Off the Chart: A Business of Medicine Podcast

Recent Episodes

1. S1 Ep169: What most physicians get wrong about direct primary care, with Josh Umbehr, M.D.

   Jul 20, 2026

   Dr. Josh Umbehr, family physician and co-founder of Atlas MD, discusses the direct primary care (DPC) model he pioneered in Wichita, Kansas since 2010. The conversation covers the financial mechanics of DPC practices, including panel sizing, pricing strategies, and overhead reduction, with Umbehr arguing that lower-priced practices often achieve higher profitability through larger patient volumes. He addresses common physician misconceptions about DPC, the patient relationship dynamics that emerge from extended visit times, and his prediction that insurance-based primary care will largely disappear within 3-5 years as the current system becomes economically unsustainable.

2. S1 Ep168: Same procedure, 12 times the price: U.S. Women's Health Alliance sounds the alarm

   Jul 16, 2026

   Richard Payerchin from Medical Economics hosts a discussion with Dr. Jack Feltz (president of the U.S. Women's Health Alliance), Dr. Rebecca Herrero (president and CEO of Women's Health Associates of Southern Nevada), and attorney Dan Fryer (co-managing partner of Friar Levitt) about the erosion of independent medical practice in women's healthcare. The guests explain how hospital reimbursement advantages—sometimes 5-12x higher for identical procedures—are driving physicians out of private practice and reducing patient choice and affordability. They detail proposed legislation aimed at creating fairer competitive conditions, including clarifications on fair market value and narrowing reimbursement deltas between office and hospital outpatient settings, while maintaining support for physician-owned hospitals as a competitive mechanism.

3. S1 Ep167: What your practice is actually worth, with Andy Colbert of Ziegler

   Jul 13, 2026

   Andy Colbert, senior managing director at Ziegler investment bank, discusses the economics of independent medical practices and the strategic options available to physician groups. With 20 years in healthcare investment banking and experience advising on over $6 billion in transactions, Colbert explains why practices need 40-50+ providers to remain sustainably independent, how physicians often misvalue their practices, and the trade-offs between private equity partnerships, hospital alignment, and forming management services organizations (MSOs).

4. S1 Ep166: Considering concierge? Know the legal traps first, with Ericka Adler, J.D.

   Jul 9, 2026

   Erica Adler, practice group manager of healthcare for Rexel and Andras, discusses the legal considerations physicians must navigate when transitioning to concierge or hybrid concierge medical practices. The episode covers key legal pitfalls including the requirement that membership fees be tied to non-covered services, the critical importance of reviewing insurance contracts before implementing concierge models, and the necessity of clear patient agreements. Adler emphasizes that physicians often overlook contract review, Medicare coverage changes, and market research—and that proper planning with legal counsel, accountants, and marketers is essential to avoid contract violations, patient abandonment claims, and financial failure.

5. S1 Ep165: The four forces reshaping physician pay, with Tynan Kugler of PYA

   Jul 6, 2026

   Tynan Kugler, a principal in PYA's consulting practice, discusses the four major forces reshaping physician compensation: supply and demand imbalances, the shift toward employment and health system affiliation, reimbursement pressures, and the interplay between productivity-based and value-based payment models. The episode explores how medical organizations balance competitive physician pay with rising costs through compensation model redesign, care optimization, and shorter guarantee periods, while addressing why reducing physician compensation is so difficult once established.

6. S1 Ep164: Pay is up, productivity is down. Is it sustainable? With Andy Swanson of MGMA

   Jul 2, 2026

   Andy Swanson, Chief Customer Success Officer at MGMA, discusses the Medical Group Management Association's provider compensation and productivity data report, which shows physician pay rising while productivity declined for the first time in years. The conversation covers what's driving the split, the impact of the new Medicare efficiency adjustment on procedural specialties, physician burnout as a baseline condition, AI adoption challenges, and the critical metric practice leaders should track beyond work RVUs.

7. S1 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

   Jun 29, 2026

   Dr. Tracy Zvenyach, Vice President for Advocacy and Research at the Obesity Action Coalition, discusses Medicare and Medicaid's new coverage programs for GLP-1 obesity medications, including the Medicare GLP-1 Bridge program and the Balance model for state Medicaid programs. The conversation covers clinical eligibility criteria, drug pricing challenges, compounded alternatives, and the persistent issue of weight bias and stigma in healthcare settings and policy design.

8. S1 Ep162: From hello to hired, with Trent Cotton of iCIMS

   Jun 25, 2026

   Trent Cotton, head of talent insights at iCIMS, discusses findings from iCIMS' February 2026 healthcare hiring report with Medical Economics managing editor Todd Triox. The conversation covers why clinical applications jumped 10% in January despite a 20% rise in openings with only 5% increase in hires, identifying bottlenecks in the recruitment process and candidate dropout rates. Cotton provides strategies for smaller practices to compete with hospital systems through better candidate experience, pay transparency, and strategic AI deployment.

9. S1 Ep161: The No Surprises Act's new payment dispute rule, with Anders Gilberg of MGMA

   Jun 22, 2026

   Anders Gilberg, SVP of Government Affairs at MGMA, discusses the new Independent Dispute Resolution (IDR) rule under the No Surprises Act with Physicians Practice Managing Editor Keith Reynolds. The conversation covers key regulatory changes including the reduction of IDR initiation fees from $115 to $15, new transparency requirements via remittance advice codes, and persistent challenges such as providers winning arbitrations but failing to receive payment. Gilberg also previews upcoming regulatory milestones including HIPAA rules and physician fee schedule changes.

10. S1 Ep160: How to sell your practice, with Kevin Baker of Emergency Care Partners

    Jun 18, 2026

    Kevin Baker, Director of Business Development at Emergency Care Partners, discusses strategies for physicians planning to sell their practice or succession plan. The conversation covers common mistakes sellers make (poor preparation, disorganized finances, focusing solely on valuation), optimal timing for transactions (3-5 years in advance), key valuation drivers (earnings quality, risk profile, growth potential), and structural differences between selling to hospital systems, private equity groups, or junior partners. Baker emphasizes the importance of early advisory team assembly, clean financials, and preparing for both the transactional and emotional aspects of a practice sale.