Neal K. Shah, CEO of CareYaya Health Technologies and co-founder of Counterforce Health, joins the show to talk about claim denials and how AI can help fight them.

Be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know.

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Overview of the podcast and introduction of the guests discussing claim denials and AI's role.

Neil Shah shares his experience in healthcare and the impact of claim denials on patients.

Neil recounts his wife's cancer battle and the frustrations of dealing with denied claims.

Discussion on how insurance companies leverage AI against patients and providers.

Insight into the financial and administrative burdens claim denials impose on healthcare providers.

Details on how denied claims lead to significant financial losses for medical practices.

Discussion on the potential of AI to streamline the appeals process and reduce costs.

Neil introduces Counterforce Health and its mission to democratize access to AI tools.

Introduction of Maxwell, an AI designed to assist with health insurance appeals.

Maxwell shares shocking statistics about the financial impact of denied claims on practices.

Discussion of the three most common denial reasons that practices can address to improve collections.

Maxwell walks through a specific case of a denied claim for a CPAP machine.

Neil encourages providers to use the tools offered by Counterforce Health to combat claim denials.

Neil discusses potential reforms to the claim denial process and the need for better regulation.

Importance of educating patients about their rights regarding claim denials and appeals.

Neil emphasizes the need for advocacy and systemic change in the healthcare system.

Closing remarks and gratitude expressed for the discussion and insights shared.

Medical Economics Editorial Director Christopher Mazzolini and Senior Editor Richard Payerchin join the podcast to discuss the new issue of Medical Economics Insider,  our brand-new premium interactive digital edition designed to provide physicians with the in-depth insights and practical tools needed to thrive in today’s evolving health care landscape.

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Medical Economics Insider: https://www.medicaleconomics.com/view/medical-economics-insider-march-2025-save-your-practice

Leah Binder, president and CEO of The Leapfrog Group, joins the show to talk about notable trends in patient safety.

Be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know.

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Introduction to Patient Safety (00:00:00)

Discussion on alarming statistics about patient harm in hospitals, highlighting the severity of the issue.

Overview of the Leapfrog Group (00:01:04)

Leah Binder introduces the Leapfrog Group's mission to improve health care quality and safety through public reporting.

Current Status of Patient Safety (00:02:38)

Leah Binder shares disturbing statistics about patient harm and preventable deaths in American health care.

Positive Trends in Patient Safety (00:04:51)

Despite bad news, Binder discusses successful hospitals demonstrating significant improvements in patient safety measures.

The Role of Physicians in Patient Safety (00:08:11)

Binder emphasizes the importance of primary care physicians using their voice to advocate for patient safety.

Building Relationships with Employers (00:10:29)

Discussion on the need for healthcare providers to connect with employers to enhance primary care's role.

Trends in Hospital Safety Measures (00:12:58)

Binder describes trends in maternity care procedures, noting significant reductions in episiotomy and elective deliveries.

Discussion on the deployment of technology, including computerized physician order entry systems, to enhance patient safety.

Artificial Intelligence in Healthcare (00:19:08)

Exploration of how AI could improve patient care and safety through real-time data synthesis and alert systems.

Policy Solutions for Patient Safety (00:23:21)

Binder discusses the need for federal lawmakers to enhance patient safety and quality through better transparency measures.

Quality Measurement in Healthcare (00:24:38)

Discussion on improving quality and safety measurements by utilizing EMRs instead of traditional claims data.

Future of Quality Monitoring (00:25:43)

Anticipation of advancements in enterprise-wide monitoring of quality and safety in health care systems.

Appreciation for Healthcare Providers (00:26:13)

Acknowledgment of the vital role clinicians play in improving lives and the collective emphasis on healthcare.

Closing Remarks (00:27:08)

Gratitude expressed for the conversation and the importance of ongoing discussions in health care.

Episode Wrap-Up (00:27:41)

Final thanks and encouragement to subscribe for future episodes and updates from Medical Economics.

Rohit Harve, a technical operations partner and health care expert with PA Consulting, joins the show to talk tariffs and their impact on the medical device industry.

Be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know.

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Impact on Consumers (00:00:00)

Prices will be passed on to consumers, affecting doctors, patients, and health care providers.

Introduction to the Topic (00:00:14)

Austin Littrell introduces the episode and the guest, Rohit Harve, focusing on tariffs in the medical device industry.

Current Landscape of Tariffs (00:01:01)

Rohit discusses the volatile situation regarding tariffs and their effects on the medical device industry.

Profitability and Market Dynamics (00:01:20)

Tariffs impact profitability, growth, and market dynamics, especially in discretionary care segments.

Cost of Goods and Components (00:02:29)

Increased costs for components like semiconductors and materials will affect margins and pricing power.

Impact on Healthcare Costs (00:04:17)

Increased costs will ultimately affect health care expenses for consumers, doctors, and patients.

Supply Chain Issues (00:06:14)

Tariffs will complicate supply chains, pushing manufacturers to seek local suppliers amid regulatory challenges.

Challenges of Reshoring (00:09:07)

Moving complex manufacturing back to the U.S. is challenging due to time, cost, and skill shortages.

Competitiveness in Global Market (00:11:17)

Tariffs will hinder U.S. medical device companies' competitiveness and innovation in the global market.

Industry Response and Lobbying (00:12:22)

Active lobbying efforts are ongoing to address tariffs and their implications for the health care sector.

Future of Tariffs (00:14:12)

The likelihood of a deal on tariffs is uncertain, with potential adjustments in magnitude anticipated.

Uncertainty's Impact (00:15:18)

Uncertainty surrounding tariffs affects the medical device industry, though it may handle fluctuations better than others.

Insights on Efficiency (00:16:41)

Startups should focus on product efficiency and competitiveness in the global market amidst changing conditions.

Conclusion of Discussion (00:17:35)

Todd thanks Rohit for the insightful conversation on tariffs and their economic implications for health care.

Zed Williamson, founder and CEO of Physician Growth Accelerator, joins the show to talk about common challenges physicians face in private practice, explaining how to manage a successful practice without sacrificing patient care. For more from Zed and his team, check out the Physician Growth Accelerator website, podcast, and YouTube channel.

Plus, starting this Wednesday, March 19, find new episodes of the Physician Growth Accelerator podcast at MedicalEconomics.com.

Also, be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know.

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Introduction to Burnout (00:00:00)

Discusses the misconception that burnout stems from busyness, emphasizing the emotional aspect instead.

Podcast Introduction (00:00:19)

Austin Littrell introduces the podcast and the guest speakers, setting the stage for the discussion.

Overview of Physician Growth Accelerator (00:01:05)

Zed Williamson explains the mission of his company and its focus on improving private practices.

Challenges in Private Practices (00:01:12)

Details the variability in outcomes among practices despite similar inputs, highlighting internal constraints.

Consulting Philosophy (00:02:26)

Zed describes the "do it with you" approach to consulting, emphasizing collaboration over mere advice.

Importance of Clinical Excellence (00:04:10)

Stresses that clinical excellence must be the primary focus of medical practices for patient trust.

Business vs. Patient Care Mindset (00:04:23)

Explains the need for physicians to shift their mindset from treating business issues like patient problems.

Cultural Foundations of Practice (00:07:01)

Discusses the significance of a supportive culture in practices and its impact on performance.

Creating a Supportive Culture (00:07:21)

Explores how to intentionally drive a practice's culture to align with its goals and values.

Revenue Cycle Management (00:09:22)

Highlights the importance of understanding the lifetime value of patients for better financial forecasting.

Managing Administrative Burdens (00:12:35)

Offers strategies for practices to proactively manage administrative tasks and reduce burdens.

Approaching Technology (00:14:48)

Discusses the double-edged sword of technology in practices and the importance of strategic implementation.

Shifting Mindsets for Business Success (00:18:19)

Encourages physicians to adapt their thinking to balance clinical practice and business management effectively.

Identifying the Destination (00:20:36)

Discusses the importance of setting measurable goals to guide physicians in their practice.

Addressing Physician Burnout (00:24:01)

Explores the causes of burnout and emphasizes rekindling passion for work to alleviate stress.

Creating a Better Work Environment (00:25:13)

Suggests ways to improve the working conditions for private practice physicians and reduce anxiety.

Ericka Adler, JD, of Roetzel & Andress, joins the show to discuss factors you should consider before selling your practice.

For more, be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know.

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Overview of the podcast and introduction of the speakers discussing selling a medical practice.

Discussion on the compliance review process and its significance in the sale of a medical practice.

Exploration of how staff compliance affects the sale process and potential buyer decisions.

Insight into common billing issues that arise during due diligence and their implications.

Examination of how improper compensation can lead to compliance issues in medical practices.

Strategies for ensuring HIPAA compliance during the due diligence process when selling a practice.

Discussion on how different state laws can complicate the sale of multi-state practices.

Addressing misconceptions physicians have about the sales process and buyer expectations.

Examples of mistakes by practice owners that can lead to failed sales transactions.

Understanding that buyers evaluate more than just financials; they assess overall compliance and operations.

Comparison of due diligence levels between physician groups, private equity, and health systems.

Advice on whether to remove unqualified family members from payroll before selling.

Emphasis on the importance of early planning and thorough preparation before selling a practice.

Wrap-up of the conversation, highlighting key takeaways for physicians selling their practices.

Linda Stein Gold, MD, FAAD, discusses the late-breaking tapinarof cream 1% data from a new analysis of the ADORING-3 clinical trial. Interview recorded at the 2025 American Academy of Dermatology conference in Orlando, Florida. 

Topics discussed include:

Norman K. “Kip” Beals, MD, is executive director of primary care for Independence Health System in western Pennsylvania. He is board certified in family medicine and sports medicine. A physician practicing for 35 years, Beals has worked in independent practice and as a physician leader and chief innovation officer for health systems.

Beals joins the show to discuss the evolving landscape of health care reimbursement — and how physicians can weather the storm.

For more, be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know.

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Introduction to Healthcare Reimbursement (00:00:22)

Overview of the podcast and discussion topics, including Medicare cuts and financial pressures.

Physicians' Awareness of Medicare Cuts (00:01:04)

Dr. Beals discusses how physicians typically learn about Medicare reimbursement cuts through news rather than direct communication.

Reactions to Reimbursement Cuts (00:03:12)

Physicians often feel a mix of frustration and resignation regarding ongoing cuts to reimbursements.

Burnout Among Physicians (00:04:44)

Discussion on the alarming statistic of physician burnout and its impact on healthcare practices.

Dr. Beals highlights the lack of business training for physicians during medical school.

Exploration of how physicians can approach financial challenges in their practices.

Emphasis on the need for intense collaboration among healthcare providers to improve efficiency.

Reflections on how the pandemic has forced healthcare practices to adapt and become leaner.

Discussion on using technology and innovative thinking to enhance healthcare delivery.

Dr. Beals shares the importance of understanding community needs for effective healthcare solutions.

Examples of initiatives aimed at addressing barriers to healthcare access in rural areas.

Discussion on improving healthcare outcomes and reducing costs through efficient disease management and early problem detection.

Impact of potential Medicare cuts on driving innovation and finding better healthcare solutions.

Encouragement for patients to seek care from primary care providers for efficient and comprehensive healthcare.

Advocacy for collaboration between clinical and administrative leaders to enhance patient care and community health outcomes.

Expression of appreciation for the conversation and acknowledgment of the importance of continued dialogue.

Andrea Greco, senior vice president of health care safety at CENTEGIX, joins the podcast to discuss keeping practices safe and how failing to do so can impact patient care.

For more, be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know.

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Workplace Violence is Unacceptable (00:00:00)

Discussion on the unacceptability of workplace violence in healthcare settings.

Host Keith Reynolds introduces the episode's focus on workplace safety in healthcare.

Andrea Greco explains how workplace violence affects nurse satisfaction and patient care.

Discussion on the importance of workplace safety for retaining healthcare staff, especially younger workers.

Strategies for fostering a culture of safety and well-being in healthcare organizations.

Importance of situational awareness and tools for employees to report incidents.

Exploration of barriers preventing effective incident reporting in healthcare settings.

Steps for primary care practices to enhance visitor management and reduce safety risks.

Key priorities for healthcare leaders to ensure a safe workplace moving forward.

Emphasis on putting caregivers first and maintaining a supportive environment.

Yashaswini Singh, PhD, MPH, a health care economist and assistant professor at Brown University's School of Public Health, joins the show to discuss her recent research article, "Growth of Private Equity and Hospital Consolidation in Primary Care and Price Implications," published in JAMA Health Forum.

For more, be sure to check out Medical Economics Pulse, a quick-hitting news podcast that keeps busy physicians in the know. 

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Discussion on significant pressures faced by independent primary care practices in the U.S.

Austin Littrell introduces the episode and the speakers, including guest Yashaswini Singh, PhD, MPH.

Dr. Singh discusses consolidation trends in primary care involving hospitals and private equity.

Insights on how U.S. healthcare markets struggle due to inadequate competition and increasing consolidation.

Discussion on the substantial investment by private equity firms in various healthcare settings.

Overview of the research objectives and methodology used to analyze primary care employment trends.

Key findings reveal a significant increase in hospital-affiliated primary care physicians from 2009 to 2022.

Analysis of how physician employment trends affect healthcare costs and patient pricing.

Discussion on factors contributing to price differences between hospital-affiliated and independent practices.

Examination of geographic variations in hospital and private equity affiliations among primary care physicians.

Insights into the timeline and focus shifts of private equity investment in physician practices.

Discussion on the need for further research on consolidation impacts and private equity exit strategies.

Advice for primary care physicians on navigating the changing landscape of healthcare consolidation.

Recognition of additional evolving models in primary care beyond hospital and private equity affiliations.