Reducing Administrative Burden in Specialty Practices Starts With the Work You Control

Ask any administrator at a 30-physician cardiology or orthopedic group where the day goes, and you’ll hear a familiar list: prior authorizations, denials, eligibility checks, payer calls, patient billing questions. None of it is patient care. All of it is necessary.

The data confirms what practice leaders already feel. In MGMA’s 2026 Regulatory Burden Report, nearly 95% of medical group leaders said regulatory burden had increased over the past three years, and 77% named it a major contributor to physician burnout.¹ Forty percent reported hiring multiple full-time administrative staff per physician just to keep up with payer rules, audits, appeals, and reporting.¹

Much of that burden sits outside a practice’s control. Payers set the rules. But not all administrative work is created equal, and the fastest way to reduce the load is to separate what you can’t change from what you can.

Where the burden comes from

Payer work keeps growing

Prior authorization remains the heaviest single task. The AMA’s 2025 Prior Authorization Physician Survey found physicians and their staff complete roughly 40 prior authorization requests per physician each week, spending about 13 hours on them. Forty percent of physicians employ staff who work exclusively on prior authorizations.²

For specialty groups, that volume compounds. Imaging, procedures, infusions, and surgical scheduling all tend to carry authorization requirements, so the work scales with the procedural mix that makes a specialty practice viable.

The phones tell the same story. In a March 2026 MGMA Stat poll, practice leaders named eligibility and prior authorization (45%) as the most time-consuming phone task their staff handle, ahead of scheduling (31%).³

Costs are rising faster than capacity

At the same time, running the practice costs more. In a June 2026 MGMA Stat poll, 84% of medical groups reported year-to-date operating costs higher than the same point in 2025, with labor the most-cited driver.⁴ MGMA has also noted that when experienced revenue cycle staff leave, claims, denial follow-up, and coding review start to age, slowing cash flow.⁵

So practices face a squeeze: more administrative work, higher cost per staff member, and real consequences when experienced people leave.

Patients now carry more of the bill

The third pressure is quieter but constant. According to KFF’s 2025 Employer Health Benefits Survey, the average single-coverage deductible reached $1,886, up 17% over five years and 43% over ten. More than a third of covered workers have a single-coverage deductible of $2,000 or more.⁶

For a specialty practice, that means a larger share of each procedure is owed by the patient. Every balance creates downstream work: estimates, statements, reminder calls, inbound billing questions, payment posting, and follow-up. Unlike payer requirements, almost all of that work is shaped by the practice’s own workflows.

Deductible timing adds another layer. Balances tend to spike early in the plan year, when many patients haven’t met their deductible yet. In specialties with high-dollar procedures, such as orthopedic surgery, cardiology, and GI, a single visit can produce a balance large enough that patients need a payment plan, a second explanation, or several reminders before they pay. Each of those touches lands on the same team already handling authorizations and denials.

The work you can’t control, and the work you can

Practice leaders are already moving. In a January 2026 MGMA Stat poll, automation (36%) and process fixes (23%) together made up more than half of practices’ top planned cost-cutting moves for the year, well ahead of hiring freezes or cuts (18%) and outsourcing (14%).⁷

That instinct is right. Where it’s pointed matters just as much. Many practices aim first at payer-facing tasks like prior authorization — important work, but work that leans heavily on payer portals, payer policy, and regulatory change still to come. Patient-facing payment work is different. The practice owns the process end to end, so improvements show up faster and tend to stick.

Industry data supports the scale of the opportunity. The 2025 CAQH Index estimates that moving remaining manual and partially manual administrative transactions to full automation could still save the U.S. healthcare system about $21 billion a year.⁸ Not all of that sits in patient payments, but it shows how much manual work remains in a system that already has the tools to reduce it.

Five practical ways to reduce administrative burden

These apply regardless of which systems or vendors a practice uses.

1. Map where staff time actually goes. Before buying anything, spend two weeks tracking how billing and front-office staff spend their hours. Separate payer-driven tasks (authorizations, denials, eligibility) from patient-driven tasks (balance questions, statements, payment plans, posting). Most leaders find the patient-side work is larger than expected.

2. Move financial conversations earlier. Practices that improved patient payment results in 2025 most often tightened front-end processes: time-of-service payment, clearer estimates, and stronger accountability for registration and billing roles.⁹ A clear estimate before a procedure prevents many of the confused phone calls that follow a surprise statement.

3. Consolidate patient communication. When a patient receives a pre-service estimate from one system, a statement from another, and a reminder call from a third, each touchpoint generates questions. One consistent thread across the patient’s financial journey reduces confusion and inbound volume.

4. Let patients help themselves. Text and email payment links, online payment plans, and clear self-service answers handle routine questions without a phone call. MGMA has long pointed to digital billing as a way to reduce mailed statements, manual payment posting, and outbound calls about balances.¹⁰

5. Redeploy capacity to the work that needs judgment. The goal of reducing administrative burden isn’t fewer people. It’s experienced people spending their time where their expertise matters: complex denials, appeals, difficult patient conversations, and payer escalations. Framing automation this way also helps with retention, since staff see the change as an upgrade to their role rather than a threat to it.

A Rivia Health perspective

Rivia Health works with specialty practice groups managing exactly this tension. Payer work isn’t going away, and billing teams are already stretched thin. One pattern holds across those practices: patient payment workflows are where a team can win back capacity fastest, because the practice controls the process from start to finish.

That’s why Rivia Health supports both pre-service and post-service payment workflows in a single patient communication thread, integrates bidirectionally with EMRs like athenahealth, Veradigm, and Greenway, and keeps outreach going beyond 90 days so balances don’t quietly age into write-offs. Patients get clear, timely messages by text and email, and they can pay in a few taps.

The results show up in staff workload as much as in revenue. Practices using Rivia Health see roughly 30% fewer inbound billing calls, 75% of patients paying within two days, and AR days reduced from around 60 to around 30. For a billing team, that means less time on routine balance follow-up and more time for the work that genuinely needs a skilled, caring person.

Where to start

Reducing administrative burden in specialty practices won’t come from a single tool or a single fix. It comes from being deliberate about which work requires human expertise and which work a well-designed process can handle.

Start with the time audit. If patient payment work is taking more of your team’s week than it should, that is a good place to begin — and a good place to see how other specialty groups have approached it.

Sources

1. MGMA. “New MGMA 2026 Burden Report Finds Increased Regulatory and Administrative Burden Drive Physician Burnout, Threatening Patient Access.” April 2026. prnewswire.com
2. American Medical Association. “AMA survey: Prior authorization reform pledge falls short with physicians.” 2026 (2025 Prior Authorization Physician Survey). ama-assn.org
3. MGMA Stat. “Phones are still a bottleneck costing medical practices time they can’t afford.” March 2026. mgma.com
4. MGMA Stat. “Operating costs keep climbing for medical practices in 2026.” June 2026. mgma.com
5. MGMA Stat. “Stabilized but not solved: Staff turnover in medical practices looking no better, no worse in 2026.” 2026. mgma.com
6. KFF. “2025 Employer Health Benefits Survey.” October 2025. kff.org
7. MGMA Stat. “Automation, process fixes top list of cost-cutting moves for medical practices in 2026.” January 2026. mgma.com
8. CAQH. “2025 CAQH Index Report: Executive Report.” February 2026. index.caqh.org
9. MGMA Stat. “Patient balance collection: What’s moving the numbers and how to get ahead.” October 2025. mgma.com
10. MGMA Stat. “Amid staffing shortages, it’s time to help patients help themselves via self-service tools.” 2022. mgma.com