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MGMA 2026 Regulatory Burden Report: A Growing Crisis in Healthcare

The Medical Group Management Association (MGMA) has recently released its 2026 Regulatory Burden Report, revealing alarming insights into the increasing regulatory and administrative pressures facing medical practices across the United States. The findings underscore a system under duress, with significant implications for both physician wellbeing and patient care access.

Key Insights from the Report

According to the MGMA, a staggering 95% of respondents indicated that the regulatory burden on their practices has escalated over the past three years. This year’s report is based on comprehensive data collected from leaders representing over 230 medical group practices nationwide, providing a detailed snapshot of how relentless paperwork and complex payer requirements are straining healthcare.

Administrative Challenges and Physician Burnout

Anders Gilberg, senior vice president of MGMA government affairs, commented on the findings, noting that issues like Medicare Advantage prior authorization, excessive claim denials, and automatic downcoding are significantly delaying patient care and undermining adequate physician payments. The increase in administrative staffing costs is another major concern; 40% of practices reported hiring multiple full-time administrative staff per physician just to cope with payer rules, audits, and reporting requirements. This means resources that could be dedicated to patient care are being diverted to tackle burdensome paperwork.

Medicare Advantage and Its Impact

The report highlights that three out of the top five administrative challenges are linked to Medicare Advantage programs, including prior authorizations, claim denials, and automatic downcoding. With Medicare Advantage covering more than half of Medicare-eligible beneficiaries, the overwhelming majority of practices (79%) that reported a transition to this program observed a negative operational impact. Many expressed worries that ongoing participation in such programs, under current conditions, may soon become financially unsustainable.

The Call to Action

MGMA is advocating for congressional intervention. It emphasizes the urgent need to improve government regulations impacting medical groups, particularly around prior authorization processes. They implore Congress to strengthen oversight of Medicare Advantage plans, which have been cited as contributing to delays and administrative complexities.

The Broader Effects of Burnout

Among respondents, 77% cited regulatory burden as a significant driver of physician burnout. The consequences are dire: longer patient wait times, reduced availability of healthcare providers, and, ultimately, diminished access to care for patients. Physicians are increasingly opting to reduce their work hours or retire early due to the stress associated with compliance and regulations.

MIPS Reporting and Its Implications

Over half of the surveyed practices remain enrolled in the Merit-based Incentive Payment System (MIPS). However, 86% felt that the quality reporting demands imposed by MIPS increased their administrative strain. They contend that MIPS often prioritizes compliance reporting at the expense of actual meaningful quality improvements. Additionally, they hold physicians accountable for costs that may be outside of their control, further complicating administrative workflows.

Conclusion: A Call for Reform

MGMA's report serves as a clarion call to policymakers. The organization urges for the reform of burdensome protocols in order to ease the administrative load facing healthcare professionals. Without these critical changes, ongoing regulatory demands and increased burnout will continue to threaten not only the viability of medical practices but also the crucial access to care that patients rely on.

For further information, the 2026 Regulatory Burden Report is available for review through MGMA’s official website, where additional resources and advocacy efforts are also detailed. Promoting a sustainable healthcare system requires collective action and effective policy reform.