Off the Chart

Three counseling codes took effect Jan. 1 for vaccine visits that end without a shot. CMS will not pay for them and neither will most private payers.

Insurers pledged six fixes to prior authorization in June 2025. A year later, only 24% of physicians say denials are getting the specialty-matched review that was promised first.

Seventy-nine percent of independent practice leaders say technology is what keeps them independent. Only 64% trust the tools they already have. Veradigm's Aaron Ledbetter explains what sits inside that gap, and why a denied claim still takes one to two weeks to reach the physician it belongs to.

Jay Bregman of Andel says direct-to-employer purchasing takes prior authorization out of the prescription entirely, but the price a patient gets is tied to an employer's willingness to keep paying.

Shawntea Gordon of Atlas & Perpetua Healthcare Consulting says the cost most practices cut first is usually the one that was never the problem.

Joanne Frederick of Government Market Strategies argues the fix for runaway health care costs turned out worse than the problem it solved.

Nearly half of health care organizations say patient access improved this year. Fewer than one in five patients agree. Experian Health's chief operating officer explains what practices are measuring that patients are not, and why a missing cost estimate now keeps patients out of the exam room entirely.

A pediatrician at the center of the country's largest cyclospora outbreak on why the official case counts are almost certainly too low, and what most labs aren't looking for.

Another conversion factor cut is on the table for 2027, and MGMA's Anders Gilberg breaks down why budget neutrality keeps forcing cuts in one specialty to pay for another and what the end of MIPS means for physicians.

Female physicians leave clinical practice at a median age of 49, compared with age 64 for their male colleagues, and the practice patterns patients value most may be part of what drives them out.

Most physicians know the direct primary care pitch; whether the economics hold up once you're in it is the more difficult question to answer.

A reimbursement gap of five to 12 times for the same procedure is letting hospitals outbid private practices for their own physicians. Three U.S. Women's Health Alliance advocates explain what it costs patients and what they are asking Congress to do about it.

Independent medical practices face a hard question as consolidation accelerates: keep going it alone, or find a partner. Ziegler's Andy Colbert breaks down what a practice is really worth and how physicians should weigh their options.

As more physicians weigh a move to concierge or hybrid practices, health care attorney Ericka Adler, J.D., breaks down the contract and Medicare traps that can turn a panel-shrinking strategy into a legal problem.

PYA's Tynan Kugler breaks down the four forces pulling physician pay in competing directions, and why getting the underlying compensation model wrong can be expensive and legally complicated to undo.

For the first time in years, physician pay and productivity have split, and a new Medicare efficiency adjustment is about to make 2026 a hard year to benchmark, schedule and recruit.

Two new federal programs are opening Medicare and Medicaid coverage for GLP-1 obesity drugs, and Tracy Zvenyach, Ph.D., M.S., RN, of the Obesity Action Coalition explains what it means for primary care physicians and their patients.

Clinical applications are climbing while hires lag behind, and Trent Cotton of iCIMS says the practices that win top talent are the ones that make hiring fast, personal and transparent.

A new federal rule makes it far less expensive for practices to challenge denied and reduced payments, but Anders Gilberg of MGMA says the more difficult problem is getting insurers to pay up after physicians win.

The highest offer is rarely the best deal. If you're waiting until you're ready to sell, you've waited too long.

Nearly 40% of Gen Z patients don't have a primary care physician, and Andrea Giamalva, M.D., FAAFP, says urgent care is quietly stepping in to fill the gap.

John Cianca, M.D., FAAPMR, left institutional medicine 22 years ago to build a cash-only solo practice. He says the care he delivers is better for it.

Why medical groups miss budget for reasons that have nothing to do with money, and how finance professionals become strategic advisers.

Two Physicians Foundation experts discuss why where a patient lives may shape their health more than the care they receive and what physicians can actually do about it.

Panacea Financial's 2026 survey found that physician financial confidence barely budges across an entire career. The reasons why go deeper than income.

Carlos Cardenas, M.D., explains why a CMS request for information may signal the most significant opening for physician-owned hospitals since the Affordable Care Act slammed the door 15 years ago.

Pediatric neurosurgeon and author Leon Moores, M.D., makes the case that every physician is already a leader and shares what it takes to guide a team through uncertain times.

Prosper Beyond VBC's Doral Jacobsen on why most practices lose negotiations before they even get in the room, and what to do differently.

Lumeris CMO David Carmouche, M.D., makes the case that AI's biggest opportunity in primary care isn't replacing physicians, it's giving them back the time and cognitive space to actually practice medicine.

Skillsoft's Asha Palmer, J.D., explains why banning artificial intelligence (AI) doesn't stop your staff from using it — and what a practical governance plan actually looks like for smaller practices.