The call announcing the award almost went unanswered.
When an unknown number appeared on Adam Pople’s phone, he followed a rule familiar to anyone tired of spam calls: “At first I was like, don’t answer that,” he recalled. Then an email arrived from the same number, prompting him to call back and learn he'd been named MGMA’s 2026 Legislative Liaison of the Year.
His reaction was “a mix of surprise and gratitude,” he told Daniel Williams, senior editor and host of the MGMA Insights Podcast Network. The recognition carried weight because Pople, director of ambulatory acceleration at St. Francis Healthcare System and Missouri MGMA’s legislative liaison, knew how much advocacy work happens outside public view.
“There are so many people behind the scenes who do amazing things through MGMA at both the national and state levels,” he said. “It just feels amazing to have these efforts acknowledged.”
The mentors who made advocacy approachable
Pople’s interest in policy began early in his healthcare career, when he worked in durable medical equipment in Montana. Two people, John Gallagher and Emily Kevin, showed him how healthcare professionals could participate in state and federal advocacy rather than simply absorb decisions after they were made.
“They just showed me the ropes and helped me understand how to get involved,” Pople said. “I think folks like that — they inspire the next generation, and that’s something I hope to do with this award, too.”
His route from Montana to Missouri included a short stay in Colorado and several professional transitions. He has been in his current organization and role for just over a year, but the central lesson from those early mentors has remained intact: Healthcare expertise belongs in the legislative process.
Pople has “never been afraid of a good debate,” but he rejects the idea that effective advocacy requires a lifelong fascination with politics. “Really, I get involved with this because it impacts us (medical practice leaders),” he explained.
Pople encourages practice leaders to engage before a policy takes effect. “Folks like to complain about it after the fact,” he said. “You have to get involved before so we can ... make it as good as we can.”
A liaison translates policy into operating decisions
Pople describes the legislative liaison as “a connection between practice leaders and government happenings.” He doesn't spend his free time watching C-SPAN or reading congressional records. His skill is more practical: Translating a dense bill into operational consequences, bringing a practice’s story to a policymaker, and making government feel less remote to healthcare leaders who have patients to serve and organizations to run.
“Sometimes what happens behind the walls of a state capitol seems really complicated,” he said. “I try and take that complicated language and procedure and all the different aspects of the legislation and distill it down into something that’s easier for everybody to understand.”
Missouri’s General Assembly session runs from January through May, creating a compressed period in which bills can advance, stall, change, or disappear. Pople first had to understand that process and learn to navigate the tracking websites maintained by the state House and Senate.
“We have a short General Assembly season that goes from January to May,” he said. “So that’s a short time for bills to happen; things happen fast.”
He also identifies what a proposal would require from a practice, how its status is changing, and when MGMA members have an opportunity to influence it. For Pople, it's not just which bills are out there, it's also, "How can we affect change and how can we be a part of that process?” he said. “I’m trying to leverage my knowledge to make it easier for others.”
Prior authorization gives the debate a human cost
Prior authorization reform became the central issue during one of Pople’s visits to Jefferson City. Missouri MGMA coordinated with the Missouri State Medical Association during its White Coat Day, combining the perspectives of practice leaders and physicians in meetings with lawmakers.
“This is an area where we have tried for a number of years to get prior authorization reform passed in Missouri,” Pople said. “This year was another year where we almost made it, and then it fell apart right at the end.”
The persistence reflects the scale of the burden. According to MGMA Goverment Affair's position paper, The Prior Authorization Landscape in 2025, 92% of surveyed medical group practices had hired or reassigned employees specifically to manage prior authorization requests. Six in 10 reported that at least three employees typically participate in completing one request, while 35% spent more than 35 minutes on an average request. Additionally, the MGMA 2025 Prior Authorization Issue Brief found that 89% of medical practices considered prior authorization very or extremely burdensome.
Pople advises advocates not to stop with the statistics. “A policy position is one thing,” he said. “Statistics are better if you can come with the idea of the true, tangible ways it’s impacted you — but the best thing you can do is bring a story.”
That story might involve delayed care, an inconvenience for a patient, additional staff work, or a condition that worsened while approval remained pending. His formula combines evidence with experience.
“If you can come to the table with your policy position, your statistic, and your story to illustrate your point, you’re much more likely to secure their support,” Pople said. “Really, all we have to do is be storytellers.”
The legislator is not the healthcare expert
Many healthcare leaders hesitate to contact lawmakers because they assume the person holding office possesses specialized policy knowledge they lack. Pople pushes back on that assumption.
“They’re a senator, but you’re the expert in what you do,” he insisted.
State legislators arrive with varied professional backgrounds, including education, farming, law enforcement, and the judiciary. Few understand the daily mechanics of patient registration, coding, prior authorization, scheduling, and revenue cycle work as thoroughly as the people operating medical practices.
“We have to take our expertise and help them understand the details of it,” Pople said. “Most of them genuinely want to hear from us, because we do understand and have the expertise in our specific areas.”
His recommended workflow is to identify the legislators serving on relevant committees, contact their offices, and then request a conversation.
“Just call them, email them, and set up meetings and visits,” he said. “They’re happy to do it.”
A later encounter showed what those meetings can produce even when a bill doesn't pass. At a charity golf tournament, Pople unexpectedly ran into a state senator he had met during the prior authorization campaign. The senator recognized him, saying, “Hey, I remember you,” and restarted the conversation about what might be possible during the next legislative session.
The bill had fallen short, but Pople had gained something that could outlast a single session: A working relationship with a policymaker.
Policy awareness becomes operational readiness
Pople’s advocacy role has changed how he manages ambulatory operations. Tracking legislation gives him time to move from surprise to planning before a requirement reaches the practice.
“If you’re not paying attention to anything, then bills happen and they just kind of crush you, and you’re like, ‘Where’d this come from?’” he said. “If you pay attention a little bit, then you can get ahead of some things and start to make plans.”
He pointed to preparations surrounding the No Surprises Act — including communications to patients without insurance — as an example of policy becoming a concrete workflow. The same discipline can be applied to staffing assumptions, patient notices, technology changes, payer processes, and financial forecasts.
“You can start to plan ahead for impacts,” Pople said. “It helped me plan ahead and be able to put things in place quicker and be a little more proactive with that planning than reactive.”
The 2026 MGMA Financials and Operations Data Report describes an uneven financial environment in which operating costs remain a predictable pressure while revenue growth and cash conversion vary across practices. The report focuses on where cash is slowing down, including charge posting, aging accounts receivable, payer delays, and patient balances, and helps leaders distinguish necessary capacity from costly rework.
The operational response can begin with four questions for every significant policy development:
- What process will change?
- Who owns the response?
- What will implementation cost?
- When must the practice be ready?
Pople’s approach places those questions in front of leaders before the answers become urgent.
Teaching people to hit the target
Pople’s work outside the statehouse follows the same pattern: Make a complicated task approachable, teach the fundamentals, and let people develop confidence through repetition.
He and his wife operate a small durable medical equipment company specializing in mastectomy and lymphedema care for women who have experienced breast cancer. Pople also coaches archery for fourth- through eighth-grade students at a combined elementary and middle school.
“I love getting outside and shooting my bow,” he said. Coaching gives him a chance to teach students “how not to shoot each other and how to hit the target, and hit the target where they want to hit the target.”
The archery team participates in local and regional competitions, with opportunities for students to qualify at the state, national, and international levels. Pople did come to coaching a formal coaching pathway. Someone at the school knew he enjoyed archery and asked whether he had considered helping.
“I was like, well, that sounds like a good time,” he laughed.
His legislative path began much the same way: Someone opened a door, lowered the intimidation level, and taught him how to participate. Now, as MGMA’s 2026 Legislative Liaison of the Year, Pople is doing that for others. And what he really wants is for healthcare leaders to recognize the expertise they already possess, document what policies do inside their practices, and tell that story before someone else writes the rules.
“We can’t just sit on the sidelines,” Pople said.
Resources
- Connect with Adam Pople on LinkedIn
- Missouri MGMA
- Missouri State Medical Association (MSMA)
- The Prior Authorization Landscape in 2025 (MGMA Government Affairs)
- MGMA prior authorization position paper (MGMA Government Affairs)
- 2026 MGMA Financials and Operations Data Report
- MGMA Member Spotlight: Adam Pople on burnout, resource management and mentorship
- MGMA Annual Conference, September 27-30, in San Antonio
- 2026 Awards and Recognition Reception, September 26, at the Briscoe Western Art Museum in San Antonio (invite only)
- National Archery in the Schools Program (NASP)
