How Healthcare Medical Groups Are Building Resilience

There's a question we started hearing halfway through 2025 that caught us off guard. Not because it was surprising, but because of how suddenly it replaced everything else.

"How do we insulate ourselves?"

It wasn't about growth anymore. It wasn't about expansion plans or adding locations. It was about protection. Sustainability. Building an organization that could perform regardless of what happened next.

That shift, more than any single policy change or economic headwind, defined 2025 for the healthcare medical groups we work with. And it taught us something important about what separates the organizations that thrive from the ones that barely survive.

The Medical Groups That Thrived Weren't the Biggest. They Were the Most Resilient.

From our position working with medical groups across the country, we had a front-row seat to how organizations responded to uncertainty.  Staffing shortages continued to strain operations. Reimbursement pressures mounted. Patient expectations evolved faster than billing system capabilities.

The medical groups that navigated 2025 successfully weren't lucky. They were intentional.

Early in the year, conversations focused on opportunity. Growth targets. New service lines. Expanding patient volume. By mid-year, the tone had shifted completely. Not to pessimism, but to pragmatism. The question became: how do we protect what we've built?

And the medical groups that answered that question well shared something in common. They stopped hoping external conditions would stabilize and started building organizations that could perform no matter what happened next.

A Front-Row Seat to Challenges and Adaptation

Regulatory shifts created compliance complexity that required  attention. Patient payment behavior remained hard to predict. Digital-first expectations became non-negotiable for a generation of patients who'd rather switch providers than deal with outdated billing and payment processes.

In extreme cases, medical groups and certain specialty provider groups were facing: 76% of patient billings go uncollected. Not a small percentage. Not a rounding error. Three out of four patient bills.

That's not a collections problem. That's a structural problem. And it explains why the conversation shifted so dramatically from growth to protection. When you can't predict cash flow, you can't plan for anything else.

The medical groups that understood this early didn't wait for  a security blanket or bail out. They found systems that created predictability even when everything else felt uncertain.

Three Pillars of Resilience Emerged

Among the medical groups that navigated 2025 successfully, three patterns became clear. These weren't theoretical frameworks. They were the operating principles of the organizations that performed best when conditions were hardest.

Pillar 1: Revenue Protection: Automation That Creates Predictable Cash Flow

Medical groups dependent on manual processes, paper statements, and hoping patients would eventually pay couldn't predict when money would arrive. That makes it impossible to manage operations, let alone forecast.

The shift we saw was from reactive to proactive. From hoping to knowing.

The data backs this up. Hospitals that implement pre-service payment policies report 20% higher overall collection rates. That's not a marginal improvement. That's the difference between struggling and stability.

And patient behavior is reinforcing this shift. 92% of U.S. consumers used digital payments for healthcare in 2024, and 73% prefer to pay bills online. Digital isn't a nice-to-have anymore. It's how patients expect to interact with their providers.

Medical groups that automated billing and payment workflows, reduced days in accounts receivable, and created real-time visibility into payment status entered the second half of 2025 with predictable revenue streams. The ones that didn't spent the year chasing payments and wondering when cash would arrive.

Pillar 2: Operational Efficiency: Optimize What You Can Control

When you can't control external factors, the only lever is internal efficiency. Yet many medical groups were still drowning in manual processes. Paper statements. Manual reconciliation. Unclear payment tracking across multiple systems.

And the transparency problem makes it worse. Only 22% of consumers say they always know how much they owe before a provider visit. When patients are confused, they delay payment. When they delay payment, medical groups lose control of their cash flow timeline.

That's not a theory. That's the operational reality for medical groups without automated systems that connect service details with billing and payment science.  

The medical groups that freed their teams from manual work, automated routine tasks, and created clear visibility across the payment lifecycle didn't just survive 2025. They actually improved margins while everyone else was fighting to hold steady.

Pillar 3: Patient Experience as a Competitive Moat

In a market where patients have more choice than ever, loyalty is fragile. Yet many medical groups still treated billing as a necessary evil instead of a competitive advantage.

That's a mistake, especially during uncertain times.

The medical groups that maintained or improved patient experience during 2025 saw retention and loyalty hold steady even when patients were tightening budgets elsewhere. Convenience matters. Transparency matters. Flexibility matters.

Patient experience isn't a luxury during belt-tightening. It's a retention strategy. Medical groups that made billing clear, convenient, and flexible didn't lose volume. The ones that made it painful did.

When patients have options, they choose the path of least resistance. If your billing process creates friction, they'll find a provider whose process doesn't.

What We Learned About Ourselves

We didn't enter 2025 expecting the year to unfold the way it did. But when the conversation shifted from growth to resilience, we shifted with it.

Client feedback shaped our roadmap in real time. The pain points we heard most often became the problems we prioritized solving. When medical groups told us they were losing control of cash flow because payments made through insurance portals took weeks to reach them, we built a solution that changed the timeline completely.

"When a patient pays their bill through an insurance portal, it typically takes a provider weeks to see that payment. With our new solution, these payments are funded immediately into a provider's bank account and automatically reconciled in the medical group management or health information system." (Tom Furr, CEO of PatientPay)

That's not a sales pitch. That's a direct response to the operational friction medical groups told us was costing them time, money, and control.

2025 taught us that the best product roadmaps aren't built in isolation. They're built in partnership with the organizations facing the challenges firsthand. And when you listen closely, the solutions become obvious.

The Uncertainty Isn't Going Away

If you're waiting for stability before making changes, you'll be waiting a long time.

The challenges of 2025 won’t disappear on January 1st. If anything, the first quarter of 2026 will bring continued questions around policy, coverage, and economic conditions that individual medical groups can't control.

But the medical groups that built resilience in 2025 are entering the new year from a position of strength. They have predictable revenue streams. They have efficient operations. They have patient experience that drives retention instead of churn.

For medical groups still working on it, the window to prepare is now.

The three pillars of resilience aren't 2025 solutions. They're 2026 survival strategies. Revenue protection, operational efficiency, and patient experience aren't initiatives you complete and move on from. They're the foundation of an organization that performs regardless of external conditions.

Success in 2026 Belongs to the Organizations That Build for Volatility

To the medical provider groups, business partners, and RCM organizations that trusted us with their revenue cycle challenges in 2025: Thank you!  

“You taught us what resilience looks like, not just in theory. To our team that adapted quickly and built solutions in real time: your ability to listen, respond, and execute made the difference.2026 won't be easier. But it will be navigable for the organizations that choose preparation over hope. Let's build that together.” — Pete Heydt, President, PatientPay