Half of U.S. medical groups, 50.0%, have gone three or more years without a raise from a commercial payer, according to MGMA's poll of 203 medical group leaders published August 25, 2026. Only 29.0% received a rate increase within the past year, and 17.0% saw one within the past one to two years, while 4.0% said the question did not apply to their group.
The gap between rising costs and flat contracted rates lands on practice executives at a bad time. MGMA's June 2026 poll of 251 medical groups found 84.0% reporting higher year-to-date operating costs, a pressure that falls hardest on groups still working off rates set years earlier.
How Long Since the Last Raise
MGMA's August 25, 2026 Stat poll asked 203 medical group leaders when their group last received a rate increase from a commercial payer. The answers split unevenly: 29.0% said within the past year, 17.0% said one to two years ago, 50.0% said three years or longer, and 4.0% said the question did not apply. Half the sample is billing against contracted rates that predate the current run of cost increases entirely.
A group still working under a 2022 or 2023 contract is collecting the same dollar amount per visit or per procedure today that it collected three-plus years ago, while MGMA's own cost polling shows operating expenses climbing at 84.0% of practices this year.
Contracts Sit Unreviewed for Years at a Time
Stagnant rates track closely with how often practices look at their contracts at all. MGMA's August 15, 2023 poll of 389 medical groups found 58.0% review payer contracts annually, about 10.0% review more than once a year, and 17.0% have no regular review schedule. The remaining 16.0% review on some other cycle, commonly tied to a contract's renewal date rather than a fixed calendar.
Annual review is the norm among MGMA's respondents, but 17.0% reviewing on no set schedule is a meaningful share of practices heading into renewal without a recent look at the terms they agreed to. Among the 16.0% on some other cycle, MGMA's poll noted several groups review every three years or on a biannual schedule instead, often built around a contract's renewal date rather than a fixed point on the calendar, with a few months set aside beforehand to pull financial and operations data ahead of renegotiation.
Rate Audits Are Even Less Common
MGMA's January 5, 2021 poll of 519 medical groups measured how often a practice checks that a payer actually paid at the contracted rate, a separate question from what the contract itself says. It found 47.0% audit contracted rates annually, 10.0% quarterly, 9.0% monthly, and 9.0% semiannually, while 25.0% never audit payer rates against the contract at all.
That 25.0% figure matters because underpayment can hide inside a contract that reads fine on paper. A practice that never checks paid claims against the contracted rate has no way to know whether some of its contracts have quietly drifted below the negotiated number. MGMA's poll framed a consistent audit schedule, monthly, quarterly, or semiannual, as the way practices catch those errors before they compound across a full year of claims.
Few Practices Use Federal Rate-Transparency Data
Since 2022, federal rules have required insurers to publish machine-readable files of the rates they negotiate with providers, known as Transparency in Coverage data. MGMA's December 30, 2025 poll of 207 medical groups found only 18.0% use that data in payer negotiations. A further 46.0% said they do not, and 36.0% were unsure whether their group uses it.
Non-users pointed mainly to the size and technical format of the files, which are built for large-scale data processing rather than a billing manager opening a spreadsheet, along with limited awareness that the files exist and unclear value once a group tracks them down. Groups that do use the data reported applying it to set and defend target rates ahead of a negotiation, to compare what other practices in the same market are paid for the same CPT code, and to ground a renewal conversation in published numbers instead of a payer's own framing.
| MGMA poll topic | Key finding | Sample size | Poll date |
|---|---|---|---|
| Time since last commercial payer rate increase | 50.0% went 3+ years without one | 203 | Aug. 25, 2026 |
| Payer contract review frequency | 58.0% review annually; 17.0% on no set schedule | 389 | Aug. 15, 2023 |
| Contracted rate audit frequency | 47.0% audit annually; 25.0% never audit | 519 | Jan. 5, 2021 |
| Use of Transparency in Coverage data | 18.0% use it in negotiations | 207 | Dec. 30, 2025 |
Source: MGMA Stat polls, as cited below.
What the Four Polls Add Up To
Half of MGMA's respondents have not had a rate increase in three-plus years, about one in six never reviews a contract on any schedule, and a quarter never audits whether a payer pays the rate it agreed to. Fewer than one in five use the federal rate-transparency data built for exactly this kind of negotiation preparation.
Each figure comes from a separate MGMA Stat poll, run in a different year among a different set of respondents drawn from MGMA's membership, so the 203 practices answering the rate-increase question in 2026 are not the same 519 practices that answered the audit question in 2021. What the four polls share is what they measure: how actively a practice manages the payer side of its revenue, from the terms in the contract to the rate an insurer actually pays on a claim.
Sources
- MGMA, "Most medical groups have gone years without a commercial payer rate increase," Aug. 25, 2026
- MGMA, "Is it time to review your group's payer contracts?" Aug. 15, 2023
- MGMA, "New Year's resolution: Optimizing audits of your medical practice's payer contracted rates," Jan. 5, 2021
- MGMA, "Using TiC negotiated rate data to negotiate payer contracts," Dec. 30, 2025
- MGMA, "Operating costs keep climbing for medical practices in 2026," June 23, 2026
Talk to us
Fifteen minutes about your practice and the systems you run.