Black Book Research pulse survey of MGMA conference attendees in San Antonio finds reimbursement strain, patient coverage uncertainty and IT performance concerns rising to the top of practice leadership priorities before the midterms and into the new year.

SAN ANTONIO, TX / ACCESS Newswire / September 29, 2026 / Black Book Research surveyed seventy-four attendees of the MGMA Annual Conference, taking place September 27-30 in San Antonio, to examine medical practice concerns before the November midterm elections and entering 2027. The assessment addresses three interconnected priorities: reimbursement and financial sustainability, patient coverage and affordability, and the performance of healthcare information technology.

Respondents, classified by primary professional title, included practice administrators and managers, 24%; chief executives and executive directors, 8% ; chief operating officers and operations directors, 23% chief financial officers, finance directors and revenue-cycle leaders, 25%; physician owners and medical directors, 20% and other management and clinical titles,

1. Reimbursement and Financial Sustainability: Greater Predictability for Practice Planning

89% of Black Book respondents identified reimbursement and financial sustainability among their three leading concerns. The broader practice-management environment remains cost-sensitive. 97% reported higher year-to-date operating costs than at the same point in 2025. Leaders cited staffing, benefits, supplies and vendor expenses among the pressures.

For 2027 planning, the issue is not simply whether revenue increases, but whether reimbursement supports staffing, appointment availability and the cost of collecting payment. Financial caution can coexist with investment when a practice can identify a specific operational benefit.

Potential outcomes include closer scrutiny of payer contracts, hiring and expansion plans; stronger denial prevention; and selective outsourcing. Practices may favor targeted improvements over broad capital commitments when implementation costs and returns are easier to establish.

2. Patient Coverage and Affordability: Keeping Patients Connected to Care

90% identified patient coverage, affordability and continuity of care among their three leading concerns.

CMS’s Medicaid community-engagement rule generally requires states to implement new eligibility conditions for certain adults no later than January 1, 2027, subject to exclusions and exceptions. This creates an immediate planning consideration for practices serving affected patients.

The management concern extends beyond collecting patient balances. It includes whether patients understand coverage changes, keep follow-up appointments and remain connected to treatment when their financial circumstances change.

Potential outcomes include more frequent eligibility verification, clearer cost estimates, enrollment-assistance referrals and outreach to patients who miss scheduled care. The operational demands will differ by payer mix and patient population; practices should not assume a uniform effect across locations or specialties.

3. Healthcare IT, AI and Administrative Capacity: Demonstrating Value Beyond Adoption

87% identified IT performance and technology-enabled administrative relief among their three leading concerns. This priority connects electronic health records, practice-management systems, prior authorization, revenue-cycle automation and cybersecurity to a central question: Does the technology remove work, or move it somewhere else? Earlier MGMA research identified integration difficulties, training needs, implementation costs and inconsistent use among reasons some leaders had not seen improved provider productivity. Others reported gains, particularly in documentation. That combination supports a more nuanced interpretation of practice-leader sentiment: interest in innovation alongside scrutiny of its practical return.

Black Book’s on-site analysis places integration, total ownership cost and measurable workflow improvement at the center of the 2027 IT discussion. Relevant measures include authorization turnaround, repeated data entry, staff time per claim, after-hours documentation and patient-access delays.

Potential outcomes include consolidating overlapping applications, requiring clearer implementation and support commitments, and testing automation before broader deployment. Evaluations should also address security, downtime procedures and the staff effort required to maintain new tools.

“Medical practices are entering 2027 with reimbursement pressure, patient coverage uncertainty and technology performance converging at the point of care,” said Douglas Brown, founder of Black Book. “These are no longer separate financial, access and IT issues. They are interconnected operating realities that determine whether practices can sustain capacity, keep patients connected to care and give physicians and staff technology that actually reduces administrative work. The practices gaining ground will be those that connect reimbursement intelligence, patient access and digital workflow into one operating strategy, and measure technology by the clinical and financial capacity it gives back.”

Black Book’s MGMA-attendee pulse survey reflects participating respondents, not all MGMA members or U.S. medical practices. Conference attendance does not imply MGMA sponsorship or endorsement. Separately attributed MGMA research provides industry context. Potential outcomes are Black Book’s analytical implications.

About Black Book Research

Black Book Research is an independent, vendor-agnostic healthcare market research organization specializing in technology and services evaluation, client experience and competitive intelligence. Media Contact research@blackbookmarketresearch.com 800-863-7590 https://www.blackbookmarketresearch.com

SOURCE: Black Book Research

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