Weekly roundup
Here’s what you missed last week!
🏛️ Policy & Payers
Plan for tighter balance billing enforcement as lawmakers press for stronger No Surprises Act enforcement.
Expect new scrutiny on vertical integration with a proposed bill to bar insurer clinic ownership.
Revisit pharmacy contracts as employers shift to transparent PBMs, dropping big-three reliance from 72% to 61%.
Brace for coverage churn as an ACA subsidy expiration analysis projects 4.8M losing insurance, with sharp state variance.
📈 Business & Tech
Calibrate roadmaps to a long horizon as AI-driven models could shift $1T in spend by 2035.
Track payer stack changes as regional Blues co-found the Stellarus platform to integrate AI in health plans.
🩺 Clinical
Improve refill rates and outcomes with a human-in-the-loop adherence model pairing tech and navigators.
Expand reach without new sites via a rural virtual care expansion aimed at closing treatment gaps.
⭐ Just for Fun
The Deep Dive
Why patient no-shows are skyrocketing (and what to do about it)
Why it matters. Missed visits drain revenue, block access, and burn out staff. In an Aug. 12 MGMA Stat poll, 73% of medical practices said no-show rates were flat (60%) or down (13%) compared with 2024, while 27% saw increases.
What’s driving no-shows? Coverage churn and cost sensitivity are still reshaping demand. During the unwinding of continuous Medicaid coverage, roughly 31% of people with a completed renewal were disenrolled in reporting states, which created confusion about eligibility and out-of-pocket costs (perfect conditions for delayed or missed care). Lead time is another lever: the farther out you schedule, the more likely people are to disappear. Evaluations of open-access scheduling show that shortening days-out (the “third next available”) lowers no-show rates, especially for routine follow-ups.
Transportation remains a stubborn barrier. A national brief found 21% of adults without access to a vehicle or public transit skipped needed care, a reminder that no amount of reminder tech can overcome lack of transportation. The right dose of telehealth helps: post-pandemic evidence tilts toward lower non-attendance for virtual visits overall, though results vary by population and setting.
Digital friction quietly undoes good intentions. One-way reminder texts, locked portals, and clunky rescheduling paths still push patients off the schedule; two-way channels and simple self-reschedule options remain underused in many groups.
What’s working? From what we’ve seen, leaders who kept no-shows steady or edged them down consistently point to boring-but-powerful basics:
Implementing frequent, conversational reminders (two-way SMS with confirm/reschedule flows, backed by live calls for high-risk visits)
Enabling easy cancellation and rebooking, and templates that protect near-term access so patients aren’t booked months out
Prioritizing right-sized modality, leaning on video for medication checks, results reviews, and short follow-ups, then watched completion rates by visit type to tune the mix over time.
On the operations side, teams that treated access as a measurable clinical quality metric moved fastest. They converted more templates to same-/next-day capacity and ran recurring “backlog scrubs” to pull forward patients scheduled far out. Expect fewer no-shows simply by shortening the wait.
Derm has its own patterns. Surgical and high-prep days (e.g., excisions, staged repairs, phototherapy starts) benefit from a light navigator touch to confirm readiness (e.g. driver availability, wound care expectations, coverage status) and to offer practical help like ride codes or NEMT when appropriate. Short telehealth touchpoints for med checks or results reviews keep patients engaged between procedures and can reduce fall-offs before follow-up. Finally, make rescheduling truly “tap-to-move” from your reminders; don’t force portal logins for simple changes.
How do I know what’s working?
Stand up a simple access and attendance scorecard by site and service line.
Track no-show and late-cancel rates by visit type/modality, third-next-available, days-out at scheduling, the reclaimed-slot rate after misses, and completion rates for cohorts you’ve flagged as high risk.
Share wins with frontline teams and celebrate reclaimed capacity like new revenue... because it is.
Start with the single lever that moves most organizations: cut your average days-out; the no-show rate tends to follow.
Bottom line: Practices reclaiming capacity in 2025 do three things well: shorten access, remove practical friction, and match the visit to the work.
The Toolkit
Things to check out this week
📄 Article You Need: MGMA Stat: Patient no-shows in 2025 - fresh pulse-check showing 73% of practices saw flat or lower no-show rates this year, helpful for benchmarking your own trendline before you change workflows.
🛠️ Tool You Should Try: Relatient Dash patient self-scheduling & engagement - Best in KLAS 2024, with self-scheduling plus two-way messaging to cut days-out and fill backlogs; practical for turning “tap-to-move” reschedules into completed visits.
🎧 Event Alert: MGMA Leaders Conference (Orlando, Sept 28–Oct 1, 2025) - timely sessions on access, RCM, and AI; a good place to pressure-test your no-show playbook with other practice leaders.
Need a pro?
When you're ready for an expert to make your practice's billing bulletproof, schedule a strategy call with our team.
That’s it for this week.
This one was super fun. Hope you enjoyed it too.
