Shows / Off the Chart: A Business of Medicine Podcast
Off the Chart: A Business of Medicine Podcast
Off the Chart: A Business of Medicine Podcast features lively and informative conversations with health care experts, opinion leaders and practicing physicians about the challenges facing doctors and medical practices. New episodes release every Monday and Thursday morning. Brought to you by Medical Economics and Physicians Practice.
Off the Chart: A Business of Medicine Podcast Staff
Hosts: Keith Reynolds, Austin Littrell
Contributors: Chris Mazzolini, Todd Shryock, Richard Payerchin, Keith…
Episodes
Off the Chart: A Business of Medicine PodcastS1 Ep201: Why ACOs still need Congress after the 2027 fee schedule, with Aisha Pittman of NAACOS
The final 2027 Medicare Physician Fee Schedule, released Nov. 4, cuts the conversion factor 1.83% for clinicians in qualifying advanced alternative payment…
Off the Chart: A Business of Medicine PodcastSpecial Report: Medicare’s final 2027 fee schedule cuts deeper than proposed, with Taya Gordon of Atlas & Perpetua Healthcare Consulting
Medicare’s final 2027 physician fee schedule, released Nov. 4, cuts the conversion factor 2.31% for most clinicians starting Jan. 1, a deeper cut than CMS…
Off the Chart: A Business of Medicine PodcastS1 Ep200: Who reaches Medicaid patients before they lose coverage? with Colby Takeda of Pear Suite
Starting Jan. 1, most adults who got Medicaid through expansion will have to prove they’re working, in school, in job training or doing community service to…
Off the Chart: A Business of Medicine PodcastS1 Ep199: Your patients want a quick fix for their heart, with two Mayo Clinic cardiologists
Francisco Lopez-Jimenez, M.D., M.S., MBA, and Kyla M. Lara-Breitinger, M.D., M.S., are preventive cardiologists at Mayo Clinic and co-authors, with the late…
Off the Chart: A Business of Medicine PodcastS1 Ep198: Medicare’s 2027 fee schedule won’t settle the physician pay debate, with four health policy experts
If the proposed 2027 Medicare physician fee schedule is finalized, real Medicare payment rates will be 35% below 2016 levels, according to Jonathan Ketcham…
Off the Chart: A Business of Medicine PodcastS1 Ep197: Pay cuts, payer AI and the staff who keep leaving: What we heard at MGMA’s 100th annual conference
The Medical Group Management Association (MGMA) held its 100th annual conference Sept. 27-30 in San Antonio, and the Medical Economics and Physicians Practice…
Off the Chart: A Business of Medicine PodcastS1 Ep196: Treating patients with half the chart, with Sandra Johnson of CliniComp
Forty-seven percent of chief information officers (CIOs) named cost as their top barrier to interoperability in a survey CliniComp conducted with the College…
Off the Chart: A Business of Medicine PodcastS1 Ep195: Using AI to fix the hiring mess AI made, with Dina Taylor of HireVue
A single job posting can draw 1,000 applicants in a week, according to Dina Taylor, chief evangelist at HireVue. She says no hiring team has the time to read…
Off the Chart: A Business of Medicine PodcastS1 Ep194: The revenue your practice is already losing, with MGMA Acting CEO Akash Madiah
Akash Madiah has seen the Medical Group Management Association (MGMA) from both sides. He used its data to redo physician compensation plans while working in…
Off the Chart: A Business of Medicine PodcastS1: Special Report: The leadership skills transforming health care today, with Kate Atchley of the Haslam College of Business
Health care organizations often promote their top clinicians into leadership roles with little preparation for the business side of the job, according to Kate…
Off the Chart: A Business of Medicine PodcastS1 Ep193: What’s holding direct primary care back, with Kenneth Qiu, M.D.
Direct primary care physicians charge an average of about $98 a month for a membership, and those who consider their practices full care for roughly 400 to 700…
Off the Chart: A Business of Medicine PodcastS1 Ep192: The calls your practice isn't answering, with Amol Nirgudkar of Patient Prism
Amol Nirgudkar, CPA, CGMA, estimates that 25% to 30% of calls to health care offices go unanswered during business hours. He says patients who reach voicemail…
Off the Chart: A Business of Medicine PodcastS1 Ep191: When a negative review becomes defamation, with Michael Pelagalli of Minc Law
In a June survey from reputation management company rater8, 55% of adults said they had walked away from at least one physician because of something they read…
Off the Chart: A Business of Medicine PodcastS1 Ep190: Lost between the payer and the pharmacy, with Dean Erhardt of D2 Solutions
D2 Solutions' survey, "Patient Access Barriers 2026," found that 21% of patients delayed starting a prescribed medication because of confusion or access…
Off the Chart: A Business of Medicine PodcastS1 Ep189: Value-based care is still treading water, with Dan D'Orazio of Sage Growth Partners
Nearly two decades into the push toward value-based care, Dan D'Orazio says the industry isn't much further along than it was when the effort began. He says…
Off the Chart: A Business of Medicine PodcastS1 Ep188: Why your patients don't fill prescriptions, with Joseph Kleiman of Buzz Health
In a Buzz Health survey of prescribers, 54% said patients often or very often fail to start therapy because of cost, but only 17% said prescription abandonment…
Off the Chart: A Business of Medicine PodcastS1 Ep187: Medicare's plan to pay half for same-day care, with Anders Gilberg of MGMA
Public comments on Medicare's proposed 2027 physician fee schedule closed Sept. 14 with a provision on the table that would pay 50% for one of two services…
Off the Chart: A Business of Medicine PodcastS1 Ep186: When physicians know the right care and can't give it, with Rebecca Schoon of Pacific University
In a national survey of more than 1,200 practicing physicians, 47% said they often or always lacked the time to give patients optimal care, and 27% said they…
Off the Chart: A Business of Medicine PodcastS1 Ep185: Who gets paid when the AI does the work? with Caroline Pearson of the Peterson Health Technology Institute
A clinical artificial intelligence (AI) tool costs little to run and can be billed many times over, while fee-for-service rates are set on the clinician time…
Off the Chart: A Business of Medicine PodcastS1 Ep184: Why banning corporate medicine won't save independent practice, with Wayne Winegarden, Ph.D., of the Pacific Research Institute
Thirty-three states now restrict the corporate practice of medicine to some degree, and lawmakers in several more are moving to tighten those limits. Wayne…
Off the Chart: A Business of Medicine PodcastS1 Ep183: The first thing to do after a medical error, with Anthony Orsini, D.O.
Fewer than half of physicians know the exact steps to take when a medical error occurs, according to a survey cited by Anthony Orsini, D.O. That gap, he…
Off the Chart: A Business of Medicine PodcastS1 Ep182: The interchangeable physician, with Lawrence Casalino, M.D.
Lawrence Casalino, M.D., Ph.D., M.P.H., practiced primary care for 20 years before spending six on the Medicare Payment Advisory Commission. In his recent New…
Off the Chart: A Business of Medicine PodcastS1 Ep181: Why physicians are getting sued less and paying more, with The Doctors Company President Robert White
One in 21 physicians was sued last year, the lowest rate since 1973. The average payment made on behalf of a physician and reported to the National…
Off the Chart: A Business of Medicine PodcastS1 Ep180: Why private equity can own a hospital and a physician can't, with Gary Price, M.D., of The Physicians Foundation
Physicians have been effectively barred from owning hospitals since 2010, when a provision of the Affordable Care Act finished what the Stark law started. Gary…
Off the Chart: A Business of Medicine PodcastS1 Ep179: Vaccine schedules, stocking costs and the back-to-school visit, with AAFP President Sarah Nosal, M.D.
Three Current Procedural Terminology codes for immunization counseling on days when no vaccine is administered, 90482 through 90484, took effect Jan. 1, 2026…
Off the Chart: A Business of Medicine PodcastS1 Ep178: A year after the prior authorization pledge, what changed? with Colin Banas, M.D., of DrFirst
In June 2025, dozens of health insurers pledged six fixes to prior authorization. A year later, the AMA found that just 24% of physicians say denials are…
Off the Chart: A Business of Medicine PodcastS1 Ep177: What's really keeping practices independent, with Aaron Ledbetter of Veradigm
Independent practices know technology is what keeps them independent. They just don't trust the technology they have. Veradigm surveyed 360 leaders at…
Off the Chart: A Business of Medicine PodcastS1 Ep176: Cutting the PBM out of your patient's GLP-1, with Jay Bregman of Andel
GLP-1s broke the traditional pharmacy benefit, and a growing number of employers are responding by buying brand drugs straight from the manufacturer and…
- Off the Chart: A Business of Medicine Podcast
S1 Ep175: Most practices cut the wrong thing first, with Shawntea Gordon of Atlas & Perpetua Healthcare Consulting
Practice costs are climbing on every line at once: staffing, medical supplies and a technology stack that has grown at some organizations from two or three…
Off the Chart: A Business of Medicine PodcastS1 Ep174: Insurance was never meant to be a first-dollar payer, with Joanne Frederick
Joanne Frederick, CEO of Government Market Strategies, has spent more than 30 years working inside Medicare, Medicaid, Tricare and VA health programs, and she…
Off the Chart: A Business of Medicine PodcastS1 Ep173: The patient access blind spot, with Mindy Fortson of Experian Health
Nearly half of the health care organizations in Experian Health's 2026 State of Patient Access Survey say patient access improved over the past year. Among…
Off the Chart: A Business of Medicine PodcastS1 Ep172: A primary care physician's guide to cyclosporiasis, with Molly O'Shea, M.D.
Cyclosporiasis presents like a lot of other summer illnesses, but it runs six weeks untreated and the routine ova and parasite panel will not find it unless…
- Off the Chart: A Business of Medicine Podcast
S1 Ep171: Another year of Medicare cuts, with Anders Gilberg of MGMA
CMS has released its proposed 2027 Medicare Physician Fee Schedule, and once again it carries a conversion factor cut: 1.68% for physicians outside an…
Off the Chart: A Business of Medicine PodcastS1 Ep170: Better care, shorter careers for women physicians, with Lisa Rotenstein, M.D., MBA, M.Sc.
Female physicians spend more time with patients, write longer notes and field more messages, and research suggests their patients do better for it. They also…
Off the Chart: A Business of Medicine PodcastS1 Ep169: What most physicians get wrong about direct primary care, with Josh Umbehr, M.D.
Direct primary care has been around long enough that most physicians know the pitch: drop the billing, charge a monthly membership, keep a smaller panel and…
Off the Chart: A Business of Medicine PodcastS1 Ep168: Same procedure, 12 times the price: U.S. Women's Health Alliance sounds the alarm
The same low-risk procedure can cost five to 12 times more in a hospital outpatient department than in a physician's office. That gap is giving hospitals the…
Off the Chart: A Business of Medicine PodcastS1 Ep167: What your practice is actually worth, with Andy Colbert of Ziegler
Independent practices are being squeezed from every direction: rising labor costs, shrinking reimbursement and an administrative load that keeps growing. Andy…
Off the Chart: A Business of Medicine PodcastS1 Ep166: Considering concierge? Know the legal traps first, with Ericka Adler, J.D.
More physicians are turning to concierge and hybrid concierge models to shrink their panels and steady their finances, but the move carries legal exposure…
Off the Chart: A Business of Medicine PodcastS1 Ep165: The four forces reshaping physician pay, with Tynan Kugler of PYA
Physician compensation has never been simple, but in 2026 it is especially fraught. Medical groups and health systems are contending with workforce shortages…
Off the Chart: A Business of Medicine PodcastS1 Ep164: Pay is up, productivity is down. Is it sustainable? With Andy Swanson of MGMA
For the first time in years, physician compensation and productivity have moved in opposite directions — pay is up, encounter volume is down — and practice…
Off the Chart: A Business of Medicine PodcastS1 Ep163: What physicians need to know about Medicare's new obesity drug coverage, with Tracy Zvenyach, Ph.D., M.S., RN, of the Obesity Action Coalition
For years, Medicare and Medicaid effectively excluded coverage for the medications proven to treat obesity. That is starting to change. In 2026, CMS rolled out…
Off the Chart: A Business of Medicine PodcastS1 Ep162: From hello to hired, with Trent Cotton of iCIMS
Health care hiring is in a strange place. Clinical job applications jumped 10% at the start of 2026, yet the gap between open positions and actual hires keeps…
- Off the Chart: A Business of Medicine Podcast
S1 Ep161: The No Surprises Act's new payment dispute rule, with Anders Gilberg of MGMA
When a patient is treated by an out-of-network physician at an in-network hospital, the resulting payment dispute is supposed to be settled through the No…
Off the Chart: A Business of Medicine PodcastS1 Ep160: How to sell your practice, with Kevin Baker of Emergency Care Partners
Selling a medical practice is one of the most consequential financial decisions a physician will ever make, and many start the process far later than they…
Off the Chart: A Business of Medicine PodcastS1 Ep159: The new front door to health care, with Andrea Giamalva, M.D., FAAFP, of Experity
Urgent care was never designed to be the front door to American health care, but that's increasingly what it has become. As the country faces a projected…
Off the Chart: A Business of Medicine PodcastS1 Ep158: Cash-only practice, with John C. Cianca, M.D., FAAPMR, president of the American Academy of Physical Medicine and Rehabilitation
The consolidation of outpatient medicine has swept many independent physicians into larger systems, private equity arrangements or hospital employment. John C…
Off the Chart: A Business of Medicine PodcastS1 Ep157: From spreadsheets to strategy, with Melinda Mastel, MBA, MS, of the Medical College of Wisconsin
Strategic thinking is often treated as an executive skill — something reserved for leadership retreats and long-range planning sessions. Melinda Mastel, MBA…
Off the Chart: A Business of Medicine PodcastS1 Ep156: Why where you live may matter more than how you're treated, with experts from the Physicians Foundation
Social drivers of health (SDOH) — food security, housing stability, transportation, utilities access and interpersonal safety — account for roughly 80% of what…
Off the Chart: A Business of Medicine PodcastS1 Ep155: What doctors don't know about their own finances, with Michael Jerkins, M.D., M.Ed., and Jillian Vestal, J.D., of Panacea Financial
Physicians are among the highest earners in the American workforce. They're also among the most financially stressed. Panacea Financial's 2026 survey, "The…
Off the Chart: A Business of Medicine PodcastS1 Ep154: The time is now for physician-owned hospitals, with Carlos Cardenas, M.D., president of Physician-Led Healthcare for America
For the first time, CMS isn't asking whether physician-owned hospitals should be part of Medicare's care delivery models — it's asking how. Carlos Cardenas…
Off the Chart: A Business of Medicine PodcastS1 Ep153: Leadership lessons, with Leon Moores, M.D.
Happy Memorial Day, Off the Chart listeners! In today's episode, Leon Moores, M.D., a pediatric neurosurgeon, experienced health care executive and author of…
Off the Chart: A Business of Medicine PodcastS1 Ep152: The secret to winning payer negotiations, with Doral Jacobsen, MBA, FACMPE, of Prosper Beyond VBC
Most practices feel defeated going into payer negotiations before they even start. In this episode of Off the Chart: A Business of Medicine Podcast, Doral…
Off the Chart: A Business of Medicine PodcastS1 Ep151: Make the right thing the easy thing, with David Carmouche, M.D., of Lumeris
Primary care is facing a collision of two trends: a growing patient population with more chronic disease, and a workforce that will be short 85,000 to 90,000…
Off the Chart: A Business of Medicine PodcastS1 Ep150: Shadow AI: It's already in your practice, with Asha Palmer, J.D., of Skillsoft
If you haven't given your staff a sanctioned artificial intelligence (AI) tool, chances are they've already found one on their own. In this episode, Asha…
Off the Chart: A Business of Medicine PodcastS1 Ep149: Rebuilding vaccine trust, with David Dodd of GeoVax
Vaccine confidence in the United States has declined sharply, and the reasons are complicated — organizational upheaval at the CDC, conflicting guidance from…
Off the Chart: A Business of Medicine PodcastS1 Ep148: The real problem with health care, with Melissa Lucarelli, M.D., FAAFP, and Erica Rowe Urquhart, M.D., Ph.D., MBA
What's really driving the dysfunction in American health care? Longtime Medical Economics editorial advisor and family physician Melissa Lucarelli, M.D…
Off the Chart: A Business of Medicine PodcastS1 Ep147: Why getting paid keeps getting harder, with Roshan Patel of Arrow
Getting paid for services already rendered shouldn't be this hard. But for most physician practices, navigating insurance payments has become one of the most…
Off the Chart: A Business of Medicine PodcastS1 Ep146: The primary care crisis, by the numbers, with experts from the Milbank Memorial Fund, the Physicians Foundation and the Robert Graham Center
Earlier this year, the Milbank Memorial Fund, the Physicians Foundation and the Robert Graham Center jointly released "Investing in Primary Care: The Missing…
Off the Chart: A Business of Medicine PodcastS1 Ep145: The revenue cycle mistakes quietly draining your practice, with Kem Tolliver of Medical Revenue Cycle Specialists
Most practices manage their revenue cycle reactively — putting out fires instead of preventing them. In this episode, Kem Tolliver, FACMPE, CPC, CMOM, CEO of…
Off the Chart: A Business of Medicine PodcastS1 Ep144: The AI scribe era is here, with Robert Wachter, M.D., and more
Ambient artificial intelligence (AI) scribes have become the fastest-adopted physician technology in recent memory. At UCSF, 70% of physicians now use one…