Gary Price, M.D., MBA, joins Medical Economics senior editor Richard Payerchin to discuss The Physicians Foundation’s latest initiatives, including open grants addressing social drivers of health and physician well-being. Price reflects on the legacy of Richard “Buz” Cooper, M.D.’s research linking poverty and health care costs, highlights examples of community-driven solutions and explains how food insecurity and local conditions shape patient outcomes.

The conversation also delves into new survey findings on medical misinformation and disinformation, why rural doctors see it as a bigger challenge and how physicians must evolve their communication strategies to meet patients where they get their information.

The Physician Foundation's survey: "The Effect of Misinformation and Disinformation on Physicians’ Ability to Provide Quality Care"

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Anders Gilberg, senior vice president of government affairs at the Medical Group Management Association (MGMA), joins the show with updates from Washington on the most important topics affecting medical groups and health care policy.

Speaking with Keith A. Reynolds, editor of Physicians Practice, Gilberg talks about the impact of recent health care legislation on Medicaid and Medicare payments, the administrative and financial challenges facing medical groups, upcoming policy deadlines (e.g., telehealth, ACA subsidy expirations) and MGMA's ongoing advocacy efforts to support physicians and improve health care policy.

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Introduction and Episode Overview (00:00:13) Host introduces the episode, guests and main topics: healthcare legislation, Medicaid/Medicare payments, administrative challenges and upcoming conference.

Introducing the "One Big Beautiful Bill Act" (00:01:34) Explanation of the bill’s name and focus on healthcare provisions relevant to medical groups.

Medicaid Cuts and Implementation Timeline (00:02:11) Discussion of predicted Medicaid cuts, administrative issues and the delayed implementation until 2027-2028.

Medicare Payment Adjustments and Ongoing Advocacy (00:04:37) Covers Medicare reimbursement increase, unaddressed 2025 cut and the need for a permanent solution.

Administrative Workload and Revenue Cycle Management (00:05:40) Addresses administrative challenges, eligibility verification and the impact of ACA subsidy expiration.

Legislative Productivity and Administrative Simplification (00:07:18) Talks about Congress’s productivity, legislative process and prospects for administrative simplification bills.

Prior Authorization Reform and Medicare Advantage (00:08:18) Focus on prior authorization issues in Medicare Advantage and the need for legislative reform.

Physician Fee Schedule Changes (00:09:38) Explains major changes in the physician fee schedule, including specialty vs. primary care payment shifts.

Impact of Fee Schedule on Specialties (00:10:54) Details how the new methodology may affect different specialties, especially non-primary care practices.

Promoting Patient Care Online (00:13:28) Brief mention of Patient Care Online as a clinical resource for primary care physicians.

Technology, EHR and Interoperability Initiatives (00:14:00) Discussion of AI in healthcare, interoperability and voluntary pledges for IT standardization.

Government Data and Physician Payment (00:16:21) Explores the potential impact of politicized economic data on physician payment calculations.

P2 Management Minute: Morale Boosters (00:18:25) Segment on practical tips for boosting staff morale and emotional intelligence in medical practices.

Upcoming Policy Deadlines: Telehealth and Rural Payment Parity (00:19:40) Overview of key policy issues expiring at end of September: telehealth flexibilities and rural payment parity.

Affordable Care Act Subsidies and Political Implications (00:22:32) Discusses the expiration of ACA subsidies, potential premium increases and political ramifications.

MGMA Leadership Conference Preview (00:24:44) Preview of the upcoming MGMA Leadership Conference, its content and networking opportunities.

Episode Wrap-Up and Closing Remarks (00:26:40) Host thanks guests and listeners, promotes newsletter and closes the episode.

Lucienne Marie Ide, M.D., Ph.D., founder and CEO of Rimidi, joins the show to discuss the proposed 2026 Medicare Physician Fee Schedule and its impact on remote patient monitoring (RPM) programs.

Ide shares insights on new billing codes, increased flexibility for physicians, the role of artificial intelligence (AI) and the evolving integration of RPM into standard health care practice.

Read her full analysis of changes coming to RPM in the proposed 2026 Medicare Physician Fee Schedule: "Big Changes Outlined for Remote Patient Monitoring in the Proposed 2026 Physician Fee Schedule."

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Introduction to the Episode (00:00:00) Dr. Ide hopes RPM becomes a standard part of health care, not just an innovative modality.

Podcast Introduction and Overview (00:00:25) Host Austin Littrell introduces the episode, guests, and the focus on RPM and Medicare fee schedule changes.

Guest Introduction (00:01:19) Richard Payerchin introduces Dr. Lucienne Ide and Rimidi's focus on RPM and chronic condition management.

State of Remote Patient Monitoring (00:02:05) Dr. Ide discusses the maturity and mainstream adoption of RPM in the US health care system.

Defining RPM and RTM (00:02:22) Clarification of remote physiologic monitoring vs. remote therapeutic monitoring and their respective focuses.

Current and Proposed RPM Billing Codes (00:03:19) Explanation of code 99454, current requirements, and proposed changes for more flexible billing.

Proposed Time-Based Codes for RPM (00:04:58) Discussion of new codes allowing billing in 10-minute increments, increasing flexibility for practices.

Importance of Flexibility in RPM (00:05:59) How new codes allow for clinical judgment and tailored interventions for different patient needs.

Financial Sustainability and Physician Appeal (00:07:42) How added flexibility reduces financial risk and may encourage more physicians to adopt RPM.

Physician Reimbursement Rates for RPM (00:09:35) CMS plans to hold RPM reimbursement rates steady for 2026, with possible overall rate increases.

Documentation and Audits in RPM (00:11:23) Importance of documentation for demonstrating patient benefit, compliance, and supporting continued reimbursement.

Addressing Fraud, Waste, and Abuse (00:13:12) Welcoming scrutiny to ensure appropriate use of RPM and prevent bad actors from exploiting the system.

Evidence and Research on RPM Outcomes (00:14:10) Discussion of accumulating evidence for RPM’s benefits and the need for more granular data on patient subgroups.

AI and the Future of RPM (00:15:28) Potential for AI to improve efficiency in RPM, and implications for physician compensation and CPT codes.

Wearables and Consumer Health Devices (00:17:52) Exploring the overlap between consumer wearables and formal RPM, and current limitations in mainstream medicine.

Cybersecurity and Data Privacy in RPM (00:20:34) Growing importance of cybersecurity as RPM integrates with EHRs and the need for high standards in data protection.

Industry Response to Proposed RPM Changes (00:22:31) Little protest to proposed RPM code changes; focus on reimbursement rates and public comment period.

Advice for Primary Care Physicians (00:24:13) Encouragement for physicians to view RPM as standard care, benefiting both patients and practice finances.

Patient Response and Selection for RPM (00:25:35) Importance of patient selection, communication of benefits, and addressing copay concerns for successful RPM adoption.

Episode Conclusion (00:27:33) Closing remarks, appreciation for the conversation, and episode wrap-up.

Podcast Outro and Subscription Information (00:28:00) Host thanks listeners, provides subscription info, and credits the production team.

Marschall Runge, M.D., Ph.D., dean of the University of Michigan Medical School, CEO of Michigan Medicine and author of The Great Healthcare Disruption, joins the show to dissect exactly what's broken in U.S. health care — and what we can do to fix it.

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Introduction and Overview (00:00:00) Dr. Runge and the hosts introduce the episode’s focus: challenges and dysfunctions in the U.S. health care system.

What’s Broken in U.S. Health care? (00:01:20) Discussion of patient frustrations: appointment delays, rising drug prices, insurance confusion and system complexity.

Retailers in Health care: Why Didn’t It Work? (00:02:22) Exploring why Walmart, Amazon and others struggled to deliver primary care and the issue of fragmented medical records.

Primary Care Challenges (00:06:08) Examining the importance of primary care, low physician numbers, burnout and why fewer medical students choose this path.

Practice Management Tip: Patient Care Online (00:09:30) Brief segment promoting Patient Care Online as a resource for clinical information.

AI in Medicine: Promise and Limitations (00:09:49) How AI is being used for note-taking, scheduling and efficiency; its current benefits and limitations in health care.

Health care Equity and Access (00:14:06) Concerns about technology access disparities between urban and rural/low-income areas; discussion of universal health care models.

History and Impact of HMOs and Capitation (00:17:31) Reflection on HMOs, capitation, and their effects on primary care and health care delivery in the U.S.

U.S. Health Outcomes and Prevention (00:19:07) U.S. ranking in healthy life expectancy, rising chronic diseases and the need for better prevention and health management.

Practice Management Minute: Staffing Metrics (00:19:55) Tips for medical practices on when to add staff, based on wait times, overtime and labor costs.

Health care Innovation and Drug Development (00:21:04) U.S. leadership in medical innovation, new weight loss and genetic therapies and the challenge of high drug costs.

Healthy Aging and Lifestyle Factors (00:24:16) Key lifestyle factors for healthy aging: sleep, fitness, community and policy approaches to promote healthy choices.

Misinformation in Medicine (00:26:43) Concerns about health misinformation on social media and the need for better health education in schools.

Conclusion and Farewell (00:28:46) Closing remarks, thanks to the guest and information on subscribing to the podcast.

Brad Boyd, principal of management consulting at BDO USA, joins the show to talk about how artificial intelligence (AI) and other health technologies are helping physicians navigate the prior authorization process, reduce administrative burdens and improve patient care.

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Introduction to the Episode (00:00:21) Overview of the podcast, episode focus on prior authorizations, and introduction of guest Brad Boyd.

Biggest Pain Points in Prior Authorization (00:01:36) Discussion of administrative burdens, labor shortages, increased denials, and financial pressures on providers.

AI’s Immediate Impact on Prior Authorization (00:04:47) How automation and AI can reduce administrative workload and free up clinical staff.

Rules-Based vs. Generative AI (00:06:26) Differences between rules-based automation and generative AI in revenue cycle management.

Data Requirements for AI Solutions (00:09:26) Discussion on the need for organized, governed data for effective AI implementation.

Provider vs. Payer AI Systems (00:10:54) Exploration of incentives, trust issues, and the divide between provider and payer AI tools.

AI “Battles” and Denial Increases (00:13:23) Concerns about AI systems on both sides increasing denials and administrative gamesmanship.

Integrating AI into EHR Workflow (00:16:14) Importance of embedding AI tools into existing clinical and administrative workflows.

AI Access for Small and Rural Practices (00:19:46) Challenges and opportunities for smaller practices to adopt AI, including reliance on vendors and clinical alignment.

Management Minute: Employee Red Flags (00:21:56) Three red flag behaviors that signal it’s time to let an employee go in a medical practice.

Are We at a Tipping Point? (00:23:09) Discussion on regulatory attention, public uproar, and whether technology can finally solve prior auth issues.

Ethics of AI in Prior Authorization (00:25:40) Ethical concerns, data protection, and responsible use of AI in healthcare.

How to Start Streamlining Prior Auth with AI (00:28:01) Advice on developing a strategy, prioritizing use cases, and building sustainable AI programs.

Final Thoughts and Emphasis on Strategy (00:32:38) Importance of a thoughtful, long-term strategy for AI adoption in healthcare revenue cycle management.

Episode Wrap-Up (00:34:09) Closing remarks, subscription reminders, and production credits.

60 years ago today, on July 30, 1965, President Lyndon B. Johnson signed the Medicare and Medicaid Act — also known as the Social Security Amendments of 1965 — into law at the Truman Library in Independence, Missouri.

Years earlier, in 1945, it was President Harry S. Truman who first proposed a comprehensive national health insurance program to Congress. During the ceremony in 1965, President Johnson called Truman "the real daddy of Medicare," presenting the former President and the former first lady, Bess Truman, with the first and second Medicare cards.

Today, 60 years later, more than 66 million Americans are dependent on Medicare.

In this episode, Medical Economics Senior Editor Richard Payerchin is joined by Clifton Truman Daniel, President Truman's eldest grandson, and Mark Adams, the director of the Truman Library.

They reflect on Medicare’s legacy, Truman’s push for universal care and what his ideas still mean for health policy today.

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Introduction and Historical Context (00:00:00) Overview of Medicare’s 60th anniversary, President Truman’s early advocacy, and introduction of guests.

Guest Introductions (00:01:17) Clifton Truman Daniel and Mark Adams introduce themselves and share their backgrounds.

Medicare’s Historic Connection to Truman (00:03:47) Discussion of why LBJ signed Medicare at the Truman Library and the Truman-Johnson relationship.

Personal Anecdotes: Truman and Johnson Families (00:07:03) Stories about the friendship between the Truman and Johnson families, including the portrait incident.

Truman’s Vision for Health Care (00:08:51) Truman’s 1945 message to Congress and why health care was central to his Fair Deal agenda.

Physician Leadership and Opposition (00:11:47) Truman’s views on physician leadership, AMA opposition, and his preference for decentralized health care.

Supporters and Opponents of Truman’s Health Initiatives (00:13:12) Who supported and opposed Truman’s health care proposals, including labor unions and conservative groups.

Historical Context: 1945–1965 (00:15:51) Social and political developments that led to Medicare and Medicaid, including the Great Society.

Truman’s Post-Presidency Involvement (00:17:10) Truman’s continued interest in national affairs and his relationships with later presidents.

Recurring Health Care Challenges (00:19:50) Discussion of persistent health care issues from Truman’s era to today and his likely reaction.

Decentralization in Health Care (00:23:28) Truman’s emphasis on state and local involvement in health care delivery.

Impact on Life Expectancy (00:25:51) Improvements in American life expectancy since Medicare’s passage and Truman’s likely response.

Personal Health and Family Legacy (00:27:24) Truman family health stories and the importance of health in their lives.

Closing Remarks and Podcast Outro (00:30:42) Thanking guests, encouraging subscriptions, and podcast credits.

Bobby Mukkamala, M.D., president of the American Medical Association (AMA) joins the show to talk about what the AMA is doing for pressing issues like prior authorizations, private practice, artificial intelligence and scope of practice.

This is part two of our conversation with Mukkamala. If you haven't already, be sure to check out part one, "From patient to president, with AMA President Bobby Mukkamala, M.D.," to hear about his personal health journey, in addition to the AMA’s stance on primary care, health policy and physician reimbursement.

The episode is out now, available below, or wherever you listen to your podcasts:

Medical Economics: https://www.medicaleconomics.com/view/ep-74-from-patient-to-president-with-ama-president-bobby-mukkamala-m-d-part-1-

Physicians Practice: https://www.physicianspractice.com/view/ep-74-from-patient-to-president-with-ama-president-bobby-mukkamala-m-d-part-1-

Apple Podcasts: https://podcasts.apple.com/us/podcast/from-patient-to-president-with-ama-president-bobby/id1522950336?i=1000718285185

Spotify: https://open.spotify.com/episode/6iM1U2tMLUAygnAKe1zlzY

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Introduction and Episode Context (00:00:00) Overview of the episode, speakers and recap of part one; sets up topics for this episode.

Prior Authorization Challenges and AMA Reform Efforts (00:01:15) Discussion of the frustrations with prior authorization, real-world examples and AMA's advocacy for reform.

Decline of Private Practice and Physician Autonomy (00:06:38) Explores the shift from private practice to employment, threats to autonomy and AMA's support for independent physicians.

Promoting Private Practice to Medical Students (00:08:39) Encouraging medical students to consider private practice and the importance of independence in medicine.

Clinical Resource Plug: Patient Care Online (00:10:02) Brief mention of Patient Care Online as a resource for primary care physicians.

Artificial Intelligence in Medicine: Promise and Pitfalls (00:10:14) Examines AI's potential in healthcare, concerns about implementation and AMA's approach to augmented intelligence.

P2 Management Minute: Reducing Malpractice Risk (00:13:44) Tips for physicians on reducing malpractice risk through communication, documentation and patient relationships.

Scope of Practice and Team-Based Care (00:14:48) Concerns about non-physician providers, importance of physician-led teams and maintaining care quality.

Closing Thoughts and Call for Unity (00:18:49) Dr. Mukkamala's message to physicians about working together to improve health care and the AMA's role.

Outro and Subscription Information (00:20:03) Wrap-up, how to find part one and information on subscribing to the podcast and newsletters.

Bobby Mukkamala, M.D., president of the American Medical Association (AMA) joins the show to discuss the AMA's mission in the year ahead, health care policy, challenges facing primary care and his personal health journey.

This is part one of a two-part interview with Mukkamala. Don't miss part two — where he talks about reimbursement struggles, prior authorization frustrations, the potential of artificial intelligence (AI) in medicine and physician autonomy — available next Monday, July 28, right here and wherever you get your podcasts.

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Introduction and Overview (00:00:00) Dr. Mukkamala discusses advocacy for patients and physicians, setting the tone for the episode.

Podcast Introduction and Guest Background (00:00:22) Host Austin Littrell introduces the episode, guests and main topics to be discussed.

Dr. Mukkamala Personal and Professional Background (00:01:27) Dr. Mukkamala shares his medical background, family, and practice history in Flint, Michigan.

AMA’s Mission and Dr. Mukkamala's Goals (00:02:14) Discussion of the AMA’s mission, current challenges in medicine and Dr. Mukkamala's presidential goals.

Dr. Mukkamala's Experience as a Patient (00:03:42) He recounts his brain tumor diagnosis and how being a patient changed his perspective on health care.

Challenges in Primary Care (00:06:01) Exploration of the burdens facing primary care physicians, including regulations, burnout and workforce shortages.

Primary Care and Systemic Barriers (00:06:48) Further discussion on prior authorizations, insurance hurdles, and the impact on patient care and physician burnout.

Healthcare Becoming Transactional (00:09:21) Concerns about the loss of physician-patient relationships and the impact of insurance compensation models.

Policy, Politics and the AMA’s Role (00:11:19) Discussion of major policy changes in 2025, federal agency restructuring and the AMA’s advocacy approach.

Impact of Policy on Medical Research and Practice (00:13:13) How changes in funding and policy affect medical research, innovation and Dr. Mukkamala's personal treatment.

Medicare Reimbursement Challenges (00:16:21) Examination of stagnant Medicare reimbursement, its ripple effects and the AMA’s advocacy for payment reform.

Health Equity and Outcomes (00:20:31) Addressing health equity gaps, local disparities in Flint and the AMA’s efforts to raise awareness and drive change.

Episode Conclusion and Next Steps (00:23:52) Host wraps up, previews part two and provides subscription information for listeners.

Richard H. Hughes IV, J.D., M.P.H., joins the show to talk about the recent lawsuit filed against Health and Human Services Secretary Robert F. Kennedy, Jr., by major medical groups — including the American Academy of Pediatrics, the American College of Physicians, the Society for Maternal-Fetal Medicine and a "Jane Doe" pregnant physician — regarding the removal of the COVID-19 vaccination for pregnant women and healthy children from the immunization schedules of the U.S. Centers for Disease Control and Prevention (CDC).

Hughes is a health care attorney representing the plaintiffs in the lawsuit. He also serves as voting director for the nonprofit vaccine advocacy organization, Vaccinate Your Family.

For more information on the lawsuit, check out this Medical Economics article:

'Existential threat to vaccination' — Physicians, public health experts sue HHS over RFK Jr's COVID-19 vaccine directive

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Introduction to the Lawsuit (00:00:00) Overview of the lawsuit challenging HHS Secretary’s actions undermining vaccine access and confidence.

Podcast and Guest Introduction (00:00:24) Host introduces the podcast, episode topic, and guest Richard H. Hughes.

Background of the Lawsuit and Plaintiffs (00:01:31) Details on the lawsuit’s plaintiffs and the specific HHS action being challenged.

Significance of Vaccine Recommendations (00:03:32) Discussion on the importance of official vaccine recommendations in clinical practice and policy.

Impact on Public Health and Clinical Practice (00:05:24) How the directive affects providers, patients, and vaccine access, especially for pregnant women and children.

Scientific Basis of the Directive (00:06:27) Questioning whether the HHS directive was based on established scientific evidence and proper procedures.

ACIP Deliberations and Future Vaccine Targets (00:07:55) Discussion of ACIP’s recent actions and potential future changes to the immunization schedule.

Role of Medical Organizations and Need for Legal Action (00:09:30) Why legal action is necessary despite strong medical society recommendations.

Continuation of Medical Recommendations (00:11:00) Assurance that medical organizations will continue to make vaccine recommendations.

Legal Process and Next Steps (00:11:31) Explanation of the legal process, upcoming hearings, and expected timeline for a court decision.

Potential Impact on Upcoming Flu Season (00:12:15) Whether court action can occur in time to affect the upcoming respiratory and flu season.

Message to Primary Care Physicians (00:12:54) Encouragement for physicians to rely on professional guidelines and address vaccine misinformation.

Closing Remarks and Farewell (00:13:35) Conclusion of the interview and expressions of appreciation.

Podcast Outro and Subscription Information (00:14:10) Host wraps up the episode, provides subscription and newsletter information.

Susan Dentzer, president and CEO of America's Physician Groups, joins the show to talk Medicare reform and the specific proposals included in America's Physician Group's latest report, "Medicare Done Right."

Download the full report: https://www.apg.org/wp-content/uploads/2025/04/Medicare-Done-Right-Final-4.1.25.pdf

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Introduction and Episode Overview (00:00:00) Austin introduces the episode, guest Susan Dentzer, and the focus on Medicare reform and accountability.

Biggest Issue with Medicare and Key Fix (00:01:18) Susan discusses the main problem with Medicare and the report’s top recommendation: increasing accountability in both Medicare arms.

Accountable Relationships in Practice (00:02:25) Explains what it means for every beneficiary to have an accountable relationship with a healthcare professional, especially for small practices.

Importance of Care Coordination and Outcomes (00:03:47) Highlights the value of primary care teams, care coordination, and minimizing unnecessary hospital use for better outcomes.

Problems with MIPS and MACRA (00:04:16) Critique of the current MIPS/MACRA system, why it hasn’t worked, and the need for system-level reforms.

Restoring and Expanding Incentives (00:06:24) Calls for restoring and expanding advanced alternative payment model bonuses to better reward clinicians in accountable models.

Challenges for Small and Independent Practices (00:07:28) Addresses the risks and complexities of two-sided ACOs for small practices and suggests partnership solutions.

How At-Risk MA Arrangements Save Money (00:10:04) Explains how Medicare Advantage at-risk models achieve better outcomes and could save $22 billion if replicated in traditional Medicare.

Improving Medicare Advantage: Prior Authorization and Star Ratings (00:14:00) Discusses the popularity of MA, issues with prior authorization and star ratings, and visions for improvement.

Dental, Vision, and Hearing Coverage in Accountable Models (00:17:10) Proposal to offer extra benefits to traditional Medicare patients who join accountable care models and how it could work.

Top Medicare Policy Change for 2025 (00:20:51) Susan’s pick for the most impactful policy change: updating the Medicare physician fee schedule to reflect practice cost inflation.

Clarifying Medicare Advantage Misconceptions (00:23:31) Emphasizes the diversity within MA, the benefits of delegated risk models, and the importance of understanding risk adjustment.

Conclusion and Report Access (00:26:37) Wrap-up, thanks to Susan, and information on where to find the full report and subscribe to the podcast.