Our Practice Management Committee actively tracks local and regional issues affecting physician practices, including problems with commercial payors.
Use the Practice Management Issue Form at the bottom of this page to report specific challenges so we can identify trends and advocate more effectively on your behalf.
What Our Members Told Us
In April 2026, the Medical Society convened its Business of Medicine Forum, bringing together more than 100 physicians and practice managers for a full day of education and dialogue. The forum produced a rich body of feedback, organized around the issues members identified as most pressing.
Select each issue below to read what members reported.
Financial sustainability
Commercial fee schedule reductions in 2024, combined with Medicare cuts in 2025, have created compounding financial pressure on practices already operating on thin margins. Employee health insurance costs have doubled in five years for some practices. Members asked payors directly: what happens to patient access if independent primary care is no longer financially viable?
Provider representative access
The loss of dedicated local payor representatives was among the most consistently raised concerns. Without a direct contact, routine issues such as billing discrepancies, claim denials, and credentialing status require multiple attempts through digital portals with no clear path to resolution. Members want a local, knowledgeable contact with the authority to act.
Prior authorization burden
Extensive and inconsistent prior authorization requirements are consuming staff time and overriding clinical judgment. Procedures approved for prior authorization are being denied at the claims stage. Members called for meaningful reduction in authorization requirements, particularly for lower-level procedures and imaging.
Claims processing and denials
Denial explanations are frequently insufficient. Down-coding, sometimes a year or more after submission, is hitting specialist practices hard. Guidance from payor call centers is inconsistent. Members are asking for transparency and accountability in the adjudication process.
Credentialing delays
Long credentialing timelines are delaying patient access and imposing financial gaps on practices that hire new providers. Plans do not backdate approvals, meaning the entire cost of the delay falls on the practice.
Technology and administrative tools
Availity and related platforms are fragmented and insufficiently supported. Multiple portals, inconsistent rules, and limited human backup are adding to administrative burden rather than reducing it.
Report a Practice Management Issue
This work belongs to all of us. If you have encountered issues with payor contracts, credentialing, claims, or the tools your practice depends on, we want to hear from you.
Your experience drives our advocacy, and the strength of that advocacy depends on the engagement of every member. Please complete the form below.
The Practice Management Committee reviews these submissions, vets practice management issues, identifies common payer concerns, and uses this information to guide educational programming and payor outreach. While we cannot address every individual case, your input directly informs our conversations with insurers and supports our advocacy work.