Physician-owned practices grew their share of receivables collected inside 30 days by 2.0 to 7.0 percentage points in 2024, while hospital- and health-system-owned groups saw that same share fall by double digits, according to MGMA benchmarking data. At those hospital-owned groups, the share of receivables aged past 120 days climbed 9.5 to 15.9 percentage points over the same year.
The gap shows up against a backdrop of days in A/R that, for most practices, barely moved. An MGMA Stat poll fielded July 28, 2026, with 203 applicable responses, found 43.0% of medical group leaders said their days in A/R stayed about the same as a year earlier, 32.0% said it rose, 22.0% said it fell, and 3.0% were unsure. Nationally, the trend still points up: AMS Solutions' 2026 benchmark report, published July 31, 2026, put the average at 42 days in A/R, up from 38 the year before, alongside a claim denial rate of 9.0%, up from 7.5% in 2023.
A Poll of 203 Practices Shows the Middle Holding Steady
The MGMA Stat poll's headline number, 43.0% reporting no real change in days in A/R, masks how much movement sits on either side of it. Add the 32.0% reporting an increase to the 22.0% reporting a decrease, and well over half of practices saw real movement in either direction, even as the poll's own framing called the overall trend flat. MGMA's benchmarking data also shows first-submission denial rates holding between 7.0% and 8.0% for four straight years, well above the sub-5.0% rate MGMA considers achievable. That gap between actual and achievable denial rates is a large part of why days in A/R keep drifting rather than settling.
The Real Split Is Ownership, Not Specialty
MGMA's 2024 benchmarking data breaks the aging trend down by ownership type, and the two groups moved in opposite directions. Physician-owned practices increased their 0-to-30-day A/R share by 2.0 to 7.0 percentage points. Hospital- and health-system-owned groups moved the other way, with their 0-to-30-day share falling by double digits and their 120-plus-day share rising 9.5 to 15.9 percentage points over the same year.
| Ownership type | 0-30 day A/R share, 2024 | 120+ day A/R share, 2024 |
|---|---|---|
| Physician-owned | Up 2.0 to 7.0 points | Not broken out separately by MGMA |
| Hospital- or health-system-owned | Down by double digits | Up 9.5 to 15.9 points |
Source: MGMA, "Days in A/R holds steady for most practices, but payer pressure persists in 2026," July 30, 2026.
MGMA does not publish the exact dollar swing behind those percentage-point shifts, but the direction is consistent: smaller, physician-owned groups collected faster in 2024 while larger, hospital-affiliated groups let more of their receivables age past four months.
Denials and Appeals Are Still the Biggest Leak
A separate MGMA Stat poll from January 6, 2026, with 288 applicable responses, asked medical group leaders where their practice's revenue leaks the most. Denials and appeals led at 48.0%, followed by front-end issues such as eligibility and registration errors at 23.0%, billing and collections at 14.0%, coding at 13.0%, and charge posting at 2.0%. The same poll found 68.0% of groups added or expanded AI tools somewhere in the revenue cycle over the past year, most often for documentation and scribing rather than denial prevention itself.
MGMA's breakdown of the same poll names specific drivers inside each category. Denial leakage traces mostly to medical necessity denials, bundling and global-package edits, prior authorization friction, and eligibility or coordination-of-benefits problems. Front-end leakage traces to eligibility verification errors, outdated demographic data, and authorization delays at check-in. Billing and collections leakage traces to high patient deductibles and aging balances that go uncollected. That leakage split lines up with the A/R aging data. When nearly half of leaders name denials and appeals as the largest single leak, and first-submission denial rates sit two to three points above what MGMA calls achievable, claims spend more days moving through rework before they convert to cash.
Point-of-Service Collection Still Skips Most Non-Copay Balances
MGMA's 2024 data also shows a gap in how consistently front desks collect at the time of the visit. Copayments got collected at time of service 72.0% of the time. Other patient-due balances, such as a share of the deductible, got collected at time of service only 27.0% of the time. That 45-point gap means most non-copay balances still go out the door as a bill mailed later, a step that adds its own delay before the practice sees the money.
Unpaid Balances Cost Hospital-Owned Groups the Most
Bad debt per full-time-equivalent physician gives the clearest dollar figure in MGMA's 2024 data, though it is reported for hospital-owned groups only. Nonsurgical specialty groups averaged $43,073 in bad debt per FTE physician. Surgical specialty groups averaged $48,337 per FTE physician, roughly $5,264 more. MGMA did not publish a matching bad-debt figure for physician-owned practices in this release, so a direct independent-versus-hospital-owned comparison on that specific number is not available. What is available points the same direction as the aging data: hospital-owned groups are carrying more receivables past 120 days, and those balances are where bad debt tends to originate.
What the Numbers Suggest for Independent Practices
None of MGMA's figures explain why physician-owned practices gained ground on A/R aging while hospital-owned groups lost it, and the poll does not ask leaders to name a cause. The pattern still holds across every ownership-linked figure MGMA published this cycle, from the A/R aging split to the $5,264 gap in bad debt between surgical and nonsurgical hospital-owned groups. For a practice manager comparing notes with a hospital-employed counterpart, that pattern is a real, measurable difference in how fast the same kind of claim turns into cash.
Sources
- MGMA, "Days in A/R holds steady for most practices, but payer pressure persists in 2026," July 30, 2026
- MGMA, "Detecting and fixing leaks across the revenue cycle," January 6, 2026
- HIT Consultant, "AMS Solutions Releases 2026 Benchmark Report on The State of Medical Billing," July 31, 2026
Talk to us
Fifteen minutes about your practice and the systems you run.