Episode Details

In this episode of the MGMA Week in Review podcast, hosts Daniel Williams, senior editor at MGMA, and Colleen Luckett, editor and writer at MGMA, discuss the latest healthcare news and trends. They cover the Supreme Court's review of the Affordable Care Act's preventive services mandate, the rise of virtual nursing, and the growing use of AI in healthcare decision-making.

Key Takeaways:

• The Supreme Court has agreed to review a challenge to the ACA's requirement for insurers to cover specific preventive services at no cost, which could limit access to crucial services like cancer screenings and HIV prevention medications.
• Virtual nursing programs are becoming a game-changer in healthcare staffing, with the potential to significantly shift traditional nurse-patient ratios and provide more flexibility for experienced nurses.
• AI tools have surpassed EHR usability as the top tech priority for medical leaders i n 2025, with key goals including automating documentation, improving patient interactions, and enhancing operational efficiency.
• The use of AI by insurance companies to decide which medical treatments to approve is raising concerns, with examples of patients being denied necessary care and the error rates of these systems being as high as 90%.
• A new AI algorithm called RADAR, developed by Linus Health, has shown impressive accuracy in identifying undiagnosed cognitive impairments like Alzheimer's and dementia, potentially transforming value-based care.

Resources Mentioned:

• Axios article on the Supreme Court's review of the ACA's preventive services mandate
• Becker's Hospital Review article on virtual nursing
• MGMA Stat poll on tech priorities for medical leaders in 2025 
• Med City News article on the use of AI by insurance companies
• Healthcare IT News on AI that identifies undiagnosed cognitive impairment 
• MGMA's updated physician fee schedule tool

Sponsor:
Capella University helps healthcare professionals earn their MHA on their terms. Their FlexPath MHA program is designed for busy MGMA members who want to advance their leadership skills with a flexible, self‑paced format — often faster and more affordably — without putting their careers on hold. Questions? Visit capella.edu/MHA to learn more.