Ten years of MGMA Stat polls show operating costs running ahead of revenue every time MGMA asked: 90% of groups said so in 2022, 89% in 2023, 92% in 2024 and 84% in 2026. MGMA's September 30, 2026 review covers more than 550 polls and more than 380,000 responses from over 10,000 respondents since the panel launched on February 9, 2016.
Payment leads the list of future complexity
MGMA asked its panel what will add the most complexity to practices through 2036. Of 228 applicable responses, 35% named payment. Workforce drew 25%, technology 21%, regulation 17% and other factors 3%.
Respondents who chose payment pointed to falling reimbursement, rising operating costs, prior authorization, denials and more movement away from fee-for-service. Together, payment and workforce account for 60% of the responses.
Payment was also the first topic MGMA polled. In the first poll in 2016, 100 groups answered a question on readiness for value-based payment: 26% said yes and 66% said no.
| Source of complexity through 2036 | Share of 228 responses |
|---|---|
| Payment | 35% |
| Workforce | 25% |
| Technology | 21% |
| Regulation | 17% |
| Other | 3% |
Source: MGMA Stat, 2026 poll, 228 applicable responses.
Benefit spending shows the same pressure. Only 16% of groups added or increased benefits in 2026, down from 45% in 2022.
Costs and revenue since 2022
MGMA tracked how many groups said costs outpaced revenue. The share was 90% in 2022, 89% in 2023 and 92% in 2024. In 2026 it was 84%, the lowest of the four readings and still more than eight in ten groups.
The 2026 reading comes from a June 30, 2026 poll with 221 applicable responses. It asked about year-to-date costs against the same period in 2025, so the wording differs from the earlier polls.
The same poll asked about revenue. In 2026, 47% of groups reported higher year-to-date revenue than a year earlier, 14% reported about the same, 36% reported a decrease and 2% were unsure. In a June 17, 2025 poll, 56% reported an increase, 13% reported flat revenue, 30% reported a decline and 1% were unsure.
The lead of groups with rising revenue over groups with falling revenue shrank from 26 points in 2025 to 11 points in 2026.
Prior authorization and Medicare rates
MGMA asked groups in several years whether prior authorization requirements had increased. In 2016, 82% said yes. In 2017 and 2018 the figure was 86%, and in 2019 it reached 90%.
In 2019, 67% of groups said Medicare rates fell below the cost of delivering care. MGMA repeated the Medicare question in 2021 and 2026, but the review does not give those results.
Pay design changed as well. The share of groups using quality metrics in physician compensation was 27% in 2016, 36% in 2018 and 38% in 2019. It reached about 50% in 2023 and 50% in 2024.
Staffing and benefits
MGMA ran polls on staff shortages in several years. In May 2018, 61% of groups faced a shortage of qualified nonclinical applicants. In September 2018, 59% had experienced physician departures. On March 17, 2020, 40% reported staff shortages.
In a 2025 poll, nearly 50% of groups named medical assistants as the hardest role to recruit.
The share of groups adding or increasing benefits moved with the labor market:
- 2021: 26%
- 2022: 45%
- 2023: 35%
- 2024: 21%
- 2026: 16%
Workforce also took a larger share of the poll slate. From 2016 to 2019 it made up 3% of polls, or 7 of 216. From 2021 to 2026 it made up 23%, or 66 of 285.
Technology and daily operations
Telehealth expansion in MGMA polls went from 21% of groups in January 2017 to 26% in 2018 and 29% in 2019. On March 31, 2020, 97% of groups had expanded telehealth access.
A July 2018 poll on patient portals drew 1,785 responses, the most of any MGMA Stat poll. Of those groups, 90% offered a portal. In 2018, 68% of groups sent text appointment reminders and 82% ran patient satisfaction surveys.
In a November 2019 poll, 89% of groups still used fax machines.
AI now takes about 20% of all MGMA Stat polls in 2026. MGMA's first AI question, in March 2018, found 35% of respondents would consider medical advice from AI and 40% would not.
What the 2020 polls and burnout polls found
MGMA ran 51 COVID-19 polls between March 17 and June 9, 2020. On March 19, 89% of groups reported PPE shortages. On April 7, 97% reported a drop in patient volume, from 1,713 responses.
On April 14, 76% of groups had applied for Paycheck Protection Program loans. By May 8, 89% were reopening for in-person visits. By June 9, 87% had recovered some patient volume.
A June 2018 burnout poll drew 1,746 responses. Of those, 45% said yes to burnout and 28% said somewhat. In a September 2017 poll of 1,643 responses, 60% of respondents rarely or never managed a daily lunch break.
How MGMA changed its polling
Yes-or-no questions made up about 60% of polls through 2020. In 2025 and 2026 they make up about 30%. By 2024, 90% of polls included a tailored follow-up question. About 33% of polls in 2025 and 2026 compared results with the prior year.
Regulatory questions took about 15% of the slate from 2016 to 2018 and less than 10% since 2022.
Sources
- MGMA, MGMA Stat at 10: a decade of change in medical practices, September 30, 2026
- MGMA, Revenue growth narrows as costs climb: the 2026 squeeze on medical practices, July 2, 2026
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