Business Intelligence, Growth Strategies, and Industry Acquisitions: Here’s What We Learned at MGMA 2024

Earlier this week we attended the 2024 Medical Group Management Association Leader’s Conference in Denver. The event gave us the opportunity to meet with industry leaders and listen in to game-changing education sessions about everything AI, to mergers and acquisitions, to compliance, innovation, and more. Read on to check out our key takeaways.

AI’s Role in Enhancing Healthcare: Bolstering Provider Efficiency and Medical Documentation

Key Takeaway: While healthcare has been historically slow to adapt to change (especially technological change), AI and automation are becoming increasingly relevant for tackling clinician burnout, financial pressures, and administrative inefficiencies.

The ‘Run, Grow, Transform’ model is common across many industries, but ‘Transform’ is especially difficult and slow in healthcare as the industry struggles to keep up with technological change.

In the context of healthcare:

• Run: Maintain high standards of patient care while managing costs.
• Grow: Incrementally improve patient care with new technologies like telemedicine or EHR systems.
• Transform: Embrace disruptive innovations, such as AI-powered tools, to fundamentally shift how clinicians engage with patients and handle administrative tasks.

AI tools can help practices alleviate physician and staff burnout by reducing the time spent on administrative tasks.

Charting New Horizons: Navigations Successions in Acquisitions

Key Takeaway: Mergers and acquisitions in healthcare are largely driven by factors like service expansion, economies of scale, and provider recruitment, but the post-acquisition phase presents significant challenges, including delays in billing, system integration, and process alignment.

• The healthcare industry has seen a shift in physicians moving from smaller practices to larger, more consolidated groups. Key factors driving acquisitions include:
  • Expansion of service lines and market presence
  • Provider attraction
  • Impact of payor dynamics
  • Economies of scale
  • Challenges in private practice recruitment
• Post-acquisition phase is an ongoing endeavor, and is usually the most challenging aspect of a consolidation.
  • Example of a common challenge: Payers are slow to update providers to a new tax ID, often leading to new delays in billing and reimbursement
  • The need to integrate new systems (such as new EHR systems, practice management systems, or third party technologies) and processes (billing and RCM) and ensure alignment across all staff.

Business Intelligence for Your Bottom Line: Data Analysis for Medical Practices

Key Takeaway: Many smaller practices still use manual methods for data and reporting, but they see the value in analyzing data and trends on a regular basis to identify and address issues early.

• Example of how many small medical practices are creating reports
  • EHR data is pulled in a SQL Server, and that data is then displayed via pivot tables in Excel or Power BI. However, this requires the practice to have a data analyst on staff, or someone who is familiar with advanced data manipulation.
• Many smaller practices leverage ‘waterfall reports’ to visualize and predict cash flow
  • If I billed $200K in February, when will those charges get paid (March? April? etc.). Imagine having a tool that automatically pulls this trend analysis for you!
• Patient Cost Estimates
  • When trying to understand which procedure codes to include in a self pay estimate, look at historical data to see which procedure codes were commonly billed together.

A fellow attendee shared the following anecdote: Their team noticed that denial rates for certain surgeons at their practice were higher than average. When they dug into this, they realized these surgeons were providing services to patients without obtaining prior authorizations. They brought this data to their surgical team and showed them the trends and results, which encourage a positive behavior change.

Lead Your Healthcare Practice into the Future: Cutting-Edge MSO Strategies for Growth, Compliance, and Innovation

Main Takeaway: MSOs are increasingly leveraging technology, focusing on patient-centric care, and supporting the shift to value-based care to enhance operational efficiency and improve patient outcomes.

• A Management Services Organization (MSO) is an entity that partners with healthcare providers to handle non-clinical administrative services, allowing providers to focus on patient care
  • The main purpose of a MSO is to streamline administrative tasks and improve operational efficiency for healthcare practices and facilities.
• Healthcare MSO Trends
  • Increasing adoption of technology to improve efficiency and quality of care
  • Shifting to a patient-centric approach, placing greater emphasis on the patient experience to improve patient satisfaction and retention
  • Transitioning to a value-based care model by rewarding providers for positive patient outcomes rather than number of services provided

‍