Independent Practice Q4 Planning: Finish 2026, Build 2027

The fourth quarter gives every independent practice two jobs at once: finish 2026 strong, and decide what the practice will be built on in 2027 and beyond. The first job protects this year's results. The second protects your independence. The practices that do both before January start the new year ahead instead of catching up.

Here is how to approach both in the next ninety days, without trying to fix everything at once.

What should an independent practice focus on in Q4?

Focus on two things: closing the year cleanly and choosing your first move for 2027. Closing cleanly is about revenue and records you already earned. Choosing a first move is about the operating foundation you will run on next year.

To finish 2026 strong:

• Work open claims and denials while they are still recoverable.
• Complete open charts and unsigned notes on this year's encounters before the books close.
• Close quality gaps before the performance year ends on December 31, so this year's work is captured when you report.
• Make room on the schedule for patients who want care before their plan year resets.

To prepare for 2027:

• Build the budget around proposed changes, not last year's assumptions.
• Pick one workflow to modernize first, with a named owner and a date.

What is changing for independent practices in 2027 and beyond?

Two kinds of change are arriving together: Medicare policy and the way care itself is delivered.

On policy, CMS has proposed a CY2027 non-QP conversion factor of $32.8409, down 1.68% from the CY2026 non-QP rate of $33.4009. The final rule is expected in November 2026, effective January 1, 2027 (CMS, proposed rule, 2026). CMS has also proposed ending traditional MIPS after performance year 2028 (CMS, proposed rule, 2026).

On care delivery, four shifts are reshaping the foundation of healthcare, and each one reaches the independent practice:

1. AI moves to the front door. About two-thirds of people with health questions now turn to AI tools for answers, and around 20% of people who consult AI about their health decide not to see a clinician they otherwise would have (Oliver Wyman, 2026).
2. Clinical pathways move into the workflow. Pathways are personalized to each patient's history and circumstances, in real time, at the point of care.
3. Care follows the person. Follow-up becomes continuous, so care extends well past the visit.
4. The economics of care evolve. As AI is increasingly used to review clinical decisions and bills, the medical record is becoming more of a negotiating document, and new payment models are on the horizon.

This is not a technology trend to watch from a distance. It is the ground your practice will be standing on.

Why does a clean medical record matter more now?

Because the record is becoming the practice's most important asset in every conversation that follows a visit. A complete, well-supported record carries weight in a claim, an audit, or a new payment arrangement alike.

That makes documentation integrity infrastructure, not paperwork. It is also why strong revenue cycle management for specialty practices starts at the encounter, not at the claim.

Where should your practice start with AI?

Start with one workflow, not four. You do not need to solve everything at once. Choose the workflow your team is most ready, and most motivated, to improve.

Good first candidates are workflows that already have structure:

• Scheduling and patient access
• Prior authorization follow-up
• Pathway-based documentation
• Post-visit follow-up and outreach

Pair the workflow you choose with a clear owner and a written review process. Our guide to AI governance for medical practices shows what that looks like.

Not sure which workflow is ready? The AI Readiness assessment identifies which of your workflows is ready for AI, with a path for physicians and one for practice administrators.

What you can do this week

Book one hour with your medical director and practice administrator before the CY2027 final rule, expected in November. Bring three things:

1. Your year-end close list: open claims, open charts, quality gaps.
2. The proposed 2027 changes above.
3. One workflow you are ready to modernize first.

Leave the room with an owner and a date. That is a Q4 plan. See how TRIARQ supports independent practices across practice capabilities.

Connected Care. Shared accountability. Better outcomes.

Finish 2026 strong and build for 2027. Take the AI Readiness assessment.

FAQ

What should an independent practice do in Q4?

Do two things: close 2026 cleanly and choose a first move for 2027. Work open claims and denials, complete open charts, and close quality gaps before the performance year ends. Then build next year's budget around the proposed CMS changes and pick one workflow to modernize first.

Which AI workflow should a medical practice start with?

Start with one workflow that already has structure, such as scheduling, prior authorization follow-up, documentation, or post-visit outreach. Give it a named owner and a written review process. TRIARQ's AI Readiness assessment identifies which of your workflows is ready for AI.