Andrew Swanson, of MGMA, on financial challenges of running a practice

Physicians Practice
From your vantage point at MGMA, what's the biggest financial challenge that practices are facing right

Andrew Swanson
Now? No doubt about it, it's compressing reimbursement. I mean, we hear it every day, and we share in the struggle. I mean, you know, with overhead costs rising exorbitantly over the past few years, and reimbursement simply not keeping up, all of our members and customers are squeezed, and I wish there was more we could do on the revenue front to make more. But when reimbursement is collapsing, as it is, as Medicare rates are getting cut by three and a half percent this year, and in private payers following along, uncompensated care going up—you know, the revenue just isn't where it was, and with costs going up so significantly, it's just putting an untenable squeeze on things.

Physicians Practice
All right. So, you know, like you were mentioning, you know, there's a there's a tight squeeze money-wise. What are some new ways that the organization is bringing more value to its members?

Andrew Swanson
Yeah, I think what MGMA is trying to do is find those solutions that can really help, kind of, the operations of the medical group function a little bit more efficiently. Of course, here at the conference, we're talking a ton about technology—not just AI, but all of those systems that can really help augment staff, or where staff is vacant because the vacancies can't, can't fill staff. You know, looking at the ways to really affect some things that have been labor-intensive and replacing those with not just technology, but better operating principles and processes. And that's largely what the association is trying to do—is introduce those things that are going well for practices around the country to other folks who are feeling the squeeze, helping reduce, kind of, that overhead burden, take some cost out of the business, or at least make the cost more manageable, so that even in an arena where reimbursements are shrinking, we can still keep that margin of profitability and so groups can continue to thrive and serve the communities they need to serve.

Physicians Practice
So what's the main theme or message that you guys are hoping that leaders are taken away from this year's conference.

Andrew Swanson
Yeah, two, I would say—so the theme of this year's conference is “next is now,” and I think closely aligned to that message. And I'll explain a little bit more about why we think that's important. Is, you know, we're trying to have folks see the world as it is, not as they fear it could possibly become or, or maybe not through rose-colored glasses in the way they hope it would be, but really embracing people's, kind of, leadership at whatever level inside of a medical group that they happen to sit at and taking on the onus of, you know, the future is now, right? I mean, now is the time to act. And so taking this notion of, if I understand the problems of today—thinking about our patients, thinking about our providers, and thinking about the medical group as an enterprise, as a team—and thinking a little bit more about that which can be resolved today, and really taking some practical action on how to make change today, and really empowering folks to really take the onus of that, of that ownership and own the problems and challenges that they have, and really looking at solutions and providing that guidance and support along the way. And so we just want people to kind of, you know, live in the now, right? I mean, take, take, take the, take the reins, right, right today, and I think, I think we've got a group of empowered leaders who really want to, to be released—right—given, given that mantle of responsibility, and really harness, kind of, their energy and excitement around solving some, some tough challenges. And that's not overnight. Sometimes it takes, you know, weeks and months and years to solve some of these things, but really feeling, kind of, empowered to do that, and then sharing community and allowing people to talk to one another through their ups and downs and trials and tribulations and, in sharing the winds along the way. Because I think there's plenty of those to celebrate as well. All right?

Physicians Practice
So, you know, there's—you mentioned, you know, the squeeze of reimbursements. We're also hearing a lot about, like, staff shortages since the pandemic and things like that. You know what, what's really keeping practice leaders up at night?

Andrew Swanson
Well, I mean the simple existential viability question, I think, is, you know, first and foremost: can we keep our doors open? But I've talked, I've talked a lot this, this week so far, about thinking about our patient base, our communities differently, and I think it's very resonant. With folks— we live in the digital age. Many of our patients now have become digital natives. And so, you know, 10 years ago, we used to grouse about people coming in with WebMD open on their phones and self-diagnosing and all those things. And now I think a lot of those gripes have gone away, because, like I said before, we're living in—this is the way it is. And so thinking about patients in a kind of consumer-friendly, experience-oriented consumerism culture, I think, is actually—maybe 10 years ago might have been a scary place to live and maybe an ethereal concept, but it is now that that's the world we live in. And thinking about patients as not just in a consumer or customer sort of way, but one that we want a deep customer relationship with. Of course, they're, they're our patients. We, they are in our care, and making sure that we're serving them in a way that is both, kind of, emboldening that trust they have in their provider, but also in a consumer-friendly and engagement-friendly way. I mean, we want patient excitement and patient engagement in their care and treatment plans, but we also want them to have scheduling flexibility, and we want to have the flexibility to adapt and meet them where they are, both in their care journeys and their lives in general. So I think the more that groups are adopting and taking on that notion of customer friendliness, consumerism—where these may have been before, maybe bad words—I think now the groups that are finding success can find empowerment and success financially, as well as in service to their patients and their communities, by embracing, kind of, that consumerism mentality.

Physicians Practice
All right, so if you had to name one leadership skill that's absolutely critical for medical group leaders today, what would it be?

Andrew Swanson
I'm laughing because I really think some of it is about finding the fun and joy in what we do. Nobody wants to say, like, a leader should be “fun,” but I think finding humor and lightness in some of, some very, very difficult situations—whether it's the financial viability of your practice or a bad, you know, patient experience—these are very serious and things that we deal with day in and day out, and the way we get through that is together. And sure, sometimes that calls for tears, and in other times that calls for a joke. And I think finding the levity and the joy in which all of us started to get into healthcare and medical practice, specifically, I think that really takes us back to who we are and why we do this, and finding the pleasure and joy in that. And that's not just for care providers. I think when physicians and nurses have these great patient experiences and they share them with others—yes, it warms people's hearts, and that's why we're here in this business. It's a calling for many people, and that doesn't happen to a front desk administrator viscerally, right? They get the second-hand story, but they can laugh with patients, they can tell them a joke, and they can receive that, that same joy and pleasure sitting in their role. And yes, dealing with a patient's finances is tough, and when people can't pay their bills and they're struggling with healthcare costs—yes, that's very heavy, and we're all people together, and so we can find joy and levity in the day-to-day as well. And I think when leaders bring that to bear, I think they're, they're human. They bring their whole person to the table, and that's in good days and bad days. But I think when we can joke and have fun with our staff and with our patients, then I think things get a lot easier and a lot more fun.

Physicians Practice
It's the old cliché: if you love what you do, you never work a day in your life, right? All right, so I'm going to ask you to whip out your crystal ball real quick—looking ahead, what's one piece of advice you'd give practices to position themselves for success in 2026

Andrew Swanson
Yeah, you know, I hate to harp on it, because it's so much in the news these days, but I think this notion of using technology is going to be where it's at. I think the success of practices is going to depend on it. I think the notion of being able to find staff—ongoing, qualified, engaged—you're going to find those people who want to be a part of your medical practice, and we hold on to them for dear life. And if we're doing a good job of scaling our businesses and serving broader swaths of the populations, we open access up, we are going to be resource-constrained. So the way we actually serve giant swaths of population, bigger and bigger swaths of populations, is going to be with technology—and I don't mean in replacement of it. We're not going to see the robot tomorrow to think about our health, but I think the way we leverage technology, especially on the back and administrative end, is going to allow our businesses—and medical practices, first and foremost, are a business—and our customers, our patients, are going to look to us to make sure we have the technology to serve them. So I think it's incumbent upon us to find the people who we can connect with, who understand how to utilize technology, how to augment the staff practices and processes that we rely on in order to serve the patients we serve today, and do it as. Faster and cheaper so that we can remain viable. And I think finding those—not just the technologies themselves, but the people who can help us implement, use, and really create efficiency—I think it's that combination of people and technology that's going to improve the processes and help us do what we do better and for more people.

Physicians Practice
Alrighty, that's all the questions I got for you, anything that you think I've overlooked, or anything you want to add,

Andrew Swanson
I think MGMA and the community we serve does amazing work, and I think the stress we're under as an industry is real, but I think there is a way through that challenge and being successful in the end, and I think we're one resource to help with that, and I know there's many others, and I just want people to embrace their community. I think the more we do this together, I think the more success we're going to find. And even when we are struggling, we will have somebody to struggle through it with. And I think that makes the struggle and challenge even easier, and then we can share in that success at the end together. And that's, that's great. I can't wait for those days.