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 Reynolds, Austin Littrell Inquiries: Please email Hosts Keith Reynolds (kreynolds@mjhlifesciences.com) or Austin Littrell (alittrell@mjhlifesciences.com) with feedback, questions, guest suggestions and more.
Episodes
More physicians are turning to concierge and hybrid concierge models to shrink their panels and steady their finances, but the move carries legal exposure that's easy to miss until it becomes a problem.
Ericka Adler, J.D., health care practice group manager at Roetzel & Andress, joins Medical Economics Managing Editor Todd Shryock to walk through the rules that trip practices up: why a membership fee has to b...
Physician compensation has never been simple, but in 2026 it is especially fraught. Medical groups and health systems are contending with workforce shortages, flat or declining reimbursement, rising operating costs and the regulatory limits that come with employed and affiliated models all at once — and a competitive offer, on its own, no longer closes the deal.
Medical Economics Associate Editor Austin Littrell...
For the first time in years, physician compensation and productivity have moved in opposite directions — pay is up, encounter volume is down — and practice leaders are trying to work out what it means heading into a turbulent year. Physicians Practice Managing Editor Keith Reynolds sits down with Andy Swanson, chief customer success officer at the Medical Group Management Association (MGMA), to unpack the group's ...
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 two new programs, the Medicare GLP-1 Bridge and the Medicaid-focused BALANCE Model, that open access to GLP-1 drugs for eligible beneficiaries and signal a shift toward treating obesity as a complex chronic disease.
In this episode, Medical Economics Senior Editor Rich...
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 widening, a sign that getting candidates in the door is only half the battle.
In this episode, Medical Economics Managing Editor Todd Shryock speaks with Trent Cotton, head of talent insights at iCIMS, about what the data reveals and what physician practices can do ...
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 Surprises Act's independent dispute resolution process. A newly finalized rule is meant to make that process work better, and for practices, the headline change is significant: the fee to initiate a dispute has dropped from $115 to just $15.
In this episode, Physicians Prac...
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 should. In this episode, Medical Economics Managing Editor Todd Shryock speaks with Kevin Baker, director of business development at Emergency Care Partners, about how practice owners can prepare for a sale or succession years before they actually need to.
Baker breaks...
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 shortage of as many as 80,000 primary care physicians by 2037 and nearly 40% of Gen Z patients go without a primary care physician at all, more Americans are turning to urgent care as their first and often only point of contact with the health care system.
Medical Econom...
The consolidation of outpatient medicine has swept many independent physicians into larger systems, private equity arrangements or hospital employment. John C. Cianca, M.D., FAAPMR, a physiatrist in Houston, Texas, and president of the American Academy of Physical Medicine and Rehabilitation, went the other way.
More than two decades ago, he left his Baylor-affiliated medical college to build a true solo, cash-only practi...
Strategic thinking is often treated as an executive skill — something reserved for leadership retreats and long-range planning sessions. Melinda Mastel, MBA, MS, FHFMA, CMPE, PMP, a financial advisor at the Medical College of Wisconsin, argues it belongs on every finance professional's desk on a normal Tuesday.
Physicians Practice Managing Editor Keith Reynolds speaks with Mastel about what actually drives budget mi...
Social drivers of health (SDOH) — food security, housing stability, transportation, utilities access and interpersonal safety — account for roughly 80% of what determines whether a patient stays healthy or gets sick. Yet most of the health care system is still organized around the 20%: treating illness after it arrives.
Medical Economics Senior Editor Richard Payerchin speaks with Dhruv Khullar, M.D., M.P.P., ...
Physicians are among the highest earners in the American workforce. They're also among the most financially stressed.
Panacea Financial's 2026 survey, "The Financial Lives of Doctors," puts numbers to that tension. Financial confidence rises from just 2.33 out of 5 in medical school to 3.27 among practicing physicians. More than half of respondents said they would not choose medicine again, or weren't sure, if federal student...
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, M.D., a practicing gastroenterologist, founder and chairman of DHR Health in Texas' Rio Grande Valley, and president of Physician-Led Healthcare for America, joins Medical Economics Senior Editor Richard Payerchin to explain why that distinction matters. They co...
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 "All Physicians Lead: Redefining Physician Leadership for Better Patient Outcomes," joins Medical Economics Associate Editor Austin Littrell to answer the question: What does it mean to lead when you don't have all the answers?
Moores argues that every physician ...
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 Jacobson, MBA, FACMPE, CEO of Prosper Beyond VBC, joins Physicians Practice Managing Editor Keith Reynolds to explain why, and what to do about it.
Jacobson walks through the three things that undermine practices before a single word is spoken: no strategy, no clarity o...
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 physicians within a decade.
In this episode, David Carmouche, M.D., executive vice president and chief medical and commercial officer at Lumeris — and a newly appointed member of the HHS Healthcare Advisory Committee — joins Medical Economics Senior Editor Ri...
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 Palmer, senior vice president of compliance solutions at Skillsoft, joins Medical Economics Associate Editor Austin Littrell to break down the real risks of shadow AI in clinical settings — not just the data privacy concerns most practices already know about, but the h...
Vaccine confidence in the United States has declined sharply, and the reasons are complicated — organizational upheaval at the CDC, conflicting guidance from different authorities, COVID-19 messaging failures and a flood of social media misinformation.
In this episode, David Dodd, president and CEO of vaccine developer GeoVax, joins Medical Economics Managing Editor Todd Shryock to share his perspective as an industry i...
What's really driving the dysfunction in American health care?
Longtime Medical Economics editorial advisor and family physician Melissa Lucarelli, M.D., FAAFP, sits down with Erica Rowe Urquhart, M.D., Ph.D., MBA, an orthopedic surgeon, 20-year independent practice owner and author of "The Invisible Hand Wielding the Scalpel: The Hidden Cause of America's Healthcare Crisis." The two physicians discuss why independent practiti...
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 frustrating and resource-intensive parts of running a business.
In this episode, Roshan Patel, founder and CEO of Arrow, joins Medical Economics Managing Editor Todd Shryock to break down why health care payment friction keeps getting worse — more prior auth re...
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