding, denials, appeals or another part of the workflow. A clearly defined problem makes it possible to choose the appropriate technology and establish a meaningful measure of success. Integration matters as much as individual functionality. Stand-alone applications may solve isolated tasks, but using numerous point solutions can produce expensive and unreliable data transfers. Ware advises practices to prioritize technology that integrates closely with the EHR, practice management platform and other core systems of record. Prediction is most valuable when it leads to prevention. Flagging a claim immediately before submission may be too late if the missing information must come from the patient or physician. More advanced revenue cycle tools can bring guidance forward in the workflow, allowing staff to obtain required information while the patient is still present or while the clinician is completing documentation. Technology may reshape staffing and outsourcing decisions. Persistent hiring challenges are encouraging more organizations to consider strategic RCM partnerships. Better dashboards, real-time tracking and operational visibility can help leaders retain oversight even when work is handled outside the practice. AI-enabled guidance may also help less-experienced employees become productive more quickly, although knowledgeable revenue cycle professionals remain essential. Net collection rate remains a critical measure of financial health. By comparing the amount collected with the amount contractually available to collect, net collection rate provides a broad view of revenue cycle performance. Because it is a lagging indicator, however, practices should monitor it alongside earlier operational measures that can expose emerging authorization, denial and workflow problems. Resources ModMed Revenue Cycle Management Connect with Rob on LinkedIn MGMA Insights Podcast Network Beyond the hype: Practical AI applications that improve access, capacity, and revenue (MGMA article) How AI and Human Talent Can Work Together to Transform Medical Practices (MGMA podcast) Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#779
August 19 · 25 min
Five Minutes to Reset: Mindfulness, Movement, and Burnout Prevention with Dr. David Klemanski
Earlier this year, MGMA Stat polling found that one in three physicians either retired or left their practice in the past year due to burnout, while nearly half of medical group leaders said physician burnout is getting worse. In this episode of the MGMA Insight Podcast Network, host Daniel Williams chats with Dr. David Klemanski, chief of the Division of Psychology and director of postdoctoral training at Cambridge Health Alliance, and a faculty member at Harvard Medical School, to explore how short mindfulness and movement practices may help medical practice workers manage stress before it becomes chronic. Dr. Klemanski shares findings from a randomized controlled trial conducted with Caravan Wellness, examining whether five- to 10-minute mindfulness or movement interventions can improve stress, emotional regulation, quality of life and motivation. The conversation moves from research design to everyday application, including what to do when a stressful moment hits, why prevention matters, and how busy healthcare professionals can begin building habits before they need them most. Episode Takeaways Stress has shifted from episodic to chronic for many people. Dr. Klemanski notes that stress is no longer something many workers experience in isolated bursts. For clinicians, practice leaders and staff members, stress increasingly functions as a constant overlay on daily life. Mindfulness is not about “doing nothing.” Dr. Klemanski defines mindfulness as paying attention in the present moment, on purpose and without judgment. In hectic medical practice environments, that can mean pausing long enough to recognize a worry loop, a reactive emotion or an unhelpful automatic behavior. Micro moments can create meaningful behavior change. The study tested brief daily interventions, typically around 10 minutes, using mindfulness practices or guided physical movement. Participants who engaged with these short practices showed improvements in stress, anxiety, emotional regulation, quality of life and motivation. The study compared mindfulness, movement and a control group. Participants were randomly assigned to mindfulness activities, physical movement activities or a wait-list control group. The goal was to examine whether brief wellness practices could produce measurable change over time. Motivation matters when building healthier habits. One of the study’s notable findings was that people who practiced these micro-interventions often became more motivated to continue wellness-oriented behaviors. Dr. Klemanski emphasized that this habit formation is central to longer-term sustainability. The best time to learn mindfulness is before a crisis moment. Dr. Klemanski cautions that trying to learn mindfulness in the middle of an emotional storm is difficult. Practicing during calmer moments helps train the brain so the skill is available when stress, rumination or frustration rises. Movement can be a mindfulness practice too. For people who struggle with seated meditation, movement-based practices such as stretching, yoga, light exercise, cardio or resistance training can offer similar benefits. The key is being intentional and present rather than simply checking out. Technology can either distract or support regulation. Daniel and Dr. Klemanski discuss the common reflex to scroll through a phone during small pockets of downtime, such as standing in line. Wellness apps may help redirect that impulse toward a more restorative use of those same few minutes. Resources Connect with Dr. David Klemanski on LinkedIn Learn more about Caravan Wellness Learn more about Harvard Medical School "Staying vigilant against physician burnout: Is progress being made?" (MGMA Stat article) "Can focusing on burnout cause more burnout?" (MGMA Insight article) "Addressing clinician burnout with a focus on their calling to medicine" (MGMA Stat article) MGMA Insights Podcast Network Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#778
August 12 · 25 min
Why Workflow, Not Technology, Is Healthcare's Biggest Challenge: A Conversation with NextGen's G. Shah
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with G. Shah, Chief Product and Strategy Officer at NextGen Healthcare, to explore why healthcare organizations need to redesign workflows around patients and providers rather than simply layering on more technology. They discuss workflow debt, provider burnout, trusted data, interoperability, and how healthcare leaders can take a more strategic approach to AI adoption. Episode Takeaways Healthcare's biggest challenge isn't technology, it's workflow design. Many organizations have accumulated layers of technology solutions over time without reevaluating the end-to-end experience for providers, staff, and patients. Broken workflows create organizational "debt." Administrative burden, staff frustration, provider burnout, and inefficient processes accumulate when organizations continue to build on outdated workflows rather than redesigning them. Technology should enable care, not dictate it. Shah argues that providers have spent years adapting to software workflows when technology should instead adapt to how clinicians deliver care. The best technology becomes invisible. Effective technology supports patient care in the background, allowing providers to focus on face-to-face conversations and meaningful interactions rather than screens and documentation. Patients experience workflow failures even when they don't see them. Delayed referrals, redundant paperwork, repeated questions, and disconnected systems all create friction that negatively impacts the patient experience. Trusted data is essential for better care and efficiency. Organizations need confidence in the accuracy, source, and provenance of information to reduce duplicate work, unnecessary testing, and repeated verification. AI alone won't solve broken processes. Applying AI to inefficient workflows may simply make broken processes run faster. Healthcare leaders should redesign desired workflows first, then determine where AI creates meaningful value. Evaluate AI through an end-to-end workflow lens. Before investing in point solutions, organizations should assess how AI tools integrate into existing workflows, share data, and support the broader patient and provider experience. Resources Connect with G. Shah on LinkedIn Learn more about NextGen Healthcare Webinar discussed in this episode: Healthcare Has Normalized Broken Workflows: How High-Performing Practices Are Redefining What's Possible (on demand) Register or access MGMA webinars Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#777
August 5 · 34 min
A Year Later: Revisiting Ochsner Health's Award-Winning Patient Access Innovation with Sean Nguyen
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams speaks with Sean Nguyen of Ochsner Health about the evolution of Ochsner's award-winning spine care initiative, the power of clinician collaboration, practical applications of AI in healthcare, and what attendees can expect from his upcoming presentation at the MGMA Annual Conference in San Antonio. Nguyen first joined the podcast as the recipient of MGMA's Harwick Innovation Award. Now, nearly two years into the implementation of Ochsner's coordinated spine care model, he shares lessons learned, measurable outcomes, and why the framework can extend well beyond spine care to improve access and care navigation across the healthcare continuum. The conversation also explores AI adoption, conference planning, and the importance of maintaining passions outside of work. Episode Takeaways Ochsner's spine care initiative was designed to create a seamless patient experience regardless of where a patient enters the healthcare system, ensuring "right care, right place, right time." Nearly two years after implementation, the program continues to demonstrate positive results through improved patient access, strong patient satisfaction scores, and high clinician engagement. One of the biggest successes has been increased collaboration among physicians, therapists, pain management teams, and other specialists across the health system. Nguyen believes the same care coordination framework can be applied to a wide range of conditions, including diabetes, hypertension, dermatology concerns, and other complex care pathways. Technology and process improvement go hand in hand. Effective coordination requires both the right workflows and the right digital tools. Ochsner is leveraging AI across multiple areas, including call center operations, decision support, ambient documentation, prior authorization workflows, and administrative burden reduction. Nguyen has become a daily user of Microsoft Copilot, using it to prepare for meetings, summarize projects, organize priorities, and enhance communication. As a member of MGMA's inaugural Annual Conference Planning Committee, Nguyen offers a behind-the-scenes look at how the conference experience is designed with attendee engagement, education, networking, and logistics in mind. Outside of healthcare leadership, Nguyen relies on movies, comics, and superheroes as a way to recharge, combat compassion fatigue, and maintain balance. Resources MGMA Annual Conference 2026 (September 27-30, San Antonio) | Sean Nguyen's session: "Blowing Up the Front Door: Reinventing Access and Redesigning Care" | Tuesday, September 29, 1:30 p.m. CT Connect with Sean Nguyen on LinkedIn Listen to Sean Nguyen's previous MGMA Insights Podcast episode discussing his Harwick Innovation Award-winning work MGMA Podcast Network Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#776
July 29 · 31 min
Looking Beyond Headcount: Rethinking Access, Workflows, and Telehealth with Drs. Pamela Ograbisz and Jamie Threatt
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams has a conversation with Dr. Pamela Ograbisz, vice president of clinical operations at LocumTenens.com, and Dr. Jamie Threatt, telehealth program director at LocumTenens.com, about the root causes of patient access challenges, optimizing advanced practice providers (APPs), reducing clinician burnout, and the role telehealth can play in expanding capacity. Rather than defaulting to recruitment when wait times grow, they explore how healthcare leaders can uncover workflow bottlenecks, redesign care delivery models, and better align resources to improve both patient and clinician experiences. Episode Takeaways Many patient access problems originate upstream from the clinician schedule. Intake processes, referral pathways, message routing, and screening workflows often create delays long before a provider shortage becomes apparent. APPs have become a standard part of healthcare delivery, but many organizations still have opportunities to use physician-APP teams more strategically to expand access in high-demand specialties. Healthcare leaders should carefully examine task ownership. Intake screening, message triage, and certain follow-up activities may not require physician involvement and can often be handled by nurses, APPs, telehealth staff, or technology-enabled workflows. Reviewing patient flow helps reveal hidden barriers. Delays related to referrals, imaging, communication handoffs, and scheduling can significantly affect access and productivity across a service line. Successful operational redesign depends on engaging the people doing the work. Physicians, APPs, nurses, technical staff, support employees, and patients each bring valuable perspectives on workflow challenges. There is no universal blueprint for operational improvement. Every organization has unique patient populations, staffing models, referral patterns, and processes that require customized solutions. Workflow inefficiencies contribute directly to clinician burnout. Administrative burdens, fragmented communication, and poorly designed processes often increase workload and reduce time available for patient care. Telehealth remains an underutilized opportunity in many organizations. Service lines with long wait times, hard-to-fill positions, or ongoing turnover may benefit from virtual care models that improve access while supporting patients with transportation, mobility, or caregiver limitations. When a service line struggles, leaders should begin by listening. Quantitative metrics are important, but clinicians and frontline staff often have the clearest understanding of what is actually broken within a workflow. Resources Connect with Dr. Pamela Ograbisz on LinkedIn Connect with Dr. Jamie Threatt on LinkedIn LocumTenens.com LT Telehealth MGMA Podcasts Productivity and Burnout article Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#775
July 22 · 16 min
From Burden to Bandwidth: Reducing Administrative Work in Healthcare
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Ranga Bodla, vice president of field and industry marketing at Oracle NetSuite, for a conversation about administrative complexity, workforce pressures, and how healthcare organizations can use AI to create more capacity across both clinical and operational teams. Previewing his upcoming MGMA Annual Conference keynote with Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences, Bodla shares why many healthcare leaders are struggling with disconnected systems, growing workloads, and mounting operational demands. He also explains how AI is being applied today to streamline documentation, automate repetitive tasks, improve reporting, and reduce the administrative work that takes clinicians and staff away from patient care. Key Takeaways: Administrative burden is consuming organizational capacity. Healthcare leaders continue to face workforce shortages, rising costs, and growing complexity, while clinicians and staff spend significant time navigating fragmented systems and manual workflows. The challenge extends beyond the exam room. Operational teams in finance, HR, and supply chain management face many of the same issues as clinical teams: disconnected systems, duplicate work, and limited visibility across the organization. AI is delivering value in repetitive workflows. Organizations are using AI to automate reconciliations, streamline reporting, improve forecasting, surface exceptions, and reduce the time employees spend searching for information. Documentation remains one of the strongest use cases for AI. Reducing documentation burden continues to be a priority for clinicians, making ambient listening and workflow-integrated documentation tools a practical starting point for adoption. Technology adoption depends on workflow integration. Employees are often resistant to learning yet another application. Successful AI tools fit naturally into existing workflows rather than requiring users to change how they work. The goal is more than productivity. According to Bodla, healthcare organizations should focus on reducing effort, not simply increasing output. The objective is to create more bandwidth for clinicians and staff by removing unnecessary work. Connected systems matter as much as AI capabilities. Organizations need access to the right data, context, and workflows for technology investments to have meaningful operational impact. Healthcare leaders should evaluate AI through a simple lens: How can it help people spend less time managing processes and more time making decisions? Resources: MGMA Events Prior Authorization 2025 Oracle Website Netsuite Website Nor-Lea Hospital Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to the MGMA Insights Podcast wherever you get your podcasts. This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#774
July 15 · 24 min
Finding the Human in the Machine — Dr. Michael Blackman on AI, Trust, and Smarter Workflows
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Dr. Michael Blackman, Chief Medical Officer at Greenway Health, to explore the evolving role of AI in medical practices — and why the human element remains essential. From ambient documentation to clinical decision support, they unpack where AI is delivering real value today, where it still falls short, and how practice leaders can adopt these tools without overwhelming their teams or compromising patient trust. Key Takeaways: AI is an assistant — not a replacement. Human oversight remains critical, especially in clinical decision-making where the stakes are high. Not all AI outputs are created equal. Clinicians must evaluate results in three categories: clearly correct, clearly incorrect, and the risky “plausible but uncertain” middle ground. Ambient documentation is delivering immediate value by improving patient interaction and reducing time spent on note-taking — while shifting clinicians from authors to editors. Critical thinking and “show your work” still matter. AI-generated recommendations should always be backed by verifiable evidence, especially in clinical contexts. Adoption starts with the problem — not the technology. Practices should identify specific workflow challenges first, then implement AI tools that integrate seamlessly into those processes. AI is reshaping team dynamics. As a “new team member,” it requires adjustments in communication, workflows, and even how clinicians interact with patients during visits. Incremental gains add up. From message prioritization to surfacing relevant patient data, small efficiencies across workflows can meaningfully reduce burnout over time. Transparency builds patient trust. Explaining how AI is used — especially when it enhances focus on the patient — can improve comfort, engagement, and adherence. Resources: Connect with Dr. Blackman on LinkedIn. Greenway’s Novare platform (AI-driven EHR) AI by Design in Healthcare: Rethinking the EHR from the Ground Up, with Dr. Michael Blackman (MGMA Insights Podcast) "AI is slowly redesigning work in medical practices rather than replacing workers" (MGMA Stat Article) "Automatic for the people: AI moves for medical practices to boost the front office and access" (MGMA Stat Article) "AI governance in medical group practices: Rules for the humans in the loop" (MGMA Stat Article) Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#773
July 8 · 29 min
The $150 Billion Blind Spot in Ambulatory Care That's Hiding in Plain Sight with Michelle Skinner
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams chats with Michelle Skinner, MBA, BSN, RN, chief clinical executive at Teletracking, about the growing complexity of ambulatory care and what it takes to keep patients connected to the right care at the right time. Their conversation explores referral leakage, scheduling inefficiencies, and provider capacity constraints — along with practical ways health systems and practices can improve visibility, streamline operations, and protect both patient access and financial performance. Key Takeaways Ambulatory care now dominates the care landscape More than 60% of care is delivered outside hospital walls, forcing organizations to rethink how they coordinate patient movement across distributed networks. Referral leakage is a massive, often hidden problem An estimated $150 billion is lost annually due to patients leaving the network, while 38% of referrals never fully close the loop — frequently due to lack of visibility and communication gaps. The biggest issue isn’t staffing — it’s fragmentation Many practices feel “busy and full,” yet system-level data shows inefficiencies. The disconnect stems from siloed information, not necessarily insufficient effort or staffing. Referral coordination is overly manual and unsustainable Staff often juggle hundreds of referrals, relying on spreadsheets, duplicate reports, and inbox management — creating delays and increasing the risk of errors or patient drop-off. AI and automation can eliminate low-value administrative work Tools like automated duplicate cleanup and referral tracking can significantly reduce manual workload, allowing teams to focus on complex, high-touch cases. Scheduling inefficiencies are often hiding in plain sight Mismatches between supply and demand — such as unused appointment slots or rigid scheduling templates — can limit access even when capacity technically exists. Data transparency aligns stakeholders and drives change When physicians, schedulers, and administrators see the same data, it becomes easier to address bottlenecks, adjust workflows, and improve patient access collaboratively. Start with outcomes, not technology Successful transformation begins by identifying pain points (e.g., referral delays, duplicate work, lost patients) and aligning stakeholders — technology should support clearly defined goals, not lead them. Resources Connect with Michelle Skinner on LinkedIn Teletracking MGMA Insights Podcast Network "Putting the power of scheduling into patients’ hands" (MGMA Stat Article) "Closed-loop referral management: Who owns each step in your practice?" (MGMA Insights Article) "Patient access priorities for 2026: Tackling wait times, phones, no-shows and more" (MGMA Stat Article) Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#772
July 1 · 20 min
Retention Isn’t Optional — Rethinking Physician Recruitment and Long-Term Success with AAPPR CEO Carey Goryl
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams chats with Carey Goryl, CEO of the Association for Advancing Physician and Provider Recruitment (AAPPR), about physician recruitment, onboarding, and — most critically — retention strategies. Carey shares fresh research insights from AAPPR, highlighting where healthcare organizations are making progress, where gaps remain, and what leaders can do now to build more effective, sustainable retention efforts. Key Takeaways: Only about 40% of healthcare organizations report having a formal physician retention strategy, though many are engaging in informal or inconsistent retention activities. A major gap is ownership, not effort. Few organizations clearly define who is accountable for retention outcomes across HR, operations, clinical leadership, and recruitment. Retention efforts often exist in silos, from compensation and bonuses to mentorship programs and scheduling flexibility, without a cohesive, measurable strategy. Foundational metrics — such as days to fill, cost to hire, and one- and five-year retention rates—are often missing, making it difficult to evaluate success or improve outcomes. The first week and first three to six months of onboarding are critical — early impressions can strongly influence whether a provider stays long term. Organizations can take immediate action by auditing current retention activities, identifying stakeholders, and forming a cross-functional team to align efforts and establish accountability. Humanizing the onboarding experience is essential — beyond logistics, organizations should recognize the life transition physicians are making and provide meaningful support. Retention maturity exists on a continuum — whether an organization is just starting or more advanced, there is always a next step toward a more structured, strategic approach. Resources: Connect with Carey on LinkedIn AAPPR Research Hub MGMA Insights Podcast Network Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#771
June 24 · 26 min
Negotiating Beyond the Rate — A Conversation with Kevin Barron on Payer Strategy, AI, and Playing the Long Game
On this episode of the MGMA Insights Podcast Network, host and senior editor Daniel Williams sits down with Kevin Barron, vice president of payer relations at University Health in San Antonio. The conversation explores the realities of payer contracting, from aligning internal priorities to navigating underpayments and denials, along with how integrated contracting and revenue cycle strategies can drive better outcomes. Barron also shares how AI is reshaping contract review workflows and why relationships — not just numbers — define success at the negotiating table ... with a few fun detours into Spurs basketball and Disney along the way. Key Takeaways: Rates aren’t the whole story — While reimbursement rates matter, contract language, policies, and operational requirements often have a greater long-term financial impact. Consistency across stakeholders is critical — Successful negotiations begin with internal alignment across finance, physicians, and operations on what truly matters. Live the contract after signing — Negotiations may take months, but organizations must manage and monitor performance for years afterward. An integrated approach strengthens results — Combining contracting, auditing, and contract management under revenue cycle enables better accountability and performance tracking. Underpayments often stem from outdated data — Frequent payer fee schedule updates require constant monitoring and system alignment to prevent payment discrepancies. Denials management requires proactive strategy — Grouping, trending, and assigning accountability for denials can help identify root causes and drive improvement. Relationships drive negotiation success — Understanding payer constraints and communication styles leads to more productive, balanced agreements. AI is a force multiplier — Tools are dramatically reducing contract redlining time and increasing consistency, freeing teams to focus on strategy and relationships. Resources Connect with Kevin on LinkedIn. Never Split the Difference by Christopher Voss Epic Resolute Billing System MGMA Payer Contract Playbook MGMA Analyzing Payer Contracts Playbook MGMA DataDive (Signature benchmarking resource) "The race for more revenue in medical groups: What’s your gameplan?" (MGMA Stat article) MGMA Annual Conference | Sept. 27-30 | San Antonio, TX This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#770
June 17 · 32 min
What Behavioral Science Can Teach Healthcare About Patient Follow-Through — A Conversation with Sarah Waters, PhD
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Sarah Waters, PhD, founder of 50 West and a behavioral scientist trained at the London School of Economics. They explore how behavioral science can reshape patient engagement, reduce no-shows, improve medication adherence, and drive meaningful change in clinical outcomes. Sarah shares practical strategies for identifying patient barriers, reframing communication, and designing systems that help both patients and care teams follow through. Key Takeaways: Knowing isn’t enough — design for doing: Patients (and clinicians) often know what they should do, but behavior change requires intentional system design, not just more information or reminders. No-shows are predictable — and preventable: Long scheduling lead times increase no-show risk. Practices can reduce this by tightening scheduling windows, analyzing patterns by day/time, and proactively addressing barriers at booking. Ask better questions upfront: Instead of asking “When are you available?”, ask “What days don’t work for you?” — this subtle shift prompts patients to consider real-life constraints earlier. Move beyond “corporate nagging”: Repetitive reminders without context lead to disengagement. Understanding why a patient isn’t showing up (transportation, fear, misunderstanding) enables more effective, targeted outreach. Small barriers become big obstacles: Minor uncertainties — like not knowing what a procedure involves — can feel overwhelming. Address emotional and logistical friction early to prevent dropout. Stories outperform statistics: Data may inform, but narratives stick. Sharing relatable patient experiences can help demystify procedures like colonoscopies and mammograms. Habit formation drives long-term outcomes: Programs that reduce ER visits and hospitalizations focus upstream — building simple, repeatable behaviors (e.g., daily monitoring) that compound over time. Medication adherence needs systems, not willpower: Pair medications with existing routines (like brushing teeth) and create backup plans for disruptions to improve consistency. Resources: Connect with Sarah Waters, PhD, on LinkedIn 50 West Consulting MGMA Insights Podcast Network "Patient no-shows in 2025: What’s changing and what to do about it" (MGMA Stat article) MGMA Events: Conferences and Webinars Register for the MGMA Annual Conference (September 27-30, 2026 | San Antonio, TX) Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#769
June 10 · 38 min
From Fire Hose to Field Guide — A Conversation with MGMA's Cristy Good on Turning Questions into Solutions
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with longtime MGMA leader and senior editor Cristy Good for a wide-ranging conversation about MGMA’s 100th anniversary, the evolution of Ask an Advisor, and how members can better navigate MGMA’s growing library of tools, playbooks, and communities. Drawing on her background in lab science, practice management, and hospital operations, Good shares how her real-world experience shapes the resources MGMA builds — and how members can use them to solve everyday operational challenges while also prioritizing professional growth and well-being. Episode Takeaways Good’s career path — from laboratory test development to physician practices and hospitals — informs her hands-on approach to supporting MGMA members with practical, real-world solutions. Ask an Advisor remains a key member benefit, often resulting in custom-built tools, checklists, calculators, and even policies when existing resources don’t fully address a question. MGMA playbooks are designed to consolidate articles, tools, reports, and guidance into a single, step-by-step roadmap for major topic areas like physician compensation, recruitment, and AI implementation. Playbooks help members move from “What do we do next?” to a clearer action plan, with hyperlinks that reduce the need to search across multiple parts of the MGMA website. The MGMA member community is a powerful peer-to-peer resource, especially for vendor selection, revenue cycle questions, staffing challenges, and operational benchmarking. Ask AI and Ask an Advisor serve different purposes — Ask AI surfaces existing MGMA content, while Ask an Advisor routes more complex or unmet questions directly to subject matter experts. Professional development opportunities such as ACMPE, fellowship, and virtual conferences like the MGMA Summit offer flexible ways to earn credits and deepen expertise. Wellness matters — from mindfulness and meditation to community-building activities and even fostering rescue animals, sustainable leadership requires attention to life outside of work. Resources Mentioned Connect with Cristy Good on LinkedIn Ask an Advisor (MGMA) MGMA Playbooks MGMA Member Tools and Checklists MGMA Member Community 2026 MGMA Summit (virtual conference) ACMPE Fellowship Information Mindfulness and Wellness Apps Mentioned Headspace Insight Timer Calm Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don’t forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#768
June 3 · 36 min
MGMA DataDive, Done Right: Understanding Provider Compensation with Data Experts Jennifer Sanchez and Liz Gurley
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Jennifer Sanchez and Liz Gurley, data experts at MGMA, to kick off a limited series focused on MGMA data — how it’s collected, how it’s used, and how medical groups can apply it with confidence. The conversation starts with one of MGMA’s most widely used — and most frequently misunderstood — datasets: MGMA Provider Compensation. Together, they unpack what DataDive is (and isn’t), how benchmarking really works, why percentiles cause so much confusion, and how leaders can use compensation and productivity data to support providers without turning benchmarks into prescriptions. Episode Takeaways What MGMA DataDive actually is — A national benchmarking platform built from annual survey data across private practices, health systems, and large organizations, designed to help groups compare compensation, productivity, and financial performance against true peers. Why provider compensation data is often misunderstood — MGMA does not tell practices what they should pay or produce; the data provides context and comparison, not mandates or targets. How organizations really use the data — From contract negotiations and physician recruitment to internal KPI tracking, productivity analysis, and leadership decision-making across multiple roles. Why the data lags by a year — and why that matters — Annualized, validated data allows for accuracy, consistency, and meaningful peer comparison, even if it’s not real-time. Percentiles explained without the math headache — The 50th percentile is simply the median, not a goalpost. Half of organizations fall above it, half below it, and neither position is inherently good or bad. There is no “right” percentile — Compensation philosophy varies by organization, specialty, geography, provider tenure, and strategy. Best practice is starting at the median and asking why you fall where you do. Why compensation and productivity must be viewed together — Looking at total compensation without work RVUs, encounters, or collections can lead to misleading conclusions and unproductive conversations. Tools that make benchmarking actionable — Features like the Provider Report Card, pay-to-production plotter, and upcoming Procedural Profile Platform help practices move from raw data to informed discussions and strategy. Resources Connect with Liz Gurley on LinkedIn Connect with Jennifer Sanchez on LinkedIn MGMA DataDive Collection MGMA Provider Compensation Data MGMA Procedural Profile MGMA Podcast Network Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don’t forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#767
May 27 · 29 min
Beyond the “Partnership Track” and What Physicians Expect Now — A Conversation with Tara Ossek and Matt Phillips
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Tara Ossek, Senior Vice President of Recruiting at Jackson Physician Search, and Matt Phillips, Managing Director at City Capital Advisors to examine the growing pressure points reshaping physician partnership models and private practice ownership. Drawing from conversations with physicians and practice leaders across the country, Tara and Matt discuss why recruiting and ownership strategy can no longer happen in separate silos. They break down what today’s physician candidates actually want from partnership, why vague promises around buy-ins and governance are falling flat, and how practices that delay succession and ownership planning risk losing both recruits and long-term stability. Episode takeaways Early-career physicians still value partnership, but they evaluate it like a business decision — weighing debt, lifestyle, governance, and risk alongside compensation. Vague language like “great partnership track” no longer resonates; candidates expect specific timelines, costs, expectations, and outcomes. Ownership conversations often happen too late, triggered by looming retirements or recruiting crises rather than proactive planning. Practices can’t maximize retiring partner payouts, keep buy-ins affordable, and reinvest heavily in growth at the same time — trade-offs are unavoidable and must be acknowledged. Confusion arises when practices defer ownership discussions or oversell partnership benefits that don’t align with contract language. Modern ownership structures — including LLCs, MSOs, and hybrid models — offer far more flexibility than traditional models, if practices are willing to reexamine legacy assumptions. A written, transparent FAQ addressing buy-in, timing, economics, governance, and exit scenarios can significantly improve recruiting outcomes. Succession planning and physician leadership development are no longer optional — they are foundational to long-term independence and stability. Resources Connect with Tara on LinkedIn Connect with Matt on LinkedIn Jackson Physician Search City Capital Advisors "Is your practice telling the best story it can for physician partner recruitment?" (MGMA Insights Article - RE: Jackson Physician Report) "The significance of the partnership agreement in private practice and trends in medical practice ownership" (MGMA Insights Article) MGMA Conferences MGMA DataDive Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don’t forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#766
May 20 · 27 min
"More Guts Than Brains" — Resilience, Reinvention, and Lifelong Learning with MGMA Fellow Pat Kroken
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams has a wide‑ranging conversation with Pat Kroken — MGMA Fellow, healthcare communications leader, and competitive powerlifter — about resilience, career reinvention, and the unexpected paths that shape leadership in healthcare. From books and community learning to recovering from a life‑altering injury and competing on the world stage, Pat shares stories and lessons that resonate far beyond titles or job descriptions. Episode Takeaways A lifelong love of reading can become a professional advantage — especially when paired with community discussion and shared perspectives, as seen in the MGMA Book Club. Careers in healthcare don’t always begin with a plan — sometimes they begin with a phone call, transferable skills, and the willingness to say yes. MGMA involvement at the state and national levels can accelerate learning, expand professional networks, and open leadership opportunities early in a healthcare career. The FACMPE provides structure, credibility, and confidence — particularly for professionals entering healthcare from other industries. Resilience is often learned through adversity; trusting the process can be essential when navigating injury, recovery, or major life transitions. Strength training and competitive powerlifting taught discipline, risk‑taking, and mental toughness that translated directly into leadership and career growth. Community learning — whether through book discussions or professional associations — offers insights and perspectives that individual study alone cannot provide. Pushing personal limits, even without a clear end goal, can unlock opportunities and capabilities you never imagined possible. Related Resources Connect with Pat on LinkedIn USA Powerlifting (USAPL) - the organization Pat competed with The Resilience Factor by Karen Reivich, PhD, and Andrew Shatté, PhD MGMA Book Club FACMPE certification MGMA Podcast Network Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don’t forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#765
May 13 · 28 min
Leading Through Change, Staying Grounded in Purpose — A Conversation with Melanie Stohl, Chair of Minnesota MGMA Board
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Melanie Stohl, director of pediatrics for the Pediatric Service Line at M Health Fairview and current chair of the Minnesota MGMA board. Melanie shares her leadership journey — from revenue cycle beginnings to executive-level leadership — and reflects on guiding teams through organizational transition, community crisis, and ongoing change while keeping patients, staff, and mission at the center of the work. Episode takeaways Melanie Stohl’s career path highlights the power of lifelong learning, including earning her bachelor’s degree later in life and completing a healthcare-focused MBA while leading large, complex teams. Hands-on experience across front desk operations, coding, credentialing, rooming, and leadership roles gave Melanie a system-wide perspective — helping her anticipate downstream impacts and advocate for smarter operational decisions. At M Health Fairview, Melanie oversees pediatric specialty care across roughly 27 specialties and multiple clinic entities, balancing hospital-based and freestanding clinic models. Melanie discusses leading teams through significant organizational change as University of Minnesota Physicians transitioned employment structures, emphasizing transparency, listening, and anchoring teams to the shared mission. During periods of community unrest, daily leadership huddles, open forums, and frequent communication helped create psychological safety — even when leaders didn’t yet have answers. Patient safety and access remained a priority, with teams quickly adapting through virtual visits, alternate locations, and flexible workflows when patients felt unsafe traveling to certain sites. As chair of Minnesota MGMA, Melanie is focused on growing a small but mighty chapter through monthly “power hours,” in-person engagement, and creating space for candid peer-to-peer learning. A consistent theme throughout the conversation is servant leadership — showing up as human first, leader second, and trusting that culture and purpose carry teams through uncertainty. Resources Connect with Melanie on LinkedIn MGMA Membership and Communities MGMA Education and Events MGMA Insights Podcast Network Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#764
May 6 · 42 min
Reflecting on 100 Years of MGMA | Leadership, Change, and What Comes Next
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Dave Gans, longtime MGMA leader and historian, and Akash Madiah, MGMA’s acting CEO, to mark a major milestone — 100 years of MGMA. Together, they reflect on MGMA’s origins in 1926, the enduring role of the medical practice administrator, and how the association is positioning itself to support medical practice leaders through the next century of change. Episode Takeaways MGMA was founded on a simple but powerful idea — medical practice leaders are stronger when they share challenges, data, and solutions rather than operating in isolation. Many of today’s administrative challenges — staffing, overhead, collections, physician–administrator alignment — were already being discussed at MGMA’s very first meeting in 1926. Despite sweeping clinical and technological change, the core role of the practice administrator has remained remarkably consistent for a century. The physician–administrator partnership is central to effective group practice management and remains one of MGMA’s defining principles. MGMA’s impact is deeply personal — members routinely credit the organization’s data, education, and community with helping them improve performance, advance careers, and navigate uncertainty. Conferences and peer networks remain one of MGMA’s most valuable assets, offering real-world insight that goes beyond sessions and speakers. As MGMA enters its second century, the focus is on staying outward-facing — listening to members, evolving content and data, and addressing emerging challenges like AI and administrative burden. The centennial is both a celebration and a call to action — honoring what has endured while actively shaping what comes next for medical practice management. Resources Connect with Dave Gans on LinkedIn Connect with Akash Madiah on LinkedIn A Century of Progress? - MGMA DataDive article by Dave Gans MGMA Annual Conference (Centennial Special) MGMA Data Resources MGMA Advocacy Efforts MGMA Membership Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts! This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#763
April 29 · 32 min
Thirty Years, One Practice, and a People‑First Mindset — a conversation with practice administrator Tawnya Capps
On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Tawnya Capps, CMPE, ACMPE, practice administrator at Colorado Cardiovascular Surgical Associates. In this MGMA member spotlight, Tawnya reflects on nearly 30 years in the same practice — starting at the front desk and eventually stepping into executive leadership. The conversation explores servant leadership, building trust through empathy, the value of professional networking, and what it means to model resilience and confidence for the next generation. Episode takeaways There’s power in growing up inside a practice. Having worked in nearly every role — front desk, billing, coding, HR, scheduling, and leadership — Tawnya brings deep operational empathy and credibility to her administrator role. Leadership doesn’t mean distancing yourself from the work. Stepping in to check in patients or cover gaps isn’t symbolic — it’s practical, culture‑building, and reinforces that every role in a practice matters. Careers don’t always start with a master plan. Tawnya’s path into leadership was shaped by curiosity, timing, and opportunity — not a rigid roadmap — underscoring the value of saying yes to learning. Confidence often follows validation. Earning the CMPE and later ACMPE fellowship helped Tawnya recognize that the work she was already doing day in and day out truly mattered and met a national standard. Networking reduces isolation. MGMA conferences and chapter involvement created a sense of community — a reminder that most practice leaders are facing similar challenges, especially in today’s hybrid and high‑pressure environment. Women’s leadership has evolved — and visibility matters. Seeing more women in senior roles helped Tawnya envision herself as a leader and motivated her to mentor others coming up behind her. Family and leadership are deeply connected. As a working mother raising two daughters, Tawnya’s professional resilience and growth were inseparable from her role as a parent and role model. Presence builds trust. Whether in the office, at a conference, or on a board, showing up — consistently and authentically — is a through‑line in Tawnya’s approach to leadership. Related Resources Connect with Tawnya Capps on LinkedIn Colorado Cardiovascular Surgical Associates MGMA Certification MGMA Conferences and Events MGMA Membership and Local Chapters MGMA Insights Podcast Network This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#762
April 22 · 23 min
AI by Design in Healthcare: Rethinking the EHR from the Ground Up, with Greenway Health's Dr. Michael Blackman
On this episode of the MGMA Business Insights Podcast, host and senior editor Daniel Williams, sits down with Dr. Michael Blackman, Chief Medical Officer at Greenway Health, to explore how artificial intelligence is moving beyond standalone tools and becoming embedded directly into core healthcare technology platforms. Drawing on his clinical background and health IT leadership experience at organizations like Allscripts, McKesson, and now Greenway, Dr. Blackman shares what an “AI by design” approach really means for medical practices — spanning documentation, operations, revenue cycle performance, and team-based care. Episode Takeaways AI has reached a tipping point in real-world use. While artificial intelligence has existed in healthcare for years, the last 24 months have brought practical, scalable tools — like ambient documentation — that clinicians are actively using in day-to-day practice. Ambient documentation is on track to become standard of care. Dr. Blackman likens today’s ambient documentation tools to the early days of e-prescribing: not yet universal, but increasingly inevitable as accuracy improves and costs decline. Layering tools on top of tools doesn’t work. Adding AI as yet another bolt-on solution can create fragmented workflows and added burden. True value comes when AI is integrated directly into the core platform and designed around how practices actually work. “AI by design” means rethinking the platform, not just the features. Rather than retrofitting legacy EHRs, this approach starts from the ground up — asking what can be automated, where AI adds real value, and how workflows can be simplified end to end. Operational strain touches every part of the practice. From staffing shortages and documentation demands to prior authorizations, patient messages, and claim denials, AI can help reduce friction by automating routine tasks and preventing downstream problems. Better documentation upstream improves revenue cycle performance downstream. AI-assisted documentation and coding suggestions can reduce errors, lower denial rates, and allow billing teams to focus on more complex cases instead of rework. AI is an assistant, not a replacement. Trust-but-verify remains essential. Human oversight ensures safety and accuracy — especially when it comes to orders, medications, and clinical decision-making. Success ultimately shows up in people, not technology. The real measure of AI by design is whether clinicians and staff feel the system is working for them — freeing time, reducing frustration, and allowing them to focus on meaningful work and patient care. Related Resources Connect with Dr. Blackman on LinkedIn Greenway Health Greenway Health's Novare MGMA resources on operations management This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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#761
April 15 · 31 min
What Practice Leaders Need to Know About Today’s Compliance Risks with Michelle Wright
On this episode of the MGMA Insights Podcast, Host and Sr. Editor Daniel Williams, sits down with Michelle Wright, strategic advisor and board director with more than 30 years of experience across payers and providers. Michelle shares lessons from her career spanning actuarial science, health plan leadership, provider operations, and board service — offering a candid look at why smart strategies often fail in execution. The conversation explores accountability, governance, and change management in healthcare organizations, emerging compliance and enforcement trends, and Michelle’s deeply personal advocacy work focused on access to care for individuals with profound autism. Episode Takeaways Execution — not strategy — is where organizations struggle most. Even well-designed strategies falter without clear ownership, follow‑through, and ongoing performance monitoring. Accountability must be explicit. Projects involving AI, revenue cycle, quality, or operations often touch multiple departments, but success depends on clearly defining who owns outcomes from start to finish. Governance is the connective tissue. Effective governance helps organizations document decisions, clarify expectations, and sustain progress beyond individual leaders or initiatives. Change management is consistently underestimated. Leaders often acknowledge its importance but fail to invest the time and structure required to truly change behaviors—especially during periods of stress. Operators and providers aren’t misaligned — they’re under pressure. Close working relationships can create communication blind spots that surface during change initiatives, making listening and translation critical leadership skills. Compliance risk is evolving, not disappearing. Enforcement trends are shifting as regulators increasingly use data analytics and AI to identify patterns, even when underlying rules haven’t changed. AI tools introduce new compliance considerations. Documentation, coding, and workflow automation can unintentionally create risk if organizations don’t monitor how these tools affect claims and clinical records. Access to care for individuals with profound autism remains a systemic gap. Despite significant research funding for autism overall, those with the most severe needs remain underserved in clinical care, research, and policy. Resources Connect with Michelle on LinkedIn Epstein Becker Green National Council for Severe Autism (Upcoming!) Practice Compliance in 2026: Regulatory Updates, Enforcement Trends, and Leadership Priorities — Join Michelle and attorneys from Epstein Becker Green on April 22 for the first session in MGMA’s member-exclusive, semi‑annual compliance webinar series, covering key HIPAA updates, enforcement trends, AI and Health IT risks, and practical compliance priorities for medical practices. This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.
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