One of the flagship conferences of the healthcare industry, the American Medical Group Association (AMGA) National Conference is a nexus for ideas and innovations among major physician groups. At this year’s event in April 2025, Lightbeam facilitated a focus group of 19 leaders from AMGA member organizations to identify common opportunities, challenges, and best practices for evaluating and deploying revenue growth and cost reduction strategies.
The focus group was an opportunity to learn from peers across different environments as attendees represented major healthcare providers, university hospital systems, large physician groups, and independent clinics. A common denominator amongst all attendees was that they are in the process of transitioning from fee-for-service (FFS) to value-based care (VBC) models. Here are the highlights the group identified:
Optimizing Coding
Accurate diagnosis coding can be a hassle for physician practices and healthcare teams. Lack of training, the increasing complexity of coding systems, and the urgent need for accurate documentation can be time-consuming and add to administrative burden. Coding errors can lead to care mistakes, claim denials, payment delays, potential fines, and financial instability—especially when managing hierarchal condition categories (HCCs) and assigning risk scores. Navigating accuracy from CMS HCC model V24 to V28 adds yet another layer complexity.
One participant said, “[You] cannot do anything if you don’t have data. It’s impossible to do and then integrating back into the workflow… that’s the tip of the spear.” For this reason, coding education initiatives are becoming a top priority to close HCC coding gaps and ensure revenue growth.
Driving Preventative Care and Screenings
Administrative initiatives to frontload annual wellness visits in the first quarter and half of the year are essential to facilitate accurate and timely HCC coding updates. Practices and providers are increasingly interested in AI-powered solutions to aggregate multiple data sources, including social determinants of health (SDOH), claims, and other data sources to prioritize identification of patients at highest risk or due for screenings. Regular screenings improve early detection rates and management of diseases, especially chronic conditions, which can lead to reduced admissions and lower healthcare costs.
Expanding Patient Access
The loss of primary care providers (PCPs) has resulted in a significant backlog, preventing many patients from seeing a physician and diverting primary care needs to urgent care and emergency departments, which may lead to avoidable ED visits and increased costs.
The shortage of behavioral health providers is even more acute, making it more difficult to understand and diagnosis behavioral health conditions in order to deliver whole-patient health.
To address access needs, organizations are embracing whole-patient care approaches in value-based care (VBC), and staff augmentation strategies such as deviceless remote patient monitoring technology to monitor patients outside of the hospital. It is not a replacement for a PCP, but it helps to identify and catch rising-risk patients before they show in the ED.
Harnessing Technology
Given the tsunami of AI-powered tools and platforms flooding the healthcare space, organizations continue to face challenges and confusion around identification, selection, and integrations—determining what to choose and why. The group’s feedback indicated that the actual scope of AI implementation appears to be limited at this point, but its traction is increasing as agentic AI innovations happen and demonstrate quantifiable ROI. Additionally, organizations are still challenged with implementing electronic health records (EHRs) and electronic clinical quality measures (eCQMs). Across the panel, participants concurred that rising costs and skepticism continue to impede broader adoption of the most advanced technology platforms and solutions.
One participant said, “Balancing financial sustainability with patient-centered care is essential for fostering growth while maintaining operational excellence.” To accomplish this objective, Lightbeam recommends an enterprise AI solution that offers a fully integrated portfolio of technologies and capabilities, including tools to automate repetitive administrative tasks and others to deliver actionable insights that optimize patient outcomes and reduce cost of care.
Tackle these and other mission-critical issues with the help of the Lightbeam Population Health Advisory Services team and purpose-built solutions from Lightbeam AI to automate workflows, operationalize data, and move the needle quickly.
Our actively engaged Medicare Shared Savings Program (MSSP) ACOs generated more than $250 million in gross savings in Performance Year (PY) 2023 and averaged more than $17 million in gross savings per ACO—6% higher than the average across all other industry ACOs. Another resource is Lightbeam Deviceless RPM®, which engages tens of thousands of VBC patients with chronic conditions, proactively identifying the 1-2% on any given day that experience a worsening condition or avoidable hospitalization.
To learn more, read about our industry-leading results or speak to a Lightbeam expert today.
