5 big challenges for medical practices (and why they all tie back to staffing)

This week’s MGMA Stat poll points to five unignorable priorities for medical practice leaders: staffing, margins and cost containment, health technology and AI, payer friction, and patient access/growth. Together, they form an interconnected agenda: How you staff and deploy talent shapes unit costs, influences the technology you seek out, payer yield, and your ability to expand access.  

An Aug. 19, 2025, MGMA Stat poll found 41% of medical group leaders said margin/costs were their leadership’s top priority, followed by access and growth (26%), staffing (20%), payer friction (9%), and technology and AI (5%). The poll had 343 applicable responses. [Editor’s note: Figures do not total 100% due to rounding.] 

Though staffing ranked third, it underpins the rest. Practices continue to struggle with hiring — especially medical assistants (MAs) — even as some turnover stabilizes. Staffing choices drive labor spend, productivity, throughput, and the feasibility of new service lines or extended hours. 

Margin and cost containment 

Leaders who selected margin/costs pointed first to labor: wage pressure to retain staff, market adjustments, and keeping compensation competitive. They also citied medical supplies/drugs and overhead (rent, benefits, IT). Flat or declining payer rates — notably Medicare and Medicaid — intensify the squeeze, making expenses outpace reimbursement. Secondary levers included optimizing space utilization, tightening schedules to match demand, and sharpening revenue-cycle focus on A/R and cash acceleration; a few mentioned broad cost-cutting or launching new service lines to offset shortfalls. 

Access and growth 

Respondents prioritizing access and growth emphasized capacity — chiefly, adding providers after years of clinician attrition — and translating that capacity into appointments. Operational themes included opening their practices’ visit templates, maximizing slot availability, shortening time-to-appointment, enabling online and same-day scheduling, and extending hours. Demand-generation and channel expansion (marketing, referral management, telehealth, and new sites) pair with front-of-house streamlining to route patients efficiently, including same-day sick visits that divert avoidable ER volume. 

Staffing 

Within the staffing cohort, hiring and retention dominated as top concerns: rebuilding pipelines, attracting reliable candidates, and keeping the culture healthy to reduce burnout. Compensation clarity and seasoned management were viewed by these respondents as key retention levers, as was aligning schedules to actual volume. Persistent pain points cited were thin applicant pools and attendance challenges that threaten daily coverage. 

Payer friction 

For leaders focused on payer friction, claims denials and prior authorization were the top daily bottlenecks, compounded by timely-pay delays and the difficulty of reaching payer representatives to resolve issues. Contracting and rate adequacy — including reports of arbitrary underpayments — add pressure, alongside credentialing delays and occasional quality-metric withholds that push cash flow at risk. 

Technology and AI 

Those prioritizing technology and AI clustered around three use cases: ambient scribe tools to ease documentation, automation within EHR and RCM workflows, and patient-access tools to smooth intake and scheduling. Some respondents simply said “all,” signaling interest in automation across the tech stack where it reduces workload and proves ROI. 

How the Leaders Conference helps you solve for “the big five” 

The 2025 MGMA Leaders Conference, Sept. 28 to Oct 1 in Orlando, Florida, curates sessions to move the needle where you need it most: 

1. Staffing 

From MA pipeline development and retention/engagement playbooks to data-driven staffing decisions and handling disruptive behavior, you’ll find practical models you can adapt immediately. If your needs are physician-focused, consider the early-career physician loyalty/relationship session alongside comp-strategy breakouts. 

2. Margin and cost containment 

Sessions on resource management amid shrinking fees, compliance risk/cost control, grant funding in academic medicine, and decision tools anchor a slate that also includes practical HIM/RCM efficiency demos and group-purchasing savings insights in the Solution Center. 

3. Technology and AI 

Whether you’re evaluating generative AI strategy, building an analytics stack for growth, advancing cybersecurity, or exploring clinician-centric tools, the program emphasizes proving ROI and easing clinical/admin workloads. 

4. Payer friction 

Get smarter on value-based models, payer contracting tactics, and policy direction with the latest updates from MGMA Government Affairs. Solution Spotlights dig into denial prevention/remediation and audit readiness to improve cash flow without adding FTEs. 

5. Access and growth 

If your practice’s top challenge is in capacity bottlenecks, target ambulatory expansion lessons, space optimization, and direct-pay growth. For demand generation and throughput, the AI-powered outreach and access sessions and patient/staff communication demo are fast wins. 

Bottom line 

The priorities surfaced in this week’s poll are the spine of the educational agenda at the 2025 Leaders Conference.  

Use the index above to build a personalized path through Orlando: start with one high-impact session in each category, add one or two Solution Center spotlights aligned to your biggest KPI gaps, and leave with the insights to build a 30-/60-/90-day plan that improves staffing stability, unit costs, tech ROI, payer yield, and/or patient access — now, not “someday.”