Medical practices missing revenue from overlooked inefficiencies

The Medical Group Management Association (MGMA) has issued guidance to medical practices about revenue losses they may not be monitoring properly. According to acting CEO Akash Madiah, most groups prioritize generating new income over addressing inefficiencies in their current operations. This oversight allows money that should be part of the practice’s revenue to remain uncollected. Madiah’s recommendations begin with a straightforward but frequently ignored step: understanding financial data. He advises practices to review four critical areas, productivity, staffing ratios, payer performance, and denial trends, before attempting to expand.

He says practices should make sure they’re collecting every dollar they’ve already earned before adding volume and should benchmark against peers rather than solve problems in isolation. Many groups pursue new patients or services without first securing every dollar from existing ones. Staff retention plays a significant role in hidden revenue opportunities. Madiah notes that retaining current employees often yields greater financial benefits than hiring new staff. High turnover disrupts operations, raises training expenses, and diminishes institutional expertise, all of which reduce profitability. “Retention often provides a better return than recruitment,” he says. Comparing performance with similar organizations is essential.

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Many practices address issues in isolation, assuming their challenges are unique. MGMA’s data indicates that benchmarking, such as revenue per full-time employee or denial rates, against peers can expose inefficiencies. Madiah highlights two immediate actions leaders can take. First, they should pinpoint the single most important metric, whether patient volume, collection rates, or staff productivity, and track it weekly. Second, leaders should consult with peers outside their organization. External viewpoints often reveal blind spots that internal teams overlook. While MGMA retains strong member trust, surveys reveal a need for better tools and educational resources.

Members express demand for digital solutions, local engagement opportunities, and clearer pathways for participation. Madiah’s focus for the association includes expanding data-driven products, engaging staff across all career levels, and reinforcing MGMA’s position as an industry authority. At MGMA’s 100th annual conference in San Antonio, discussions centered on administrative burdens and reimbursement reductions. Medicare cuts and prior authorization delays were primary concerns, echoing the feedback from a recent town hall session led by Anders Gilberg. Madiah’s core message to leaders remains consistent: address existing operational flaws before pursuing growth.