Thursday, August 13, 2026

Eric Paredes: The Problem We Find Too Late

One teenager died from a hidden heart condition. His parents turned grief into prevention. What does that have to do with medical billing?



“Only by increasing public awareness will we help make people realize that this is a real problem.” — Dr. John Rogers, physician and early medical adviser to the Eric Paredes Save A Life Foundation.


A 15-year-old changed the way I think about healthcare

In 2009, Eric Paredes was 15 years old.

He was athletic.

He played football.

He wrestled.

He was a sophomore at Steele Canyon High School in San Diego County.

And, as far as his family knew, he was healthy.

Then Eric collapsed.

He died from sudden cardiac arrest caused by an undetected heart condition.

His mother, Rhina Paredes, was a registered nurse at Scripps Health.

His father was Hector Paredes.

They faced something no parent should have to face.

They could not save Eric.

But they could ask a question.

A brutally simple one:

Could this have been found earlier?

That question became the beginning of the Eric Paredes Save A Life Foundation.

The foundation began providing cardiac screenings for young people.

Physicians volunteered.

Nurses participated.

Technicians participated.

Families showed up.

And one of those young people was Carson Wells.

Carson appeared healthy.

His previous sports physicals had not revealed the problem.

Then an EKG detected something different.

He had Wolff-Parkinson-White syndrome, a condition involving an extra electrical pathway in the heart that can produce dangerous arrhythmias.

Carson received treatment.

He recovered.

And eventually he chose to pursue nursing.

Read that again.

A family lost a child.

They built a system to detect risk earlier.

Another young person was found before tragedy.

That young person entered healthcare.

That is more than a touching story.

It is a lesson in how healthcare should work.


Here is the contrarian part

We often define healthcare innovation as:

new technology.

New drug.

New device.

New AI model.

New EHR.

New platform.

New algorithm.

But the Eric Paredes story suggests something different.

Innovation can simply mean finding the problem earlier.

That sounds almost too simple.

It isn't.

In fact, I think healthcare has become so obsessed with treating downstream problems that we sometimes forget how powerful upstream intervention can be.

The foundation did not ask:

How do we become better at responding to sudden cardiac arrest?

It asked:

How do we identify young people who may be at risk before sudden cardiac arrest happens?

That distinction is everything.

And it leads to a provocative question for physician owners:

What if medical billing has the same problem?


What if your billing problem isn't a billing problem?

This is where my thinking as a physician and founder of OnnX begins.

A denial is usually treated as a billing problem.

But what if the denial is only the symptom?

Consider a simple chain.

The physician sees the patient.

Something is documented.

Something is coded.

Something is transmitted.

The payer evaluates it.

The claim is paid.

Or rejected.

If it is rejected, someone starts working the denial.

But where did the problem actually begin?

Maybe eligibility.

Maybe documentation.

Maybe coding.

Maybe authorization.

Maybe a missing modifier.

Maybe payer-specific rules.

Maybe a workflow that required someone to manually transfer information between systems.

By the time the denial appears, the original mistake may be several steps upstream.

And now we have a person fixing it.

That person costs money.

The delay costs money.

The rework costs money.

The physician's attention may be consumed.

The patient may experience friction.

The practice loses time.

And everyone calls it:

“a billing issue.”

I think that description is too narrow.


The medical billing industry has a strange habit

We are very good at mopping the floor.

We are not always as good at fixing the pipe.

MGMA's January 2026 survey found that denials and appeals accounted for 48% of reported revenue-cycle leaks, followed by front-end issues at 23%, billing and collections at 14%, coding at 13%, and charge posting at 2%.

Those numbers should make physician owners uncomfortable.

Not because denials exist.

Denials will always exist.

The uncomfortable part is this:

What if the denial department is becoming the emergency department of the revenue cycle?

A place where problems arrive after they have already become expensive.

We would never design clinical medicine that way.

Imagine saying:

“We don't need preventive medicine. We'll just build a bigger emergency department.”

Nobody would accept that.

Yet healthcare financial operations often behave similarly.

More denials → more staff → more appeals → more vendors → more software.

Maybe we should interrupt the cycle.


The uncomfortable question

What if the goal of RCM should not be to become better at recovering lost revenue?

What if the goal should be:

Make less revenue become lost in the first place.

That sounds obvious.

But it changes the entire strategy.

It moves us from:

recovery → prevention

back office → entire workflow

claims → encounters

denials → root causes

staffing → work redesign

automation → intelligence

That is a much bigger shift.


Eric's story gives us a framework

I see four stages.

Stage 1: Something happens.

Eric dies.

Stage 2: Someone asks why.

His parents ask whether a hidden problem could have been detected.

Stage 3: The system changes.

A screening program emerges.

Stage 4: Someone benefits.

Carson Wells is identified before his condition becomes a catastrophe.

Now apply the same model to RCM.

Stage 1

A claim is denied.

Stage 2

Someone asks why.

Stage 3

The practice changes the workflow.

Stage 4

Future claims avoid the same failure.

That fourth stage is where the real value lives.

Not in fixing yesterday's problem.

In preventing tomorrow's.


The biggest RCM mistake may be measuring the wrong thing

Physicians are accustomed to outcome measures.

Blood pressure.

A1C.

Readmission.

Mortality.

Length of stay.

Complication rates.

We understand that the measurement should reflect the outcome we actually care about.

Yet financial operations sometimes become obsessed with activity.

How many claims were submitted?

How many denials were worked?

How many calls were made?

How many appeals were filed?

How many accounts were touched?

Those are activity metrics.

They can be useful.

But activity is not the same as performance.

I would rather know:

How many problems did we prevent?

How many claims were correct the first time?

How much rework disappeared?

How quickly did the encounter become billable?

Which recurring error did we eliminate?

Those questions move us upstream.


The hidden cost nobody puts on the dashboard

Here is the metric I think healthcare leaders should start thinking about:

Human attention consumed by preventable work.

A billing error costs more than the dollar value of the claim.

It costs someone time.

Suppose a staff member spends 15 minutes fixing a problem.

One event means almost nothing.

Now multiply it.

20 times a week.

50 times a week.

100 times a week.

Then add:

emails.

phone calls.

payer portals.

documentation searches.

reconciliation.

follow-up.

rework.

Now the practice has a second problem.

Its workforce is being used as middleware.

People are manually connecting systems that should be able to communicate.

That is expensive.

And it is demoralizing.


The 2026 squeeze makes this more important

MGMA reported in June 2026 that 84% of medical groups surveyed had higher year-to-date operating costs than the same period in 2025. Among those reporting increases, the average increase was approximately 11%. Labor was a major contributor.

At the same time, MGMA's June revenue poll found only 47% of practices reported higher year-to-date revenue, while 36% reported lower revenue.

That is the squeeze.

Costs move up.

Revenue does not necessarily move with them.

And independent practices have less room for waste.

So the question becomes:

Can we afford to keep paying humans to correct problems our systems should have prevented?

I don't think we can.


But here is another contrarian idea

The answer is not automatically AI.

I say this as the founder of an AI company.

That should tell you something.

AI is not a strategy.

AI is a capability.

If the workflow is broken, AI can make the broken workflow faster.

If the data is bad, AI can process bad data faster.

If the process is unnecessary, AI can automate unnecessary work.

That is not innovation.

That is acceleration.

Before asking:

“Where can we add AI?”

Ask:

“Why does this step exist?”

Then:

“What information should exist before this step?”

Then:

“Can the step disappear?”

Only then:

“Would AI make what remains better?”


This is where OnnX fits

I founded OnnX around a simple thesis:

Healthcare billing is not only a billing problem. It is an information problem.

The claim is downstream.

The encounter is upstream.

The financial outcome is influenced long before the claim reaches the payer.

So the opportunity is not simply to build a better claims factory.

It is to improve the information and workflow that feed the claims process.

That means thinking about:

clinical documentation

structured data

coding logic

payer requirements

workflow rules

claim readiness

exceptions

and feedback

as parts of one system.

The ambition is straightforward:

Catch problems earlier.

Reduce unnecessary rework.

Make financial workflows more predictable.

Give humans better information at the moment they need it.

That is what I believe intelligent RCM should become.


But let's challenge another industry assumption

“Outsource your billing and forget about it.”

That advice is attractive.

It is also incomplete.

Outsourcing can be extremely valuable.

A good RCM partner can provide expertise and scale that a small practice cannot build internally.

But outsourcing should not mean surrendering visibility.

If someone else manages your revenue cycle, you should still know:

What is being lost?

Why is it being lost?

Where is it happening?

How long does recovery take?

What is preventable?

What does the vendor control?

What does your practice control?

You can outsource the work.

You cannot outsource ownership.


Another myth: “More billing staff means better billing.”

Sometimes.

But not always.

MGMA's 2026 data suggests practices are increasingly looking toward automation and process redesign as ways to reduce costs while making scarce staff capacity go further.

That matters because the real objective should not be:

more people touching every claim.

It should be:

fewer claims requiring human intervention.

That is different.


The future isn't fewer humans

This is where I disagree with some of the loudest AI narratives.

I don't think the future of healthcare is:

AI replaces the biller.

I think it is:

AI removes the repetitive work that prevents the biller from doing higher-value work.

The human becomes the exception manager.

The investigator.

The decision-maker.

The person who handles ambiguity.

The person who sees the unusual case.

The machine handles the predictable.

That is a much healthier vision of automation.


What physicians should measure instead

If I were sitting with a physician-owner tomorrow, I would ask for ten numbers.

1. Clean claim rate

How often does the claim leave correctly the first time?

2. Denial rate

Not just the percentage.

The reason distribution.

3. First-pass resolution

How often is the claim paid without intervention?

4. Unbilled encounters

How many completed visits have not become claims?

5. Days from encounter to submission

How long does it take to move from care to billable transaction?

6. A/R aging

Especially the portion that is becoming difficult to recover.

7. Payment variance

Expected versus actual reimbursement.

8. Rework hours

How much human time is spent fixing recurring problems?

9. Payer-specific exceptions

Which payers create disproportionate administrative work?

10. Preventable failure rate

How many problems could have been caught before submission?

That last number may become one of the most important metrics of the future.


A provocative new KPI: Prevention Rate

Here's a concept I would like to see more practices experiment with.

Revenue Prevention Rate

Not:

“How much did we recover?”

But:

“How many potentially costly errors did we identify before they became claims problems?”

It could include:

eligibility exceptions caught before the visit,

documentation gaps identified before submission,

authorization issues identified before service,

coding inconsistencies caught before claim generation,

payer-specific requirements identified before submission.

The exact formula will vary.

The philosophy is what matters.

Measure prevention.

Because what gets measured gets managed.


The 20-minute physician-owner audit

You can start this week.

No expensive software required.

Step 1: Pick 20 recent denied claims.

Not 2,000.

Twenty.

Step 2: Put them into categories.

Documentation.

Eligibility.

Authorization.

Coding.

Modifier.

Payer rule.

Timely filing.

Other.

Step 3: Trace each problem backward.

Ask:

What happened immediately before the denial?

Then:

What happened before that?

Step 4: Find repetition.

If five of 20 claims failed for the same reason, you do not have five billing problems.

You have one workflow problem occurring five times.

Step 5: Fix the earliest failure.

Not the most visible failure.

The earliest one.

Step 6: Measure it for 30 days.

Did the problem decrease?

If yes, keep the change.

If no, investigate again.

That is continuous improvement.


What not to automate

This matters.

Do not automate a process simply because it is repetitive.

Some repetitive tasks still require judgment.

Be cautious around:

clinical interpretation

medical necessity

ambiguous documentation

compliance-sensitive decisions

patient financial communication

high-risk coding judgments

The question is not:

“Can AI do this?”

It is:

“What happens if AI gets this wrong?”

That is the better healthcare question.


Legal and compliance reality

Revenue-cycle technology operates in a highly regulated environment.

That means physicians and founders need to think beyond efficiency.

There are implications involving:

HIPAA

data security

coding compliance

documentation integrity

payer contracts

fraud and abuse laws

medical necessity

auditability

patient financial communications

AI should never manufacture documentation.

It should not create clinical facts that were not documented.

It should not encourage unsupported coding.

And it should not turn “optimization” into a euphemism for aggressive billing.

The goal is:

accurate reimbursement for appropriate care.

Not:

maximum reimbursement regardless of accuracy.

That distinction is not semantic.

It is ethical.


The ethical question nobody asks about RCM

Here is the question:

Who pays for administrative complexity?

Sometimes the payer.

Sometimes the practice.

Sometimes the physician.

Sometimes the staff.

Sometimes the patient.

Often, everyone pays a little.

That is why administrative friction is not merely an operational annoyance.

It is an allocation problem.

Every unnecessary step consumes scarce resources.

And healthcare already has too few of them.


What the Eric Paredes story teaches healthcare founders

There are three founder lessons here.

First: Start with the human problem.

Technology comes second.

The Paredes family did not start with a technology pitch.

They started with grief.

Then a question.

Then a problem.

Then a solution.

That sequence matters.

 

Second: Move upstream.

The highest-value intervention may happen before the obvious problem.

That applies to:

clinical deterioration,

readmissions,

medication errors,

prior authorization,

denials,

coding,

documentation,

and patient access.

 

Third: Build systems, not features.

A screening program is not just an EKG.

It requires:

people,

workflow,

follow-up,

referrals,

clinical interpretation,

communication,

and accountability.

Healthcare technology works the same way.

A billing AI model is not a healthcare system.

It is one component.


What the story teaches physician leaders

Physician leadership is often described as:

clinical excellence + business competence.

I would add a third element:

systems thinking.

The physician-owner needs to see the whole chain.

Patient.

Staff.

Documentation.

Technology.

Payer.

Payment.

Compliance.

Cash flow.

Access.

Quality.

Those things are connected.

If one becomes unstable, the others feel it.


The biggest mistake in healthcare innovation

We often optimize what is easiest to measure.

Claims.

Clicks.

Messages.

Appointments.

Transactions.

But healthcare is ultimately about outcomes.

Eric's outcome was tragic.

Carson's outcome was different.

The screening changed the trajectory.

That is the kind of story healthcare innovation should chase.

Not:

How many tasks did we automate?

But:

What changed because we did?


A different definition of ROI

ROI should not only mean:

dollars recovered.

Consider:

hours returned to staff

claims prevented from becoming denials

faster cash

less rework

fewer manual handoffs

better visibility

less physician involvement in administrative problems

better patient financial communication

more predictable operations

The financial return matters.

But so does the human return.


The future of independent medicine may depend on this

Independent physicians are being squeezed from multiple directions.

Operating costs are rising.

Payer complexity remains.

Regulatory requirements remain.

Staffing remains difficult.

AI is changing expectations.

MGMA's 2026 regulatory-burden report found that administrative requirements and reimbursement pressure are contributing to physician burnout, consolidation and threats to patient access. The survey included more than 230 medical groups, with 60% of respondents representing independent practices.

That is the larger story.

The question is not whether physicians dislike paperwork.

Of course they do.

The question is:

Can independent practices redesign the machinery around care quickly enough to remain viable?

That is a much more important question.


My contrarian prediction

I believe the next generation of healthcare technology will move away from department-specific automation.

Today:

Billing software.

EHR.

Scheduling software.

Prior authorization tools.

Credentialing platforms.

Analytics platforms.

Patient communication platforms.

Tomorrow:

connected workflow intelligence.

The technology will increasingly understand that the same encounter produces consequences across multiple departments.

A change in clinical information can affect coding.

Coding can affect reimbursement.

Reimbursement can affect A/R.

A payer rule can affect documentation.

An authorization requirement can affect scheduling.

Scheduling can affect access.

Access affects patients.

The system needs to understand the connections.

Not merely the individual tasks.


The phrase I would like healthcare to retire

“That's just how billing works.”

I hear versions of this everywhere.

That's just how prior authorization works.

That's just how the payer portal works.

That's just how claims work.

That's just how documentation works.

That's just how the EHR works.

Maybe.

But “that's how it works” is not the same thing as:

“that's how it should work.”

Healthcare has tolerated too much friction because the friction became familiar.

Familiarity is not efficiency.


Another phrase worth challenging

“The doctor shouldn't worry about the business.”

If the physician owns the practice, that is dangerous advice.

The physician does not need to become an accountant.

But the physician should understand the economics of the organization they are responsible for.

A practice that loses money cannot indefinitely deliver excellent care.

Financial stewardship is part of clinical stewardship.


The story comes full circle

Go back to Eric Paredes.

A 15-year-old died.

His parents did not accept that the only possible response was grief.

They asked:

What can we do differently next time?

That question created action.

Action created a system.

The system screened people.

One of those people was Carson Wells.

Carson received a diagnosis.

He received treatment.

He survived.

And he eventually chose healthcare as his profession.

That is what happens when a system learns from a tragedy.

Healthcare gets better.

Not because the past can be changed.

But because the future can be different.


And that is exactly how I think about medical billing

Every denial contains information.

Every rejected claim contains information.

Every payment variance contains information.

Every manual workaround contains information.

Every staff complaint contains information.

Every repeated exception contains information.

The mistake is treating each one as an isolated annoyance.

Maybe they are signals.

Maybe they are telling us:

The system has a weakness here.

The question is whether we listen.


The OnnX thesis in one sentence

Don't build a better system for fixing yesterday's billing problems; build a smarter workflow for preventing tomorrow's.

That is the problem I am interested in.

Not replacing physicians.

Not eliminating every biller.

Not promising magic.

Not adding AI for the sake of AI.

Reducing avoidable friction between care and payment.


If I were rebuilding a small clinic's RCM tomorrow

I would do five things.

1. Stop looking at the denial queue first.

Look at the encounter.

2. Find the earliest failure.

Trace the problem upstream.

3. Measure rework.

Human attention is an operating expense.

4. Simplify before automating.

Don't automate unnecessary steps.

5. Use AI where judgment is supported, not replaced.

Let machines identify patterns.

Let humans handle ambiguity.

That is a much more defensible model.


Three questions for every healthcare founder

What problem are you solving before it becomes expensive?

What human attention are you giving back?

What happens when your system is wrong?

If a founder cannot answer those questions, I am not sure the product is ready for healthcare.


Three questions for every physician-owner

Where does revenue leakage actually begin?

How much staff time is spent fixing preventable problems?

What could we eliminate rather than simply manage better?

Those questions are more valuable than another generic RCM sales presentation.


Myth Buster

Myth: More automation automatically means better healthcare.

False.

Bad workflow plus automation can simply produce bad outcomes faster.

Myth: Denials are inevitable, so denial management is enough.

False.

Some denials are unavoidable.

Repeated preventable denials are signals of a system problem.

Myth: Outsourcing eliminates financial responsibility.

False.

You can outsource execution.

You cannot outsource accountability.

Myth: AI will replace the billing department.

Unlikely.

AI is more likely to reshape roles, especially repetitive administrative work, than eliminate every human role. MGMA's 2026 data found that most medical groups had not yet redesigned roles around AI, while the changes already occurring were concentrated in practical administrative areas such as scheduling, registration, prior authorization, billing and routine correspondence.

Myth: The biggest RCM problem is always the biggest denial.

Not necessarily.

The largest visible problem may be downstream from a smaller upstream problem.


Practical 30-day challenge for physician owners

Week 1: Observe

Do not change anything.

Watch the workflow.

Follow 20 encounters.

 

Week 2: Measure

Categorize:

denials,

rework,

delays,

manual handoffs,

payer exceptions.

 

Week 3: Fix one upstream problem

Not ten.

One.

 

Week 4: Measure again

Did:

denials fall?

rework fall?

submission time improve?

staff hours decrease?

cash accelerate?

If nothing changed, learn why.

Then try again.

That is how real operational improvement happens.


The tools you actually need

You may already have most of them.

EHR

Practice-management system

Clearinghouse

Payer portals

Denial reports

A/R reports

Spreadsheet

Workflow map

Staff feedback

Basic analytics

And, where appropriate:

AI-assisted workflow tools

The most sophisticated technology in the world cannot compensate for a team that does not understand the process.


The future is not autonomous healthcare

At least, that is not the future I want.

I want augmented healthcare.

Physicians augmented by better information.

Billers augmented by better workflow intelligence.

Practice managers augmented by better visibility.

Patients augmented by better financial communication.

Founders augmented by real-world clinical insight.

Technology should expand human capability.

Not make human beings disappear from the system.


The deeper lesson

The Eric Paredes story is not really about an EKG.

It is about timing.

The same test administered too late can be irrelevant.

The same information discovered too late can be expensive.

The same documentation corrected after denial creates rework.

The same payer issue discovered after service becomes harder to fix.

Timing is an underappreciated dimension of healthcare technology.

Information has more value when it arrives before the decision point.

That may be one of the most important principles in healthcare AI.


Final Thoughts: Find the problem earlier

Eric Paredes died in 2009.

His parents, Rhina Paredes and Hector Paredes, could not change that.

But they changed what happened afterward.

They built a prevention effort.

Physicians such as Dr. John Rogers helped turn that effort into a clinical program.

And people such as Carson Wells became examples of what can happen when risk is discovered before catastrophe.

The lesson is bigger than cardiac screening.

It is a way of thinking.

Find the problem earlier.

That principle belongs in medicine.

It belongs in healthcare operations.

And it belongs in medical billing.

A denial is late.

A claim rejection is late.

A/R aging is late.

A cash-flow crisis is very late.

The real opportunity is upstream.

Before the claim.

Before the denial.

Before the rework.

Before the crisis.

That is where I believe healthcare technology should increasingly operate.

Not simply helping us recover better.

Helping us prevent better.


Get Involved — Challenge the Conventional Thinking

Here is my question for physicians and clinic owners:

What is the one recurring problem in your practice that everyone has accepted as “just part of healthcare” — even though it probably shouldn't be?

Tell me in the comments.

I am especially interested in problems involving:

billing

documentation

prior authorization

payer friction

staff workload

patient financial communication

EHR workflow

administrative rework

If this article challenged the way you think about RCM, share it with another physician or practice owner.

Maybe the next useful idea will come from someone who has been quietly fighting the same problem in a completely different specialty.

Raise your hand. Join the conversation. Challenge the assumptions.

Find the friction before it becomes expensive.

Move upstream before the crisis.

Help build a healthcare system that gives clinicians more time for the work only humans can do.


Continue the Conversation

I write about the intersection of medicine, healthcare operations, medical technology, AI and entrepreneurship.

The goal is not to predict the future from a conference stage.

It is to examine what is actually happening inside medical practices and ask a simple question:

Can we build something better?

Explore more practical insights and founder perspectives:

Visit the personal website:

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Free Resource

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Start with the knowledge.

Question the assumptions.

Then decide what your practice actually needs.


About the Author

Dr. Daniel Cham is a physician, medical consultant and healthcare technology entrepreneur working at the intersection of medical practice, healthcare management, medical billing and innovation.

He is the founder of OnnX, an AI-powered medical billing SaaS platform focused on helping small and medium-sized physician practices reduce unnecessary administrative friction and improve visibility across the revenue cycle.

His perspective comes from approaching healthcare technology from both sides of the equation:

the clinical side and the operational side.

His work focuses on practical questions:

How can independent physicians protect their time?

How can practices identify revenue leakage earlier?

How can AI reduce repetitive administrative work without replacing human accountability?

And how can healthcare technology become simpler, more useful and more aligned with the realities of everyday practice?

Explore Dr. Cham's LinkedIn Featured section


Disclaimer

This article is intended for general educational and informational purposes only. It does not constitute medical, legal, coding, compliance, financial or other professional advice.

Healthcare laws, regulations, payer policies, contracts and reimbursement requirements can change and vary by jurisdiction and specialty.

Physicians, healthcare organizations and practice owners should consult appropriately qualified professionals regarding decisions specific to their circumstances.

References to AI, OnnX or other technologies describe concepts and perspectives and do not guarantee particular clinical, financial, operational or regulatory outcomes.


References

1. Scripps Health — A Local Teen's Death Results in Program Designed to Save Lives.
The foundational account of Eric Paredes' death, his parents' response, and the early work of the Eric Paredes Save A Life Foundation with Scripps physician John Rogers, MD.

Read the Scripps story

2. MGMA — Detecting and Fixing Leaks Across the Revenue Cycle.
MGMA's 2026 analysis provides current data on where medical practices report revenue-cycle leakage, including the finding that denials and appeals represented 48% of reported leaks in its January poll.

Read the MGMA analysis

3. MGMA — 2026 Operating Costs and Practice Economics.
Current MGMA data illustrates the financial pressure facing medical practices, including rising operating costs and the growing role of automation and workflow redesign.

Read MGMA's 2026 practice-cost analysis


The Last Question

Eric's parents asked a question after the worst thing imaginable happened:

Could we find the problem earlier next time?

That question helped create a movement.

Now ask yourself the same question about your practice.

Could your practice find its next denial before the claim is submitted?

Could you identify the next workflow failure before it consumes another 100 staff hours?

Could you see the next revenue leak before it becomes an A/R problem?

Because perhaps the future of healthcare is not about getting better at cleaning up yesterday's mistakes.

Perhaps it is about becoming much better at seeing tomorrow's problems today.

Find the signal.

Move upstream.

Prevent what can be prevented.

That is not just better billing.

That is better healthcare infrastructure.


#Healthcare #MedicalBilling #RevenueCycleManagement #RCM #PhysicianPractice #PrivatePractice #HealthcareAI #MedicalPracticeManagement #PhysicianEntrepreneur #HealthTech #HealthcareInnovation #IndependentPractice #HealthcareLeadership #ClinicalOperations #AIinHealthcare #DigitalHealth #PhysicianLeadership #PatientCare #HealthcareTechnology #PracticeManagement

Knowledge drives progress. Start your journey here.

If this perspective resonates, repost it so another physician or clinic owner can see the problem differently.

The conversation starts when we stop accepting “that's just how healthcare works” as the final answer.

 

Wednesday, August 12, 2026

Ethan Hackney Is Six Years Old and Waiting for a Kidney. What His Story Reveals About the Healthcare Problem We Keep Missing

A six-year-old boy needs a kidney. Healthcare needs something else: fewer barriers between human need and human care.



“It felt in some way like it was this reminder that I existed and was seen at this time when so much of my experience with cancer had really been behind closed doors.” — Ashleigh Bell Pedersen, cancer survivor, speaking to NPR's My Unsung Hero, August 11, 2026.


The child behind the claim

Ethan Hackney is six years old.

He lives in Herring Cove, Nova Scotia.

And his family is searching for something no algorithm can manufacture, no billing company can process, and no healthcare executive can purchase off a shelf.

A kidney.

Ethan has lived with a serious kidney condition his entire life. His mother, Jenny Hackney, recently shared publicly that the family has reached the point where they are searching for a living kidney donor.

The request is painfully simple.

Someone, somewhere, may be able to help.

The family is asking people to share Ethan's story and help find that person. Public appeals identify Ethan by name and Herring Cove as his community.

There is something about this story that stops you.

Perhaps because Ethan is six.

Perhaps because every parent understands what six should look like.

School.

Friends.

Birthday parties.

Growing taller.

Learning things.

Making mistakes.

Getting annoyed with your parents.

Thinking the world is much bigger than it actually is.

Instead, Ethan's family is thinking about kidneys, transplant evaluation, donors, hospitals, medical decisions and whether a stranger might be willing to give part of themselves so their child can have more time.

And that is where this story becomes bigger than transplantation.

It becomes a story about what healthcare is really supposed to accomplish.

Healthcare is supposed to move a human being from need toward possibility.

Sometimes that requires a surgeon.

Sometimes a nurse.

Sometimes a physician.

Sometimes a caregiver.

Sometimes a donor.

And sometimes it requires hundreds of people working quietly behind the scenes to make sure that the care actually happens.

That last part is where physicians and clinic owners should pay attention.

Because we have created a healthcare industry that is remarkably good at solving complicated clinical problems while remaining strangely comfortable with unnecessary administrative ones.

We can perform extraordinary surgery.

Yet we still make physicians chase paperwork.

We can sequence genomes.

Yet we still make practices manually reconcile fragmented information.

We can build increasingly sophisticated artificial intelligence.

Yet a small clinic can still spend hours trying to understand why a legitimate claim was not paid.

That is not a technology problem.

At least, not entirely.

It is a workflow problem.

And workflow problems eventually become human problems.


The uncomfortable question

Here is the question I want physicians and healthcare leaders to sit with:

What if the biggest threat to better healthcare is not a lack of innovation, but the amount of human attention we waste?

We talk constantly about innovation.

Artificial intelligence.

Robotics.

Precision medicine.

Digital health.

Virtual care.

Genomics.

Remote monitoring.

Agentic systems.

Clinical decision support.

All important.

But innovation has a strange habit in healthcare.

We build something new.

Then we connect it to something old.

Then we create another login.

Another dashboard.

Another alert.

Another workflow.

Another administrative task.

Another exception.

Another person who has to make sense of it all.

Eventually, the physician is sitting at a computer after clinic, wondering why a profession built around human connection has become so dependent on human beings moving information between boxes.

That is the paradox.

We keep inventing tools to save time while designing workflows that consume it.

Ethan's story gives us a better way to think about healthcare.

The objective is not technology.

The objective is not efficiency.

The objective is not automation.

The objective is more life, better care, less unnecessary suffering, and more time for people to do the things only people can do.

Everything else is infrastructure.


What Ethan's story has to do with medical billing

At first glance, almost nothing.

Ethan needs a kidney.

A physician-owned clinic needs clean claims.

Those sound like completely different problems.

They are not.

Both are examples of the same fundamental healthcare challenge:

There is a human need on one side and a complicated system between that need and the resource required to meet it.

For Ethan, the system involves transplant medicine, donor evaluation, clinical coordination, family support and access to an appropriate donor.

For an outpatient practice, the system involves scheduling, registration, eligibility, authorization, documentation, coding, claims, adjudication, payment, denials and collections.

The clinical problem and financial problem are different.

But the operating principle is the same.

Every unnecessary barrier consumes human capacity.

And healthcare has a finite supply of that capacity.


Physicians do not have a time problem

They have a friction problem.

That distinction matters.

If you tell a physician:

“You need to manage your time better,”

you are often blaming the wrong person.

A physician cannot personally optimize away:

Payer portals.

Prior authorization.

Eligibility failures.

Duplicate documentation.

Unclear coding requirements.

Poorly integrated systems.

Manual claim corrections.

Denial follow-up.

Patient billing confusion.

Broken handoffs.

Credentialing delays.

Contract ambiguity.

Those are not personal productivity failures.

They are system design failures.

And physicians have been compensating for them for years.

They stay late.

They check messages after dinner.

They call payers.

They review charts.

They answer staff questions.

They solve problems that should never have reached them.

Then we wonder why burnout persists.

Perhaps we should stop asking:

“How can physicians work more efficiently?”

And start asking:

“Why are physicians doing this work in the first place?”

That is a much more uncomfortable question.

It is also a much more useful one.


The hidden economics of wasted attention

Suppose a physician spends 30 minutes every day dealing with billing problems.

That sounds small.

It isn't.

Thirty minutes a day becomes approximately 125 hours over a 250-day working year.

That is more than three full workweeks.

Now imagine a five-physician practice.

The number becomes roughly 625 physician hours per year.

That is not an abstract administrative burden.

That is clinical capacity.

And the calculation becomes even larger when you include:

Practice managers.

Billers.

Front-desk staff.

Nurses.

Medical assistants.

Coders.

Administrators.

Everyone who touches the problem.

This is why the cost of administrative complexity is larger than the invoice from a billing vendor.

The real cost includes the human time required to compensate for the system's weaknesses.


The statistic that should make practice owners uncomfortable

CMS has identified substantial administrative burden in prior authorization alone.

CMS has cited an estimate of approximately 13 hours per week spent by providers on prior authorization activities, equivalent to roughly 700 hours per year per provider.

That number should change the conversation.

Because 700 hours is not merely “administrative burden.”

It is time.

Time is the currency of medicine.

A physician has a limited number of hours.

A nurse has a limited number.

A practice manager has a limited number.

A patient has a limited number.

So when healthcare creates unnecessary administrative work, the system is not creating more capacity.

It is redistributing scarce human attention toward tasks that often create little clinical value.

That is expensive.

And sometimes the most expensive thing about a bad workflow is not the money.

It is what could have been done instead.


The contrarian view: stop measuring automation

This is where I disagree with much of the healthcare technology conversation.

We celebrate automation too quickly.

A company says it automated one million transactions.

Great.

But did patients get better care?

Did physicians regain time?

Did staff experience less stress?

Did preventable denials decline?

Did cash flow become more predictable?

Did the practice reduce its cost to collect?

Did patients understand their bills better?

Did the organization eliminate unnecessary work?

If the answer is no, what exactly did we automate?

Activity is not improvement.

A faster bad process is still a bad process.

A beautiful dashboard does not create value by itself.

A sophisticated AI model does not create value by itself.

A million automated transactions do not create value by themselves.

The real measure is:

What changed for the human being at the end of the workflow?


Ethan's story gives us the right metric

Imagine measuring Ethan's healthcare journey by administrative activity.

Number of appointments.

Number of forms.

Number of phone calls.

Number of referrals.

Number of tests.

Number of records exchanged.

Number of messages.

Those numbers might tell us something.

But they would miss the most important question.

Did Ethan get the kidney he needed?

That is the outcome.

Healthcare should think about its administrative systems the same way.

Not:

How many claims did we submit?

But:

How many legitimate claims were paid accurately and promptly?

Not:

How many denial tasks did our team complete?

But:

How many preventable denials did we eliminate?

Not:

How many calls did staff make?

But:

How many problems did we prevent from requiring a call?

Not:

How much work did automation perform?

But:

How much unnecessary work disappeared?

That is the difference between measuring activity and measuring impact.


The revenue cycle is not a back-office problem

Physicians often hear the phrase “revenue cycle” and mentally place it somewhere behind the clinical operation.

Billing is over there.

Clinical care is over here.

I think that separation is increasingly dangerous.

The revenue cycle determines whether a practice gets paid for legitimate care.

That affects:

Staffing.

Equipment.

Technology.

Clinical programs.

Appointment availability.

Physician compensation.

Capital investment.

Access.

And ultimately, whether an independent practice remains independent.

A practice can provide excellent medicine and still become financially unstable.

That is not a contradiction.

It is an operational reality.

Clinical quality does not automatically produce financial sustainability.

And financial sustainability does not automatically produce clinical quality.

The two have to reinforce each other.


The mistake physicians make

Many physicians assume that if they hire a billing company, the billing problem becomes someone else's problem.

It doesn't.

The work may be outsourced.

The accountability is not.

A physician-owner should still know:

What is being billed?

What is being collected?

What is being denied?

Why are claims being denied?

How much money is sitting in A/R?

How much is over 90 days?

How much staff time is spent chasing payment?

Which payers create the most friction?

Which errors are preventable?

Which problems originate upstream?

If the answer to these questions is:

“I don't know. My billing company handles it,”

that should be a warning sign.

Outsourcing can be smart.

Outsourcing visibility is not.


The bigger mistake healthcare makes

We often treat the claim as the beginning of the revenue cycle.

It isn't.

The claim is the end product of dozens of earlier decisions.

The patient enters the practice.

Information is captured.

Insurance is entered.

Eligibility is checked.

Authorization may be obtained.

The encounter occurs.

Documentation is created.

Services are coded.

Charges are generated.

The claim is built.

Only then does the claim reach the payer.

By the time billing discovers the problem, the opportunity to prevent it may already be gone.

This is why I believe:

The future of medical billing is upstream.


A denial is often a symptom

Consider a denied claim.

The obvious question is:

“How do we get this paid?”

That is necessary.

But it is not enough.

The better question is:

“Why did this claim become deniable?”

Maybe the patient's insurance information was wrong.

Maybe authorization was missing.

Maybe the authorization was attached to the wrong service.

Maybe the documentation did not support the billed service.

Maybe the code was inconsistent.

Maybe the payer rule changed.

Maybe information was entered twice and one version was incorrect.

Maybe nobody knew who owned the exception.

The denial is where the problem became visible.

It may not be where the problem began.

That distinction is one of the most important ideas in revenue-cycle management.


The upstream data problem

This is the foundation of my thinking around OnnX.

Healthcare billing is not primarily a billing problem.

It is a data-quality problem that becomes a billing problem.

The information necessary for reimbursement is scattered across:

EHRs.

Practice-management systems.

Payer portals.

Clearinghouses.

Authorization systems.

Referral workflows.

Scheduling systems.

Clinical notes.

Eligibility databases.

Human memory.

The more fragmented the information, the more humans become the integration layer.

That is expensive.

It is also fragile.

People forget.

People misread.

People copy the wrong field.

People enter information twice.

People miss an update.

People get interrupted.

People leave.

A resilient system should not depend on perfect human memory.


The best billing system should be boring

This may sound strange coming from someone building an AI-powered billing company.

But I think it is important.

The best healthcare technology should not constantly demand attention.

It should quietly make the right thing easier.

It should surface exceptions.

It should prevent avoidable errors.

It should explain what happened.

It should tell the right person what needs attention.

Then it should get out of the way.

The goal is not to create an exciting billing experience.

Nobody wakes up excited about billing.

The goal is to create a predictable one.


What physicians actually want

Most physicians do not want another dashboard.

They want to know:

Are we getting paid?

Are we missing money?

Why?

What needs my attention?

What doesn't?

Can I trust the numbers?

Is my staff drowning in administrative work?

Can I stop thinking about this?

That last question may be the most important.

Good technology earns trust by reducing the number of things people have to think about.


Three expert lessons healthcare leaders should remember

Atul Gawande: reliability beats heroics

Dr. Atul Gawande's work has repeatedly examined how complex healthcare systems can improve reliability through checklists, standardization, teamwork and process design.

The lesson for revenue cycle is straightforward.

If a workflow only works when your best employee remembers every exception, you do not have a reliable workflow.

You have a hero-dependent workflow.

That is dangerous.

Build systems that make the correct action easier.

Do not build systems that depend on extraordinary employees rescuing ordinary processes.


Don Berwick: design around people

Dr. Don Berwick's work in healthcare quality has emphasized patient-centeredness and improvement of systems rather than blaming individuals.

That principle applies directly to administrative operations.

When a patient receives a confusing bill, do not simply ask why the patient is confused.

Ask why the system produced confusion.

When a physician spends an hour fixing a claim, do not simply congratulate the physician for being diligent.

Ask why the claim required physician intervention.

Good systems make good behavior easier.


The current CMS direction: reduce administrative friction

CMS continues to push toward electronic prior authorization, interoperability, standardized data exchange and changes to physician payment and administrative processes. CMS's current physician-fee-schedule materials include proposed 2027 payment policies, while its electronic-prior-authorization work reflects a broader move toward more standardized digital workflows.

That matters.

The government, payers, physicians, vendors and technology companies may disagree about almost everything else.

But one fact is increasingly difficult to ignore:

Administrative friction is a healthcare problem.


Recent News: the billing fight is not going away

Today's healthcare headlines continue to demonstrate how much financial friction remains between physicians, payers and patients.

On August 12, 2026, Axios reported renewed lobbying around the federal No Surprises Act and its independent dispute-resolution process. Providers and insurers remain sharply divided over how disputed payments should be calculated and whether current data accurately represent the system's impact.

This is not simply a political argument.

It is an operational signal.

When payment rules become contested, practices need stronger data.

When reimbursement rules change, practices need better visibility.

When payer behavior changes, practices need faster detection.

When regulations evolve, manual workflows become more expensive.

The lesson for clinic owners is not to predict which side of every policy debate will win.

It is to build a practice capable of adapting when the rules change.

Flexibility is now a revenue-cycle capability.


Another warning: reimbursement pressure does not disappear

CMS's current physician-fee-schedule process is already looking ahead to 2027, with proposed policies open for comment.

That means physician practices should not build their economics around the assumption that reimbursement will always rise enough to compensate for inefficiency.

It may not.

If payment pressure increases, the practice has two broad choices.

Work harder.

Or reduce waste.

The first approach has a ceiling.

The second has an opportunity.


The hidden threat to independent medicine

Independent practices do not necessarily lose because they provide inferior care.

They can lose because the economics of running the practice become too complicated.

A physician can be clinically excellent and operationally overwhelmed.

That creates an opening for consolidation.

When independent practices cannot manage:

Administrative costs.

Payer complexity.

Technology costs.

Staffing.

Collections.

Compliance.

Contracting.

Documentation.

They may eventually decide that selling is easier than surviving.

That is not necessarily a clinical failure.

It is an infrastructure failure.

And if enough independent practices reach that point, patients lose choices.

That is why revenue-cycle efficiency is not merely about increasing practice profit.

It can also be about preserving independent access to care.


Five things I would change tomorrow

1. Stop asking only about collections

Ask about collection friction.

How much work does it take to collect each dollar?

 

2. Stop celebrating low denial volume without examining cause

A low denial rate can still hide serious financial leakage.

Look at dollars.

Look at preventability.

Look at repeat causes.

 

3. Stop hiring around broken workflows

Before adding another employee, identify why the work exists.

Sometimes the answer is genuinely “we need more people.”

Sometimes it is:

“We created this work ourselves.”

 

4. Stop measuring software activity

A system completing 10,000 tasks is not automatically valuable.

Measure what happened because of those tasks.

 

5. Stop treating physician time as free

This may be the most important.

If a physician spends an hour fixing an administrative problem, that hour has economic value.

It also has human value.

Do not hide it.


The 30-day practice reset

You do not need a massive transformation project.

Start small.

Days 1–5: follow one dollar

Take a claim.

Follow it from:

Patient registration.

To encounter.

To documentation.

To coding.

To claim.

To payer.

To payment.

To posting.

To reconciliation.

Document every handoff.

You will learn more from one claim's journey than from another generic billing presentation.

 

Days 6–10: find your recurring failures

Look at your last several months.

Identify the five most common denial causes.

Then identify the five most expensive.

They may not be the same.

 

Days 11–15: calculate preventability

For each major problem, ask:

Could we have prevented this?

If yes, where?

Registration?

Scheduling?

Authorization?

Documentation?

Coding?

Claim creation?

Payer configuration?

 

Days 16–20: calculate human cost

Estimate:

Staff hours.

Physician hours.

Manager hours.

Phone calls.

Portal logins.

Manual corrections.

Appeals.

Follow-ups.

Then put a dollar value on that time.

 

Days 21–25: fix one upstream problem

Do not fix everything.

Pick the highest-leverage issue.

Build a new workflow.

Assign ownership.

Define exceptions.

 

Days 26–30: measure again

Compare:

Denials.

Cash.

A/R.

Staff time.

Physician time.

Errors.

Patient complaints.

Then decide what to scale.


The metrics I would put on the wall

Every clinic is different.

But I would start with:

Clean claim rate

Preventable denial rate

Denial dollars

Days in A/R

A/R over 90 days

Net collection rate

Cost to collect

Claim submission lag

Payment turnaround

Administrative hours per 100 claims

And one metric most practices rarely track:

Physician hours spent on revenue-cycle work.

That number belongs on the dashboard.


The metric that matters most

If I could add only one question to every revenue-cycle dashboard, it would be:

How much human attention did this process consume?

Because money tells you what happened financially.

Time tells you why.

A claim that generates $500 but consumes three hours of staff work may be less valuable operationally than a $300 claim that requires almost no intervention.

This is where healthcare needs to mature.

We need to measure friction, not just transactions.


Myth Buster

Myth: “The billing company owns the problem.”

No.

The billing company may manage the workflow.

The practice owns the outcome.

 

Myth: “More automation automatically means better billing.”

No.

Bad automation can scale bad decisions.

 

Myth: “Every denial should be appealed.”

Not necessarily.

Sometimes the better investment is preventing the next 100 similar denials.

 

Myth: “AI will eliminate billing.”

Probably not.

The more realistic future is AI handling increasingly complex administrative tasks while humans supervise exceptions, compliance, judgment and relationships.

 

Myth: “Revenue cycle is purely financial.”

No.

It affects staffing, access, patient communication, physician time, and practice sustainability.

 

Myth: “Independent practices cannot compete with large health systems.”

They can.

But they need leverage.

Technology can provide some of that leverage if it is designed around the realities of smaller practices.


The ethical line AI billing must not cross

There is a temptation in revenue-cycle technology to optimize relentlessly.

More revenue.

Fewer write-offs.

Higher collections.

Faster payment.

But healthcare cannot reduce everything to optimization.

A legitimate claim should be paid accurately.

An illegitimate claim should not be manufactured into legitimacy.

AI should never be used to justify:

Upcoding.

Unsupported documentation.

Unbundling.

Manipulation.

Misrepresentation.

Aggressive patient collection.

The goal is not to extract every possible dollar.

The goal is:

Accurate reimbursement for legitimate care.

That distinction protects patients.

It protects physicians.

And it protects the credibility of healthcare technology.


Legal and compliance considerations

Medical billing technology operates in a high-risk environment.

A clinic considering automation should evaluate:

HIPAA compliance

Data security

Access controls

Business associate relationships

Audit trails

Coding compliance

Documentation integrity

Payer contracts

Fraud-and-abuse risk

Patient financial communications

State requirements

Human oversight

AI should not become a black box.

A practice needs to understand:

What information entered the system?

What rule was applied?

What recommendation was generated?

Who approved the action?

Can the decision be audited?

Can an error be corrected?

What happens when the system is uncertain?

Those questions should be answered before deployment, not after an incident.


Health equity is hiding in the billing workflow

Here is another uncomfortable truth.

Administrative friction does not affect every patient equally.

A financially comfortable patient may absorb an unexpected $200 bill.

Another patient may not.

A patient with a flexible job may spend an hour on the phone.

Another patient may lose wages by doing so.

A patient who speaks English fluently may navigate a confusing explanation of benefits.

Another patient may struggle.

A patient with stable housing may receive every letter.

Another may not.

So when we improve billing, we should not only ask:

“Can we collect faster?”

We should also ask:

“Can we make the financial experience clearer and fairer?”

That is where operational efficiency and patient-centered care meet.


Why the best healthcare technology may become invisible

The most useful technology in medicine may not be the technology physicians talk about most.

It may be the technology they stop noticing.

A system that quietly verifies information.

A workflow that catches an error before submission.

A system that identifies a payer change.

A tool that routes an exception to the right person.

A platform that tells a manager where cash is stuck.

An automated process that eliminates three manual steps.

None of these sound revolutionary.

That is the point.

The best infrastructure disappears into the workflow.

The patient sees a smoother experience.

The physician gets time back.

The staff sees fewer exceptions.

The owner sees more predictable operations.

That is innovation.


Why I founded OnnX

My interest in this problem comes from seeing the disconnect between clinical work and administrative infrastructure.

Physicians create enormous value in the examination room.

But the information generated there has to travel through an administrative maze before the practice gets paid.

Every handoff creates an opportunity for error.

Every disconnected system creates uncertainty.

Every preventable denial creates additional work.

My thesis behind OnnX is simple:

Healthcare billing should become more deterministic by improving the quality and intelligence of the information upstream.

The goal is not to create another layer between physicians and payers.

It is to reduce unnecessary layers.

For small and medium-sized physician-owned practices, that distinction matters.

They do not need more complexity.

They need leverage.


The opportunity for healthcare founders

There is a lesson here for entrepreneurs.

Do not ask:

“Where can I put AI?”

Ask:

“Where is a human being repeatedly compensating for a broken workflow?”

That is where the opportunity often lives.

Look for:

Repeated data entry.

Repeated verification.

Repeated phone calls.

Repeated portal searches.

Repeated corrections.

Repeated denials.

Repeated escalations.

Repeated reconciliation.

Repeated confusion.

Those repetitions are signals.

But there is another question founders should ask:

Why does the repetition exist?

If you do not understand that, you may automate the symptom.

The better company fixes the underlying workflow.


The future is not autonomous billing

At least, not in the simplistic sense.

The future is context-aware revenue infrastructure.

Systems that understand:

The patient.

The encounter.

The payer.

The contract.

The documentation.

The code.

The authorization.

The claim.

The denial.

The payment.

The exception.

And the next best action.

But sophisticated automation must be coupled with something equally important:

knowing when to stop.

When confidence is low, escalate.

When information is missing, ask.

When a decision carries significant risk, require review.

When the data conflict, do not pretend they agree.

The future of healthcare AI will not be defined only by how much it can do.

It will be defined by how intelligently it knows what it should not do alone.


A different definition of innovation

Innovation is not always invention.

Sometimes innovation is subtraction.

Removing a form.

Removing a login.

Removing a handoff.

Removing duplicate entry.

Removing a denial.

Removing a phone call.

Removing an unnecessary approval.

Removing an unnecessary report.

Removing the need for the physician to intervene.

That is the kind of innovation independent practices need.

Less work. More care.


The question every physician-owner should ask

Not:

“What billing software are we using?”

Ask:

“How much of our billing process exists only because our systems do not communicate?”

That question opens a very different conversation.

If the answer is “a lot,” you have found an opportunity.


The question every healthcare founder should ask

Not:

“What can our AI automate?”

Ask:

“What human attention can we return to healthcare?”

That is the better north star.


The question every healthcare executive should ask

Not:

“How much did we spend on administrative infrastructure?”

Ask:

“What did our administrative infrastructure make possible?”

Did it give clinicians time?

Did it reduce patient friction?

Did it improve financial reliability?

Did it protect access?

Did it reduce preventable work?

If not, the system may be consuming resources rather than creating capacity.


Three practical rules for 2026

Rule one: fix upstream

Do not wait for the denial.

Find the first place the information became wrong.

 

Rule two: automate the mechanical work

Let machines handle repetitive, rules-based processes where appropriate.

Let humans handle judgment, exceptions and relationships.

 

Rule three: measure time

If technology saves $50,000 but creates 500 hours of new work, the business case is incomplete.

If technology costs money but returns thousands of hours of clinical and administrative capacity, the economics may look very different.

Time belongs on the balance sheet of healthcare innovation.


The story we should remember

Ethan Hackney is not a metaphor.

He is a real six-year-old boy whose family is asking for help.

That distinction matters.

We should not use a child's medical situation simply as a marketing device.

His story deserves to remain about him.

About Ethan.

About Jenny.

About a family facing something no parent wants to face.

About the possibility that a stranger may become the person who changes a child's future.

But his story can also remind us why healthcare exists.

Not to create more workflows.

Not to generate more claims.

Not to produce more dashboards.

Not to maximize administrative activity.

To help people.

Every system we build should be judged against that standard.


Final Thoughts: We are solving the wrong problem

Healthcare does not have a shortage of intelligence.

It has a shortage of well-directed human attention.

We have brilliant physicians.

Dedicated nurses.

Exceptional technicians.

Committed practice managers.

Hard-working billers.

Caregivers who sacrifice sleep.

Families who search the country for donors.

Communities that share a child's story.

And increasingly powerful technology.

Yet we still make these people spend too much of their limited time navigating systems that were supposed to help them.

That is the contradiction.

Ethan's family is looking for a kidney.

A kidney cannot be automated into existence.

But the coordination surrounding care can be improved.

A physician cannot be replaced by a billing algorithm.

But unnecessary billing work can be reduced.

A nurse cannot be cloned.

But repetitive administrative tasks can be redesigned.

A caregiver cannot be given more hours in the day.

But healthcare can stop wasting the hours they already have.

That is the real opportunity.

Do not ask how much technology healthcare can absorb.

Ask how much unnecessary work healthcare can eliminate.

Do not ask how many transactions your system can process.

Ask how much human attention it can return.

Do not build technology merely to make healthcare more digital.

Build it to make healthcare more human.**


Get Involved: Change the Conversation

Here is the question I want to leave with physicians and clinic owners:

What is the one administrative task you would eliminate tomorrow if you could?

Prior authorization?

Eligibility?

Coding?

Denial management?

Patient collections?

Payer follow-up?

Referral coordination?

Something else?

Tell me in the comments.

Your answer may reveal a problem another physician is struggling with right now.

Share this article with a physician, practice owner, administrator, or healthcare founder who should be part of this conversation.

And if this perspective resonates, repost it.

Not to promote another technology.

But to start a better conversation about what healthcare should be optimizing for.

Get involved. Raise your hand. Step into the conversation. Share what you have learned. Help shape the future of independent medicine.

Because healthcare does not need another generation of people working harder to compensate for broken systems.

It needs better systems.


About the Author

Dr. Daniel Cham is a physician, entrepreneur, and healthcare technology consultant focused on the intersection of medical practice, healthcare operations, medical billing, artificial intelligence, and innovation.

He is the founder of OnnX, an AI-powered medical billing SaaS initiative designed around a simple premise: small and medium-sized physician-owned practices should not need layers of unnecessary administrative complexity to receive accurate and timely reimbursement for legitimate care.

Dr. Cham writes about the practical side of healthcare transformation, with particular interest in physician time, revenue-cycle performance, workflow design, healthcare AI, and the future of independent medical practice.

His perspective is shaped by the belief that technology should serve clinicians rather than create another job for them.

Connect with Dr. Daniel Cham on LinkedIn:

Dr. Daniel Cham on LinkedIn


Disclaimer

This article is intended solely for general educational and informational purposes. It does not provide medical, legal, coding, compliance, reimbursement, or financial advice.

Healthcare regulations, payer requirements, contracts, and billing practices can change and may differ according to specialty, jurisdiction, payer, and individual circumstances.

Readers should consult appropriately qualified professionals for advice relating to their specific clinical, legal, compliance, operational, or financial situation.


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Another physician may be struggling with the same administrative problem.

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One conversation can expose the problem. Thousands of conversations can change the standard.


Three References

1. Ethan Hackney and his family's public donor appeal. Jenny Hackney has publicly shared that her six-year-old son Ethan has lived with a serious kidney condition throughout his life and that the family is now seeking a living kidney donor; community posts identify Ethan as being from Herring Cove, Nova Scotia.

Public appeal and family statement

2. CMS electronic prior authorization initiative. CMS describes its continuing work toward electronic prior authorization and standardized digital information exchange, reflecting the broader movement to reduce administrative friction in healthcare.

CMS Electronic Prior Authorization

3. Current physician payment and administrative policy environment. CMS's current Physician Fee Schedule materials show that physician payment policy and administrative requirements remain active areas of change heading into 2027.

CMS Physician Fee Schedule

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