Encounter volumes are a difficult moving target as multiple pressures converge. Staffing shortages limit provider capacity despite high patient demand. Patient access remains fragmented for many organizations, as only 11% of groups have fully adopted patient self-scheduling, and even fewer use predictive analytics to combat no-shows. Telehealth policy uncertainty looms, as parity is only guaranteed through September. Early adopters of ambient AI scribe technology have reclaimed valuable physician hours previously lost to documentation.
According to a June 24, 2025, MGMA Stat poll, 48% of medical groups reported an increase in their providers’ patient encounters year to date compared to 2024. Another 26% said volumes remained about the same, while 26% noted a decrease. An additional 1% were unsure. The poll had 254 applicable responses.
- In practices with increased total encounters, respondents attributed the growth primarily to scheduling improvements, expanded operating hours, and enhanced patient access initiatives. Other key drivers included the addition of new providers, increased use of physician assistants (PAs) and nurse practitioners (NPs), and an influx of patients from local hospital groups. Additional contributing factors ranged from increased patient demand and a busy flu season to a renewed focus on wellness visits, strategic marketing, and community outreach.
- Practice leaders reporting stable encounter volumes compared to 2024 cited factors such as scheduling constraints, limited provider availability, fewer new patients, staffing shortages, and external influences like economic conditions and adverse weather.
- For practices with decreased encounter volumes, respondents identified scheduling difficulties, reduced operating hours, staffing shortages, increased competition, and waning patient demand. Other contributing issues included provider absences due to aging, maternity leave, PTO, or departures, fewer referrals following hospital acquisitions; reimbursement challenges; patient no-shows; and external disruptions such as economic pressures, EHR transitions, and inclement weather. Pediatric practices specifically noted fewer sick visits and a heavier reliance on mental health scheduling largely due to shortages of specialty providers.
More insights in MGMA’s data reports
For benchmarks and insights into total encounters and the impacts they have on work RVUs, physician and APP compensation, and collections, MGMA members can download the 2025 MGMA Provider Compensation and Productivity Data Report.
Drivers, obstacles and opportunities
Primary care specialties
Demand remains strong due to an aging population and chronic disease prevalence, but no-shows continue to constrain capacity. Medicare Physician Fee Schedule (MPFS) cuts hit E/M-heavy primary care particularly hard, though new chronic care management (CCM) and remote monitoring codes offer incremental revenue. For practices that embraced it, the expanded scope of practice for advanced practice providers (APPs) eases some productivity pressures — though medical assistant (MA) shortages persist.
Improving primary care encounters:
- Use no-show fees and open-access scheduling to boost appointment fill rates.
- Integrate value-based care strategies to enhance reimbursement.
- Shift routine visits and refills to telehealth ahead of the parity cliff.
- Expand AI/virtual scribes to APPs to free more clinical hours.
Surgical specialties
Elective procedure demand and ambulatory surgery center (ASC) volumes continue to grow, though operational inefficiencies and staffing shortages in perioperative and anesthesiology roles limit throughput. MPFS cuts have significantly affected global surgery packages, though commercial bundles and direct-employer contracts offer new opportunities. Expanded roles for surgical PAs and NPs, plus robotics-assisted procedures, help increase capacity — though investment costs remain a barrier.
Improving surgical encounters (ASC focus):
- Refine surgical scheduling to smooth peaks and valleys in daily case volumes; use predictive cancellation strategies to maximize throughput.
- Standardize pre-op protocols and same-day discharges to improve turnaround times, which boosts total capacity without raising staffing costs.
- Integrate PAs/NPs with minimally invasive technologies to enhance efficiency.
- Strengthen ASC-surgeon partnerships to capture more elective cases.
Non-surgical specialties
Chronic disease care in cardiology (AFib, CHF), gastroenterology (IBD), neurology (MS), and dermatology steadily drives visits, but biologics costs, infusion nurse shortages, and procedural-suite backlogs constrain capacity. Heightened prior authorization scrutiny further complicates scheduling, though telehealth visits alleviate some access pressures. Ambient AI adoption helps reduce documentation burdens, freeing clinical time.
Improving nonsurgical encounters:
- Expand remote patient monitoring (RPM) to increase revenue without adding in-person visits.
- Centralize scheduling for imaging and procedures to uncover hidden capacity.
- Deploy ambient AI scribes in high-volume clinics to reduce documentation time.
- Assign dedicated staff or adopt automation tools to manage prior authorizations, mitigating denials and preventing avoidable downtime or cancellations.
Multispecialty groups
Internal referrals drive volume, yet fragmented scheduling systems often leave appointment slots unused. Value-based payment growth continues but requires broader specialty participation and improved data sharing. Pooling and cross-training support staff across clinical and administrative functions are increasingly critical for managing fluctuating demands.
Improving multispecialty encounters:
- Implement enterprise-wide scheduling and unified portals to optimize appointment fills.
- Form physician-administrator dyad partnerships within each specialty or service line to align productivity with financial and quality goals.
- Expand cross-trained float pools to flexibly meet patient demand across specialties.
- Strengthen internal referrals and specialty coordination to enhance patient transitions and reduce care gaps.
Across all specialties, the path to increased encounter volume hinges on strategic staffing, smarter scheduling, and targeted tech adoption. While challenges vary by specialty, practices that streamline operations and embrace innovation are best positioned to meet demand and realize sustainable growth.
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