Finance, staffing projects top medical group leaders’ list of 2024 resolutions

It’s hardly a surprise that medical group leaders are focused on staffing and finances heading into 2024, but looming mergers and acquisitions, as well as the need to grow to be competitive in value-based arrangements, are also top of mind as administrators make their resolutions for the new year. 

A Jan. 2, 2024, MGMA Stat poll kicked off the new year by asking what areas would produce the biggest project for medical group practice leaders. A majority (70%) reported finance/revenue cycle management (41%) or staffing/HR (29%) as their focal points, followed by facilities (12%), information technology (10%) and “other” (7%). The poll had 423 applicable responses. 

Financial and revenue cycle projects in 2024 

With a new year underway alongside a lower Medicare pay rate, many practice leaders are focusing on overhead and investing time to maintain financial stability as operating costs remain elevated. As one practice leader told MGMA, this focus is meant to “offset the decrease” from CMS in the physician fee schedule, while also working to “reduce total cost of care by avoiding ER visits and hospital stays and therefore maximizing shared earnings in value-based arrangements.” 

Some of the most frequently mentioned financial projects for practices in 2024 include: 

• Building better reporting and visibility into performance for faster analysis and process improvement 
• Improved insights in claim denials 
• Identifying gaps in the prior authorization process between carriers and third-party vendors that result in delays with negative impacts on patient care 
• Bringing billing back in-house for greater process control and reduced vendor dependency. 
• Revising the organization’s chart of accounts and budget, sometimes as a function of other restructuring across the organization amid a merger and/or acquisition. 

Medical group practice staffing in 2024 

The hiring and retention woes practice leaders have suffered in recent years might have been eclipsed by financial concerns in this poll, but many of the same issues endure at the start of the new year: 

• Reducing the unfilled positions at all levels, including physician, nurses, technicians, revenue cycle and coders: As one respondent told MGMA, not resolving ongoing vacancies “will negatively impact practice expansion and growth.” 
• Improving job posting tactics to acquire a robust pipeline of qualified job candidates for each open role 
• Preparing to backfill for anticipated retirements, especially at the practice administrator level and within billing and coding specialist roles 
• Reassigning services from advanced practice providers (APPs) to medical assistants (MAs) now staffing levels have returned to normal 
• Implementing improvements to onboarding and staff training programs to build better employee engagement and limit turnover 
• Enacting projects focused on cultural alignment and leadership education/development. 

Health IT projects in 2024 

Several practice leaders told MGMA about plans to upgrade their practice management (PM) systems or transition to a new EHR later this year, often due to an ownership change requiring newly acquired practices to get in line with the acquiring organization’s systems. 

For others without such a tall task ahead of them, the IT projects tend to focus instead on optimizing existing systems or integrating new tools with them, such as new AI capabilities to streamline workflows. This area of IT work could be significant across the medical group practice landscape in 2024, as only 13% of practice leaders said AI was their top tech priority last year, while EHR usability was ranked as the top priority in the same poll.  

Facilities and more in 2024 

While many organizations report needing the people to fill their existing clinics and provider schedules, plenty of respondents to our first poll of the year say they are primed for growth:  

• Renovations to existing spaces, often to create additional exam rooms and provider offices to recruit more specialists 
• New satellite clinics 
• Construction of therapy suites 
• Building and opening new office-based surgery suites 
• Projects to explore relocation in the coming years, especially among practices currently limited by being part of a large campus 
• New primary care facilities to expand the group’s market. 

Beyond those capital projects, several practice leaders noted they are focusing on other strategic or operational areas, such as: 

• Workflow improvements and rebuilding standard work following COVID-19-related changes 
• Development of access strategies to balance preventative and acute care 
• Further development of chronic care management and remote patient monitoring services 
• New safety programs to reflect best practices in active shooter and other emergency events.   

Project management tools from MGMA 

Whatever the resolution for practice transformation in 2024 looks like, MGMA members have access to several project management tools to ensure their initiatives launch and run effectively: 

• MGMA’s project charter template (including instructional video) aids in monitoring the project's progress, identifying potential issues and implementing timely adjustments. 
• A team roster and communication plan template (with instructional videos) help you define team member roles (e.g., executive sponsor, project owner, project manager, contributing team members) and receive sign-off before a project begins. 
• Using a Gemba board template (instructional video included) provides your team with a centralized hub for monitoring key metrics, project milestones and performance indicators directly at the location where the work is happening. 

Before your next project, assess your practice 

An MGMA member recently submitted this question to Ask MGMA: “I have just been hired as a new practice administrator of a multispecialty practice. I would like to conduct a practice assessment to see what’s working and what needs to be updated. Is there any advice or tools to help me?” [Listen to the MGMA podcast below for more about this topic.] 

A great starting point in that journey should be the MGMA Strategic Planning Toolkit to help you assess where you are and where you want to go. It will give you a start in developing your mission, vision and values, as well as your long-term goals and the action plans you will use to reach them. The toolkit includes: 

• A business plan template 
• A priority decision matrix 
• A SWOT/TOWS/SWOT competitor analysis template 
• A medical practice pro forma template. 

A SWOT analysis identifies a healthcare organization's internal strengths and weaknesses, as well as external opportunities and threats, aiding strategy formulation that capitalizes on strengths and opportunities, while addressing weaknesses and threats. The TOWS matrix expands on the SWOT by combining these elements to create actionable plans. Additionally, SWOT competitor analysis positions an organization against competitors by understanding the competitive landscape and highlighting areas for differentiation. While SWOT is commonly known, TOWS may be new to some practitioners. 

TOWS analysis using SWOT analysis: 

Strengths-Opportunities: 

• Strong brand recognition can be used to attract new patients and expand into new markets. 
• Large network of providers can be used to provide care to more patients and reduce wait times for appointments. 
• Excellent patient care and high patient satisfaction can be used to attract new patients and retain existing patients. 
• Strong financial performance can be used to invest in new technology and expand into new markets. 

Weaknesses-Opportunities: 

• High cost of care can be offset by increasing the volume of patients seen or by negotiating lower rates with insurers. 
• Limited access to care in some areas can be addressed by expanding the network of providers or by opening new clinics. 
• Long wait times for appointments can be reduced by increasing the number of providers or by offering extended hours. 
• Some patients complain about the quality of care can be addressed by improving communication between providers and patients, or by providing additional training to providers. 

Strengths-Threats: 

• Strong brand recognition can be used to differentiate the practice from competitors. 
• Large network of providers can be used to provide care to more patients and reduce wait times for appointments. 
• Excellent patient care and high patient satisfaction can be used to attract new patients and retain existing patients. 
• Strong financial performance can be used to invest in new technology and expand into new markets. 

Weaknesses-Threats: 

• High cost of care can make it difficult to compete with other healthcare providers. 
• Limited access to care in some areas can make it difficult to attract new patients. 
• Long wait times for appointments can make it difficult to retain existing patients. 
• Some patients complain about the quality of care can make it difficult to attract new patients and retain existing patients. 

Practice administrators will be reviewing financial statements, budgets and the billing processes, as well as evaluating revenue streams, expenses and financial trends. They will be assessing day-to-day operations, workflows and efficiency while considering patient flow, appointment scheduling, and staff responsibilities. That is just a small part of it.  

Another great tool is our Medical Practice Evaluation Tool, free for MGMA members. It is a comprehensive, web-based assessment that provides actionable insights on how your organization measures against top-performing practices. Practice inputs are benchmarked against MGMA data, providing members with an annually updatable red, yellow or green scorecard.  

Success in these areas depends on involving your staff, physicians and other key stakeholders, communicating your assessment findings and creating measurable goals and timelines for prioritized action items. Make sure to benchmark your KPIs when possible.