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PODCAST

Off the Chart: A Business of Medicine Podcast

Medical Economics

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

business management & marketing

All Episodes

19:25

S1 Ep192: The calls your practice isn't answering,...

Off the Chart: A Business of Medicine Podcast ·

2026/10/08

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 rarely leave a message. They call the next practice in their search results.Medical Economics Managing Editor Todd Shryock sat down with Nirgudkar, co-founder and CEO of Patient Prism, which uses artificial intelligence (AI) to analyze patient calls to practices.Nirgudkar explains why access has become patients' top frustration and how

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32:52

S1 Ep191: When a negative review becomes defamation,...

Off the Chart: A Business of Medicine Podcast ·

2026/10/05

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 online. When one of those reviews is fake or false, Michael Pelagalli, J.D., says HIPAA leaves physicians with very little they can say in a public reply, and federal regulators have fined practices that said too much.Medical Economics Associate Editor Austin Littrell sat down with Pelagalli, a partner at Minc Law, a Cleveland firm that works

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30:10

S1 Ep190: Lost between the payer and the pharmacy,...

Off the Chart: A Business of Medicine Podcast ·

2026/10/01

D2 Solutions' survey, "Patient Access Barriers 2026," found that 21% of patients delayed starting a prescribed medication because of confusion or access problems, and 47% said a lack of transparency left them anxious and uncertain. Dean Erhardt says the prior authorization rejections behind many of those delays are largely administrative rather than clinical, and they often come back with no reason given.Medical Economics Senior Editor Richard Payerchin sat down with Erhardt, president and CEO of

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29:09

S1 Ep189: Value-based care is still treading water,...

Off the Chart: A Business of Medicine Podcast ·

2026/09/28

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 value-based programs are still pegged to fee-for-service, and the fee-for-service revenue hospitals collect routinely outweighs the penalties meant to move them off it.Medical Economics Managing Editor Todd Shryock sat down with D'Orazio, CEO of Sage Growth Partners, a Baltimore-based health care strategy and marketing firm.D'Orazio explains

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13:31

S1 Ep188: Why your patients don't fill prescriptions,...

Off the Chart: A Business of Medicine Podcast ·

2026/09/24

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 is highly visible in their workflows. Joseph Kleiman, president of Buzz Health, says the gap comes down to connectivity: prescriber, pharmacy and health plan systems that still don't share data.Medical Economics Managing Editor Todd Shryock sat down with Kleiman to talk through the survey, which included prescribers and electronic health

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21:41

S1 Ep187: Medicare's plan to pay half for same-day...

Off the Chart: A Business of Medicine Podcast ·

2026/09/21

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 when a patient gets an office visit and a procedure on the same day. Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association (MGMA), joins Physicians Practice Managing Editor Keith Reynolds to explain what that would look like in the exam room, why budget neutrality rules keep pitting specialties

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30:08

S1 Ep186: When physicians know the right care and...

Off the Chart: A Business of Medicine Podcast ·

2026/09/17

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 had already left a job because of moral distress. Rebecca Schoon, Ph.D., one of the authors of the Physicians for a National Health Program report behind those numbers, says the patients her team heard from in Oregon could see what was happening to their doctors and did not blame them for it.Medical Economics Senior Editor Richard Payerchin

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13:37

S1 Ep185: Who gets paid when the AI does the work?...

Off the Chart: A Business of Medicine Podcast ·

2026/09/14

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 and effort a service is expected to take. Caroline Pearson says that math is why AI could push health care costs up rather than down, and that remote patient monitoring already shows what it looks like.Medical Economics Managing Editor Todd Shryock sat down with Pearson, executive director of the Peterson Health Technology Institute, a

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23:51

S1 Ep184: Why banning corporate medicine won't save...

Off the Chart: A Business of Medicine Podcast ·

2026/09/10

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 Winegarden, Ph.D., says the crackdown is aimed at the wrong target. Medicare physician payments rose 12% between 2000 and 2022 while the cost of running a practice climbed nearly 48%.Medical Economics Associate Editor Austin Littrell sat down with Winegarden, a senior fellow in business and economics at the Pacific Research Institute and

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28:42

S1 Ep183: The first thing to do after a medical...

Off the Chart: A Business of Medicine Podcast ·

2026/09/07

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 argues, is where malpractice claims begin. Orsini, a neonatologist, founder of The Orsini Way and a member of the Medical Economics editorial advisory board, joins Medical Economics Managing Editor Todd Shryock to walk through the mistakes physicians make most often in a disclosure conversation: staying silent, getting defensive instead of

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25:45

S1 Ep182: The interchangeable physician, with...

Off the Chart: A Business of Medicine Podcast ·

2026/09/03

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 England Journal of Medicine essay, "Physicians, Corporatization, and the Unmeasured Quality of Care," he makes an argument most physicians will recognize from the inside: the accuracy and timeliness of a diagnosis, the trust built over years with a patient, the judgment behind sending someone to exactly the right specialist. None of it can be

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24:16

S1 Ep181: Why physicians are getting sued less and...

Off the Chart: A Business of Medicine Podcast ·

2026/08/31

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 Practitioner Data Bank was $514,000, the highest on record. Both numbers describe the same malpractice market.Medical Economics Managing Editor Todd Shryock sat down with Robert White, president of The Doctors Company and TDC Group.White explains why falling claims frequency has quietly absorbed years of pressure from rising severity, and why that

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35:01

S1 Ep180: Why private equity can own a hospital and a...

Off the Chart: A Business of Medicine Podcast ·

2026/08/27

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 Price, M.D., MBA, president of The Physicians Foundation, argues the restriction was a mistake from the beginning, built on a reading of the Dartmouth Atlas that researchers corrected 25 years ago and policymakers never revisited. He talks with Medical Economics Senior Editor Richard Payerchin about what the research actually shows on cost

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17:04

S1 Ep179: Vaccine schedules, stocking costs and the...

Off the Chart: A Business of Medicine Podcast ·

2026/08/24

Three Current Procedural Terminology codes for immunization counseling on days when no vaccine is administered, 90482 through 90484, took effect Jan. 1, 2026. They were built to capture the time a physician spends on a conversation that ends without a shot. CMS does not pay for them, and most private payers do not either.Medical Economics Associate Editor Austin Littrell sat down with Sarah C. Nosal, M.D., FAAFP, president of the American Academy of Family Physicians and a family physician who has

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25:06

S1 Ep178: A year after the prior authorization...

Off the Chart: A Business of Medicine Podcast ·

2026/08/20

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 consistently reviewed by an appropriately qualified clinician, and Colin Banas, M.D., M.S.H.A., chief medical officer of DrFirst, says the process is as bad as ever.Physicians Practice Managing Editor Keith Reynolds sat down with Banas to go through the pledge commitment by commitment and to look ahead to Jan. 1, 2027, when the CMS

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20:45

S1 Ep177: What's really keeping practices...

Off the Chart: A Business of Medicine Podcast ·

2026/08/17

Independent practices know technology is what keeps them independent. They just don't trust the technology they have. Veradigm surveyed 360 leaders at independent ambulatory practices, including 210 physicians, and found 79% call technology essential to staying independent while only 64% are confident their current tools can deliver. Aaron Ledbetter, solutions and growth strategist at Veradigm, joins the show to explain what sits inside that gap: denied claims that take one to two weeks to surface,

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16:53

S1 Ep176: Cutting the PBM out of your patient's...

Off the Chart: A Business of Medicine Podcast ·

2026/08/13

GLP-1s broke the traditional pharmacy benefit, and a growing number of employers are responding by buying brand drugs straight from the manufacturer and cutting the insurer and pharmacy benefit manager out of the transaction entirely. Jay Bregman, founder and CEO of Andel, joins Medical Economics Associate Editor Austin Littrell to explain how the model works from the prescriber's side: the script still starts with the patient's own physician, still travels over Surescripts and still reports back

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13:01

S1 Ep175: Most practices cut the wrong thing first,...

Off the Chart: A Business of Medicine Podcast ·

2026/08/10

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 main systems to as many as 15. Reimbursement has not moved with any of it, and when the math gets that tight the reflex is to start cutting. Physicians Practice Managing Editor Keith Reynolds sat down with Shawntea Gordon, CEO of Atlas & Perpetua Healthcare Consulting, to explain why that reflex is where most practices go wrong. A cut made

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27:38

S1 Ep174: Insurance was never meant to be a...

Off the Chart: A Business of Medicine Podcast ·

2026/08/06

Joanne Frederick, CEO of Government Market Strategies, has spent more than 30 years working inside Medicare, Medicaid, Tricare and VA health programs, and she opens with the one most physicians know least. Tricare covers 9.4 million service members, families and retirees, and pays at a discount off Medicare rates that plenty of practices already say don't cover their costs. From there Frederick makes a broader argument: that insurance was never designed to sit between a patient and a physician for

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18:19

S1 Ep173: The patient access blind spot, with Mindy...

Off the Chart: A Business of Medicine Podcast ·

2026/08/03

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 patients, fewer than one in five agree. Medical Economics Managing Editor Todd Shryock sat down with Mindy Fortson, chief operating officer of Experian Health, to work out what's behind that split, why 73% of respondents on the practice side say patients delay or forfeit care when they can't get a cost estimate up front, and how much of the

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198 results

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