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Health Affairs This Week

Health Affairs·273 episodes

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Health Affairs This Week places listeners at the center of health policy’s proverbial water cooler. Join host Jeff Byers, editors from Health Affairs Publishing, and guests as they discuss health policy’s most pressing news and trends.

Episodes

14 min
Jul 15, 2026Episode 126
BEST OF: CMS's 10-Year Value-Based Primary Care Experiment

Health Affairs This Week is on vacation in July. We will return with new episodes in August 2026. This episode originally aired on June 23, 2023. Health Affairs' Marianne Amoss and Michael Gerber break down CMS's new primary care model, the Making Care Primary (MCP) Model.Check out the first issue of Health Affairs Scholar.Related Links:The Changing Landscape of Primary Care: Effects of the ACA and Other Efforts Over the Past Decade (Health Affairs Forefront)Making Care Primary Model Summary (Centers for Medicare & Medicaid Services)CMS Launches New Pilot Program to Test Out Value-Based Primary Care in 8 States (FierceHealthcare)

19 min
Jul 8, 2026Episode 236
BEST OF: Is Value-Based Payment Failing U.S. Healthcare? | Andrew Ryan

This episode originally aired on February 27, 2026.Health Affairs’ Jeff Byers welcomes Brown University's Andrew Ryan to the pod to discuss his recent Forefront article that explores whether value-based payment and managed care can lead to addressing the core drivers of spending.Related Links:Value-Based Payment And Managed Care Will Not Solve The Affordability Crisis (Health Affairs Forefront)“All I Do Is Win”: Why Beating Benchmarks Doesn’t Mean That ACOs Are Reducing Costs (Health Affairs Forefront)

20 min
Jun 26, 2026Episode 253
Why Healthcare Costs Are Rising in America: The $9 Trillion Outlook for 2025 and Beyond

Health Affairs Publishing’s Jeff Byers welcomes Michael Chernew, professor at Harvard Medical School, back to the pod to discuss the recently released National Health Expenditures Projections for 2025–34 from the Office of the Actuary (OACT) at the Centers for Medicare and Medicaid Services (CMS). Related Links:National Health Expenditure Projections, 2025–34: Strong Utilization Growth Initially, Legislative Impacts Later (Health Affairs)The NHE Projections Through 2034: Growth Assumptions, Policy Consequences (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

19 min
Jun 12, 2026Episode 252
Medicaid Work Requirements: Who’s Affected and What’s at Stake

Health Affairs Publishing’s Jeff Byers welcomes Alison Barkoff of George Washington University to the pod to explore the evolving landscape of Medicaid work requirements. They break down who is impacted by these policies, how the requirements are structured across states, and the real-world challenges of implementation. The conversation also explores concerns about administrative burden, potential coverage losses, and what these changes mean for beneficiaries, policymakers, and providers.Topics covered:What Medicaid work requirements are and how they workWho qualifies—and who may lose coverageState-level variations and policy designAdministrative complexity and compliance challengesPotential impacts on access to care and health outcomesJoin us on June 23 for an exclusive Insider virtual event examining how antitrust policy in health care is evolving at both the federal and state levels, featuring insights from Katherine Gudiksen, Leemore Dafny, and Nathan Hostert.Related Links:Medical Frailty Rule Contravenes HR 1, Burdens The Health Care System, And Threatens Public Health (Health Affairs Forefront)States balk at the high price of Medicaid work requirements amid budget crunch (POLITICO PRO)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

17 min
Jun 5, 2026Episode 251
Will the Rural Health Transformation Fund Deliver?

Health Affairs Publishing’s Jeff Byers welcomes Sarah Jane Tribble of KFF Health News to the pod to discuss the Rural Health Transformation Fund, highlighting how it aims to improve infrastructure and access in rural communities amid ongoing challenges like hospital closures, workforce shortages, and Medicaid cuts. To learn more about the Rural Health Transformation Fund, join us on June 8 for a free event featuring Kate Sapra and Katherine Ornstein highlighting state initiatives focusing on improving care for older adults.Join us on June 23 for an exclusive Insider virtual event examining how antitrust policy in health care is evolving at both the federal and state levels, featuring insights from Katherine Gudiksen, Leemore Dafny, and Nathan Hostert.Related Links:Rural Health Payout Series (KFF Health News)Rural America at a Glance (U.S. Department of Agriculture)Federal Budget Cuts Won’t Hit All Hospitals Equally: How States Can Better Analyze Hospital And Health System Financial Data (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

25 min
Jun 3, 2026
Inside CVS Caremark: The Role of PBMs in Drug Costs & Access | SPONSORED

THIS SPONSORED PODCAST EPISODE IS BROUGHT TO YOU BY CVS HEALTH.In this sponsored episode, James Margiotta, Chief Growth Officer at CVS Caremark, joins Health Affairs Publishing's Jessica Bylander to unpack the role of pharmacy benefit managers (PBMs), their impact on prescription drug costs, and the value PBMs bring to the health care system.James has nearly 35 years of experience driving innovation, operational excellence, and enterprise value across the healthcare system. In his current role, James leads the team responsible for partnering with clients to identify their unique needs and bringing forward strategic solutions to meet their objectives.Throughout his career at CVS Health, James has scaled businesses across CVS Caremark, CVS Accountable Care, Minute Clinic, Aetna, and CVS Pharmacy — each with its own challenges, cultures, and market dynamics.James and Jessica's conversation explores how PBMs help employers, health plans, governments, and unions manage rising prescription drug costs while balancing affordability, transparency, and member experience. James explains CVS Caremark’s approach to controlling costs, dives into the growing demands for price transparency, and how artificial intelligence may transform pharmacy benefits and member navigation services.

16 min
May 29, 2026Episode 250
Will the Medicare ACCESS Model Spark the Next Health Tech Gold Rush?

Health Affairs Publishing’s Jeff Byers welcomes Andrew Rundle of the Columbia University Mailman School of Public Health to the pod to discuss his recent Forefront article about Medicare’s upcoming ACCESS model and its potential to expand digital health for chronic disease management. They discuss why the program could spur rapid growth in health tech while highlighting key challenges, including serving an older population with varying degrees of digital literacy and adapting to a new, evidence-driven marketplace. Related Links:The ACCESS Model May Set Off A Health Tech Gold Rush, But New Markets Bring Serious Obstacles (Health Affairs Forefront)A deeper dive into the ACCESS Model—Who’s participating, potential headwinds and how it could spur health plan adoption (Fierce Healthcare)ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) Model (CMS)ACCESS Model Accepted Applicants (CMS)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

23 min
May 27, 2026
Policy Changes Reshaping Family Caregiving

Welcome to a new, limited podcast series exploring major policy changes affecting older adults. This episode is part of our Age-Friendly Health series, which explores topics at the intersection of aging, health, health care, and health policy.In our third and final episode for the series in 2026, host Katherine Ornstein welcomes Alison Barkoff of George Washington University to the program to discuss the rising economic and social importance of family caregiving, recent federal policy shifts affecting Medicaid and caregiver programs, and new interventions at the state and private‑sector levels.Support for the Age-Friendly Health series is provided by The John A. Hartford Foundation.Related Links:Reflections On Caregiving Policy: Progress, Challenges, And Opportunities (Health Affairs Forefront)History Repeats? Faced With Medicaid Cuts, States Reduced Support For Older Adults And Disabled People (Health Affairs Forefront)Long Term Services and Supports InitiativeNational Strategy to Support Family CaregiversNation Alliance for Caregiving's Caregiver Nation Coalition

20 min
May 22, 2026Episode 249
Why Teens Are Turning to AI for Mental Health | Caroline Figueroa

Trigger Warning: This episode includes discussion of youth mental health challenges, including suicide and self-harm. Listener discretion is advised.Health Affairs Publishing’s Kathleen Haddad welcomes Caroline Figueroa of Stanford University to the pod to discuss how teens are using AI chatbots for mental health support and the factors driving that use, including access and stigma. It also discusses emerging concerns and potential approaches to improving safety, design, and oversight of these tools. Join us on June 23 for an exclusive Insider virtual event examining how antitrust policy in health care is evolving at both the federal and state levels, featuring insights from Katherine Gudiksen, Leemore Dafny, and Nathan Hostert.Also, learn more about the upcoming AcademyHealth 2026 Annual Research Meeting from May 30 to June 2 featuring Caroline Figueroa as part of the panel, A Responsible Approach to AI Innovation to Support the Mental Health of Young People.Related Links:Responsible AI for Youth Mental Health (Hopelab)Talk, Trust, and Trade-Offs: How and Why Teens Use AI Companions (common sense media)One in Eight Adolescents and Young Adults Use AI Chatbots for Mental Health Advice (RAND)Towards responsible AI for adolescent mental health and well-being2026 CHATBOT LEGISLATION TRACKERSign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

30 min
May 20, 2026
How the Healthcare Workforce Is Responding to New Aging Policies | Age-Friendly Health Series

Welcome to a new, limited podcast series exploring major policy changes affecting older adults. This episode is part of our Age-Friendly Health series, which explores topics at the intersection of aging, health, health care, and health policy.In our second episode, host Katherine Ornstein welcomes Bianca Frogner, director of the Center for Health Workforce Studies at the University of Washington to discuss the role of direct care workers in long‑term care, workforce shortages, policy shifts affecting Medicaid, immigration, labor standards, and more.Support for the Age-Friendly Health series is provided by The John A. Hartford Foundation.

18 min
May 15, 2026Episode 248
Abortion Access In The High Court, Again | Katie Keith

Health Affairs Publishing’s Jeff Byers welcomes Georgetown University’s Katie Keith and Deputy Editor Chris Fleming back to the podcast to unpack a new court case over mifepristone that could alter telehealth access to medication abortion and test the boundaries of FDA authority.Join us on June 23 for an exclusive Insider virtual event examining how antitrust policy in health care is evolving at both the federal and state levels, featuring insights from Katherine Gudiksen, Leemore Dafny, and Nathan Hostert.Related Links:Supreme Court Temporarily Blocks Ruling Barring Telehealth And Pharmacy Access To Mifepristone (Health Affairs Forefront)The US Food and Drug Administration’s Regulation of Mifepristone (JAMA)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

34 min
May 13, 2026
How the One Big Beautiful Bill Changes Medicaid for Older Adults and State Health Policy

Welcome to the first episode in a new, limited podcast series exploring major policy changes affecting older adults. The episode is part of our Age-Friendly Health series, which explores topics at the intersection of aging, health, health care, and health policy.In our first episode, host Katherine Ornstein welcomes Hemi Tewarson of the National Academy for State Health Policy how the The Big Beautiful Bill will impact Medicaid and state health policies affecting older adults. Their conversation explores work requirements, Medicaid financing changes, rural health investments, the sustainability of age‑friendly services, and more.Support for the Age-Friendly Health series is provided by The John A. Hartford Foundation.

21 min
May 8, 2026Episode 247
When Screening Guidelines Shift: Impacts on Healthcare Access & Use

Health Affairs Publishing's Jeff Byers welcomes Duke University School of Medicine's Mike Pignone to the pod to explore the new cholesterol screening guidelines, how evolving screening and treatment guidelines (including colon cancer and breast cancer screening guidelines) influence care, and the broader cost implications for the health system. Join Health Affairs Publishing on May 13 for an exclusive Insider virtual event exploring individual coverage health reimbursement arrangements (ICHRAs) with Urban Institute’s Jason Levitis.Related Articles:Generic cholesterol drugs save Medicare billions of dollars, study finds (UT Southwestern Medical Center)Trends in Utilization and Cost of Low-Density Lipoprotein Cholesterol–Lowering Therapies Among Medicare Beneficiaries (JAMA)A cholesterol test you've never heard of is now recommended to prevent heart disease (NPR)ACC/American Heart Association Issue Updated Guideline for Managing Lipids, Cholesterol (American Heart Association)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

14 min
May 1, 2026Episode 246
Healthcare Price Transparency 2.0: Proposed Federal Updates Explained

Health Affairs Publishing's Jeff Byers welcomes Stacey Pogue of Georgetown University’s McCourt School of Public Policy about her recent Forefront article examining proposed updates to health plan price transparency rules, focusing on efforts to improve data usability and the ongoing challenges in making healthcare costs more accessible and actionable.Join Health Affairs Publishing on May 13 for an exclusive Insider virtual event exploring individual coverage health reimbursement arrangements (ICHRAs) with Urban Institute’s Jason Levitis. Related Links:Taking Stock Of Proposed Updates To Health Plan Price Transparency Rules (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events.

12 min
Apr 24, 2026Episode 245
New Prior Authorization Proposals: Implications for Prescription Drug Access

Health Affairs Publishing's Jeff Byers welcomes Senior Editor Michael Gerber back to the pod to discuss recent federal action on prior authorization, including CMS’s proposal to expand response-time requirements to prescription drugs. The conversation also covers insurer efforts to reduce prior auth volume, the promise of AI and prior authorization, and what increased transparency could reveal about costs.To learn more, check out our recent Insider trend report on the current prior authorization landscape. And if you haven't already, join Insider today to get access to exclusive events, newsletters, cheat sheets, and reports.Related Links:CMS proposes new deadlines for prior authorizations for drugs (Healthcare Dive)2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule (CMS)A Rule by the Centers for Medicare & Medicaid Services on 02/08/2024 (Federal Register)Health Plans Reduce Prior Authorization, Support Continuity of Care and Enhanced Consumer Communications (Blue Cross Blue Shield)AI speeds up prior auth, coding while driving higher costs for health systems: PHTI report (Fierce Healthcare)Sign up for our free Health Affairs newsletters to stay up to date on health policy news and analysis.

11 min
Apr 17, 2026Episode 244
The FY 2027 HHS Budget Proposal: Changes, Cuts, and Investments

Health Affairs Publishing's Jeff Byers welcomes Deputy Editor Jessica Bylander back to the pod to explore the White House’s proposed FY 2027 HHS budget, outlining major cuts to health agencies and research programs and the emphasized investment on the Make America Healthy Again initiative.Related Links:Celebrating Big Wins of the Trump Administration (HHS)President’s Fiscal Year 2027 Budget Proposal Released (NAWDP)White House seeks 12% cut to HHS in 2027 (Healthcare Dive)Sign up for Health Affairs' free newsletters to stay up to date on health policy news and analysis.

15 min
Apr 10, 2026Episode 243
Health Policy Roundup: ACA Reform, MedPAC & Conversion Therapy in the Courts

Health Affairs Publishing's Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to discuss recent health policy developments, including a Supreme Court ruling on conversion therapy, renewed Democratic interest in Affordable Care Act reform, and key findings from MedPAC’s latest Medicare payment report.On April 20th, join us for our upcoming Insider exclusive event exploring the evolution of the Medicare Advantage market featuring Sachin Jain, David Meyers, and Grace Mackleby.Related Links:2027 Medicare Advantage Final Payment Rule: Key Changes Explained | David Meyers (Health Affairs This Week)Chiles v. Salazar (Conversion Therapy) (SCOTUSblog)Senate Democrats lay out plans to overhaul health insurance after setbacks under Trump (STAT)March 2026 Report to the Congress: Medicare Payment Policy

16 min
Apr 8, 2026Episode 242
2027 Medicare Advantage Final Payment Rule: Key Changes Explained | David Meyers

On an emergency pod episode, Health Affairs Publishing’s Jeff Byers welcomes Brown University's David Meyers to the pod to unpack the 2027 Medicare Advantage final payment rule, including the higher-than-anticipated rate increase, changes to risk adjustment models, what is V28, and the tradeoffs between market stability and long-term program sustainability. On April 20th, join us for our upcoming Insider exclusive event exploring the evolution of the Medicare Advantage market featuring Sachin Jain, David Meyers, and Grace Mackleby.Related Links:Assessing Recent Regulatory Action On Medicare Advantage (Health Affairs Forefront)

14 min
Apr 3, 2026Episode 241
Abandon High‑Deductible Health Plans Linked to Health Spending Accounts | Jeanne Lambrew

Health Affairs Publishing's Jeff Byers welcomes Jeanne Lambrew of The Century Foundation to discuss her recent Forefront article exploring whether high deductibles and health spending accounts achieve their intended goals and how alternative approaches could improve healthcare affordability and access. On April 20th, join us for our upcoming Insider exclusive event exploring the evolution of the Medicare Advantage market featuring Sachin Jain, David Meyers, and Grace Mackleby.Also, check out our newest trend report focusing on the current state of prior authorization.Become an Insider today.Related Articles:Abandon—Don’t Expand—High-Deductible Plans Linked To Spending Accounts (Health Affairs Forefront)

20 min
Mar 27, 2026Episode 240
Innovation, Consumers, and How We Get to Better Health Care | Halle Tecco

Health Affairs' Jeff Byers welcomes Halle Tecco, investor, founder of Rock Health and professor at Columbia Business School, to the pod to discuss her new book, Massively Better Healthcare: The Innovator's Guide to Tackling Healthcare's Biggest Challenges. Their conversation explores why consumers are becoming a powerful force in healthcare, how innovation happens within complex systems, and what it takes to align technology, evidence, and incentives to drive meaningful change.Related Links:Order Massively Better Healthcare: The Innovator's Guide to Tackling Healthcare's Biggest ChallengesCheck out Halle's podcast, The Heart of Healthcare Podcast

14 min
Mar 20, 2026Episode 238
Medicare Advantage Payment & Coding Fights Intensify

Health Affairs' Jeff Byers welcomes Ben Ippolito of the American Enterprise Institute to the pod to discuss the growing debate over Medicare Advantage (MA) payments and coding intensity. They break down why MA plans typically receive higher federal payments than traditional Medicare, how diagnostic upcoding factors into that gap, and what a new study in Health Affairs Scholar reveals about policy changes aimed at reducing inflated coding. On March 24th, join us for our upcoming Insider exclusive event focusing on pharmacy benefit manager reform with Harvard Medical School's Benjamin Rome.Related Articles:An updated analysis of coding pattern differences in Medicare Advantage (Health Affairs Scholar)The Trouble With MedPAC (Wall Street Journal)The Higher Price Tag on Medicare Advantage (Wall Street Journal)Aligning The MedPAC And CMS Estimates Of Coding Intensity: The Importance Of The Risk Model And Trend (Health Affairs Forefront)Medicare Advantage growth decelerates as insurers shed members for 2026 (Healthcare Dive)

13 min
Mar 13, 2026Episode 239
FDA & Rare Disease Drugs: Why Policy and Politics Are Heating Up

Health Affairs' Jeff Byers welcomes Deputy Editor Leslie Erdelack back to the pod to break down recent turbulence at the FDA following the departure of Vinay Prasad, whose decisions around rare‑disease gene therapies courted controversy. They explore the fast‑growing rare disease therapeutics market, why traditional clinical trials often don’t work for ultra‑rare genetic conditions, and the new FDA draft guidance for rare disease drug development. On March 24th, join us for our upcoming Insider exclusive event focusing on pharmacy benefit manager reform with Harvard Medical School's Benjamin Rome.Become an Insider to get access to this event, trend reports, cheat sheets, and exclusive newsletters.Related Articles:FDA vaccines chief who ran afoul of pharma to depart (Politico)Rare Disease Therapeutics Market to Surpass US$ 495.27 Billion by 2033 as Gene Therapy, RNA-based Drugs, and Biologics Transform Patient Care (PR Newswire)FDA NEWS RELEASE: FDA Launches Framework for Accelerating Development of Individualized Therapies for Ultra-Rare Diseases FDA illuminates new approval pathway for bespoke gene editing therapies (Fierce Biotech)One Pivotal Trial, the New Default Option for FDA Approval — Ending the Two-Trial Dogma (The New England Journal of Medicine)

10 min
Mar 6, 2026Episode 237
State of the Union Healthcare Policy Breakdown

Health Affairs' Jeff Byers welcomes Senior Editor Margaret Winchester to the pod to discuss Trump's recent State of the Union Address and unpacking its health care and health policy talking points, including most-favored nation drug pricing, health savings accounts, and if there's a path toward codification for either.On March 24th, join us for our upcoming Insider exclusive event focusing on pharmacy benefit manager reform with Harvard Medical School's Benjamin Rome.Related Articles:National Health Care Spending Increased 7.2 Percent In 2024 As Utilization Remained Elevated (Health Affairs)Trump’s State of the Union trumpets healthcare greatest hits, but no new policies (Healthcare Dive)

23 min
Feb 20, 2026Episode 235
Healthcare Storytelling and Digital Health Investment Trends | Christina Farr

Health Affairs' Jeff Byers welcomes Christina Farr, CEO and editor-in-chief of Second Opinion Media, back to the pod to discuss her book, The Storyteller's Advantage: How Powerful Narratives Make Businesses Thrive. The conversation explores the value of storytelling in the health care and health policy space, how to invest in posting, the catch 22 of "spicy takes," recommendations for the reluctant poster, and Christina shares a quick look into what's interesting in the digital health investment space.

17 min
Feb 16, 2026Episode 234
Sweeping Affordable Care Act Changes Proposed for 2027 (Katie Keith)

Health Affairs’ Jeff Byers welcomes Georgetown University’s Katie Keith back to the podcast to break down the newly proposed HHS rule that could bring major changes to the ACA beginning in 2027.They discuss the proposal’s biggest shifts, including a major push toward expanding catastrophic plans, new marketplace eligibility restrictions tied to the One Big Beautiful Bill Act, and potential impacts on premiums, marketplace enrollment, insurers, and consumers.Related Links:HHS Proposes Sweeping Changes for 2027 Marketplace Plans (Part 1) (Health Affairs Forefront)HHS Proposes Sweeping Changes for 2027 Marketplace Plans (Part 2) (Health Affairs Forefront)Trump Team’s Planned ACA Rule Offers Its Answer to Rising Premium Costs: Catastrophic Coverage (KFF Health News)CMS proposes sweeping ACA exchange rule (Healthcare Dive)

17 min
Feb 13, 2026Episode 233
2025 Dietary Guidelines: Protein, Policy, and the Ultra-Processed Foods Problem

Health Affairs' Jeff Byers welcomes dietitian Jenny Lo from Wellness and Sports Dietetics to discuss the recently revised dietary guidelines for Americans. They discuss what's changed, the emphasis on protein, the ambiguity over ultraprocessed foods, and the best advice she gives to new clients looking to make dietary changes. Related Articles:Panel behind new dietary guidelines had financial ties to beef, dairy industries (Stat News)Experts Who Advised on Diet Guidelines Say RFK Jr.'s Version Is Full of Errors (MedPage Today)A Multilayered Public Policy Approach To Ultraprocessed Foods (Health Affairs Forefront)MAHA says its new food pyramid is affordable and healthy. We asked experts (Stat News)

14 min
Feb 6, 2026Episode 232
Pharmacy Benefit Manager Reforms Are (Finally) Afoot

Health Affairs' Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to discuss the recently passed $1.2 trillion spending appropriations bill, its included reforms for pharmacy benefit managers, the latest round of drugs slated for the Medicare Drug Negotiation program, TrumpRx, the upcoming flat rate for Medicare Advantage plan rates, and more recent health policy news.Related Articles:Congress Reins In Drug Middlemen In Effort to Lower Prescription Prices (The New York Times)Analyzing The Drugs Selected For The 2028 Medicare Drug Price Negotiation Cycle (Health Affairs Forefront)The No UPCODE Act: Considering A Simple Start To A Complex Problem (Health Affairs Forefront)PRESS RELEASE: CMS Announces Selection of Drugs for Third Cycle of Medicare Drug Price Negotiation Program, Including First-Ever Part B Drugs

18 min
Jan 30, 2026Episode 231
What Health Policy Katie Keith Is Watching In 2026

Health Affairs' Jeff Byers welcomes Katie Keith of Georgetown Law and Deputy Editor Chris Fleming to the pod to discuss what to watch out for in 2026 for health policy. The conversation touches on Affordable Care Act subsidies, Medicaid eligibility, guidance for pharmacy benefit managers, drug price negotiations, and more.This week, we announced that Health Affairs has become Health Affairs Publishing, LLC, a single-member limited liability company wholly owned by Project HOPE. To find out more about this exciting new chapter, check out this Forefront piece.Join us for the following events:2/17: The FDA and Its Changing Relationship to Industry2/25: What Excites Insiders About Health Care in 2026?Become an Insider today to get access to these exclusive events.Related Links:Health Policy At A Crossroads: What To Watch In 2026 (Health Affairs Forefront)Prescription Drug Policy, 2025 And 2026: The Year In Review And The Year Ahead (Health Affairs Forefront)

22 min
Jan 23, 2026Episode 230
Behind Epic's Latest Antitrust Lawsuit (Gabriel Perna)

Health Affairs' Jeff Byers welcomes Gabriel Perna, Deputy Editor of Digital Health Business & Technology at Modern Healthcare, to the pod to discuss Epic Systems, how they became one of the leading American health care EHR companies, a recent antitrust lawsuit filed by Texas Attorney General Ken Paxton against Epic Systems, and even touch on ChatGPT's entrance into health care.Related Articles:Texas files antitrust suit against Epic over health data (Modern Healthcare)Texas hits Epic with an antitrust suit: Here’s what to know (Modern Healthcare)

20 min
Jan 21, 2026Episode 229
The Great Health Care Vision Board (Stacie Dusetzina)

On an emergency pod episode, Health Affairs' Jeff Byers welcomes Stacie Dusetzina of Vanderbilt University Medical Center to breakdown the recently unveiled The Great Healthcare Plan from the Trump administration.Related Articles:The Great Healthcare Plan (White House)

21 min
Jan 16, 2026Episode 228
It's Not the Prices, Stupid. Michael Chernew on US Health Expenditures

Health Affairs' Jeff Byers is joined by Michael Chernew from Harvard Medical School to explore the recent 2024 health care spending report from the Centers for Medicare and Medicaid Services (CMS).To kick off the new year, we are offering podcast videos of A Health Podyssey. Subscribe to our YouTube channel to watch those episodes. Let us know what you think about the videos by emailing us at [email protected] us on January 21 for an exclusive Insider virtual event exploring the latest drug policies with the University of Utah’s Joey Mattingly. Become an Insider to get access to this event.Related Articles:National Health Care Spending Increased 7.2 Percent In 2024 As Utilization Remained Elevated (Health Affairs)Growth In National Health Expenditures: It’s Not The Prices, Stupid (Health Affairs Forefront)

25 min
Jan 7, 2026Episode 213
BEST OF: Power and Its Impact on Medicaid w/ Jamila Michener

In the wake of Medicare and Medicaid's 60th anniversary, Health Affairs' Jeff Byers welcomes Jamila Michener of Cornell University to the pod to discuss her recent Forefront article on organized power and its impact on the future of Medicaid.Also, join us for these upcoming events:8/26: Provider Prices in the Commercial Sector: Independent Dispute Resolution (FREE TO ALL)9/3: Theme Issue Briefing: Insights About The Opioid Crisis (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)Become an Insider today to get access to exclusive events like the ones highlighted above.Related Articles:Order Fragmented Democracy: Medicaid, Federalism, and Unequal Politics (Cambridge University Press)Medicare and Medicaid at 60 Forefront Series

18 min
Dec 24, 2025Episode 190
BEST OF: What's Happening with Value-Based Insurance Design? w/ Mark Fendrick

Health Affairs' Jeff Byers welcomes Mark Fendrick of The University of Michigan's Center for Value-Based Insurance Design (VBID) to discuss the recent announcement from CMS that the Medicare Advantage VBID model would be ending after 2025, and what the future holds for VBID moving forward with the new Trump administration. Check out a recently released Health Policy brief from Nathaniel Tran and Gilbert Gonzales exploring LGBTQI+ policies.Join Health Affairs on February 25 for an exclusive Insider virtual event featuring Stacie Dusetzina and Laura Tollen discussing HHS’s announcement of the 15 additional drugs selected for Medicare drug price negotiations, including weight-loss drugs such as Ozempic and Wegovy.Also, join a live recording of A Health Podyssey on March 12 featuring Rob Lott and Yashaswini Singh discussing her recent paper on the effect of private equity on physician turnover.  Register for the live taping here. Related Articles:The End Of The MA Value-Based Insurance Design Model: What Next? (Health Affairs Forefront)V-BID X: Creating A Value-Based Insurance Design Plan For The Exchange Market (Health Affairs Forefront)Medicare Advantage Value-Based Insurance Design (VBID) Model to End after Calendar Year 2025 (CMS)

16 min
Dec 17, 2025Episode 212
BEST OF: Medicare Physicians Are Getting a Raise...But At What Cost?

Health Affairs' Jeff Byers welcomes Senior Editor Leslie Erdelack back to the pod to discuss the proposed rule change to the Medicare Physician Fee Schedule for 2026, which includes payment conversion factors for doctors, alternative payment models, add-on codes for Advanced Primary Care Management services, a new mandatory value-based payment model, and more.Order the August 2025 issue of Health Affairs.Join us for a live taping of A Health Podyssey on Tuesday August 12 where Rob Lott will discuss recent findings about changes in clinician's participation across Medicare value-based payment models with Kenton Johnston.Upcoming Events include:8/20: 340B w/ Sayeh Nikpay (INSIDER EXCLUSIVE)8/26: Provider Prices in the Commercial Sector: Independent Dispute Resolution (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)View all Upcoming Events.Become an Insider today to get access to exclusive events like the ones highlighted above.Related Articles:PRESS RELEASE: Calendar Year (CY) 2026 Medicare Physician Fee Schedule (PFS) Proposed Rule (CMS-1832-P)CMS proposes rule aligning Medicare physician payment with ‘Big Beautiful Bill,’ MACRA (Healthcare Dive)CMS proposes 3.6% pay bump for docs, takes aim at chronic conditions in physi

19 min
Dec 10, 2025Episode 208
BEST OF: US Health Spending Projections Back on the Rise w/ Michael Chernew

Health Affairs' Jeff Byers is joined by Michael Chernew from Harvard Medical School to discuss the recently released National Health Expenditures Projections for 2024–33 from the Office of the Actuary (OACT) at the Centers for Medicare and Medicaid Services (CMS).Related Articles:National Health Expenditure Projections, 2024–33: Despite Insurance Coverage Declines, Health To Grow As Share Of GDPCMS National Health Expenditure Data

17 min
Dec 3, 2025Episode 210
BEST OF: The Big Beautiful Bill: A New Era for Health Policy? w/ Katie Keith

Health Affairs' Jeff Byers welcomes Katie Keith of Georgetown Law and Deputy Editor Chris Fleming to the pod to discuss Trump administration's One Big Beautiful Bill and how this will affect Medicaid, Medicare, health savings accounts, rural hospitals, and more. Become an Insider today to get access to our trend reports, events, and exclusive newsletters.Related Links:The 'One Big Beautiful Bill,' Now Law, Does Not Protect Rural Hospitals (Health Affairs Forefront)Rural Health Transformation Program Won’t Shield Hospitals And Other Rural Providers From OBBBA’s Fallout (Health Affairs Forefront)With Budget Reconciliation Bill Enacted, Health Care Changes Loom (Health Affairs Forefront)Congress Should Remove The Rare Disease Carve-Out From Medicare Drug Price Negotiation, Not Expand It (Health Affairs Forefront)Recent Experience Shows National Medicaid Work Requirements Would Create Enormous Administrative Inefficiencies (Health Affairs Forefront)

16 min
Nov 21, 2025Episode 227
Keeping ACO Models Accountable

Health Affairs' Jeff Byers welcomes Rachel Bonesteel of Duke-Margolis Center for Health Policy to the pod to discuss her recent Forefront article focused on how ACO REACH enabled ACOs to participate in an advanced, global-risk, population-based payment model.Related Articles:ACO REACH 2023 Performance Results Indicate A Pathway To Sustainable Accountable Care (Health Affairs Forefront)Opportunities To Enhance Design And Implementation Of ACO REACH’s Core Payment Model Design Elements (Health Affairs Forefront)Enhancing Design And Implementation Of ACO REACH’s Equity-Focused And Beneficiary Engagement Design Elements (Health Affairs Forefront)Future Of Accountable Care: Lessons Learned And Potential Paths Forward During A Time Of Transition (Health Affairs Forefront)Medicare Accountable Care Organizations In 2023: Large Savings With Increasing Value-Based Programmatic Competition (Health Affairs Forefront)Medicare ACOs In 2024: Increased Participation And Evolving Policy Impacts (Health Affairs Forefront)

15 min
Nov 14, 2025Episode 226
How Are States Even Affording Health Care Costs?

Health Affairs' Jeff Byers welcomes Nathan Hostert of The Center for Advancing Health Policy Through Research at Brown University to the pod to discuss a recent Forefront article on how states are utilizing hospital price caps to save money.Become an Insider today to get access to our third trend report focusing on the influence of private equity in health care.Related Articles:How States Are Using Hospital Price Caps To Save Money (Health Affairs Forefront)Hospital Payment Cap Simulator (Brown University)Hospital Facility Prices Declined As A Result Of Oregon’s Hospital Payment Cap (Health Affairs)Hospital Payment Caps Could Save State Employee Health Plans Millions While Keeping Hospital Operating Margins Healthy (Health Affairs)How Massachusetts’s New Health Care Reform Takes Aim at Private Equity (Health Affairs Forefront)

16 min
Nov 7, 2025Episode 225
CMS Drug Price Negotiation Guidance Updates with Rachel Sachs

Health Affairs' Jeff Byers welcomes Rachel Sachs from Washington University in St. Louis and Deputy Editor Chris Fleming back to the pod to discuss CMS' final guidance for the latest round of the Medicare drug price negotiation program. Related Articles:Administration Releases Medicare Drug Price Negotiation Program Final Guidance For 2028 (Health Affairs Forefront)The Role of Combination Drugs in the Medicare Drug Price Negotiation Program (JAMA)Articulating policy options regarding implementation of the Medicare drug price negotiation program’s renegotiation provision (Brookings Institution)Eye on The IRA (Health Affairs)

19 min
Oct 31, 2025Episode 224
Why the U.S. Healthcare System Is Unwell | Allison Oakes

Health Affairs' Jeff Byers welcomes Allison Oakes, Chief Research Officer of Trilliant Health, to the pod to discuss Trilliant's recent health care trend report highlighting the health economy and breaking down the big trends, including price and affordability, demographics and lifestyle, care settings and therapies, and more.Join us for this upcoming event:11/5: Health Benefits in 2025: Insights from the KFF Employer Health Benefits Survey (INSIDER EXCLUSIVE)Become an Insider today to get access to this event and our third trend report focusing on the influence of private equity in health care.Related Articles:2025 Trends Shaping the Health Economy (Trilliant Health)

19 min
Oct 24, 2025Episode 223
Pharmaceutical Tariffs Explained: The Will-They-Won’t-They Story of 2025

Health Affairs' Jeff Byers welcomes Stacie Dusetzina of Vanderbilt University Medical Center and David Simon of the University of Connecticut back to the pod to the current state of drug prices, how proposed tariffs may impact the pharmaceutical industry, that Pfizer deal, what consumers can expect if tariffs are added to prescription drugs, what exactly TrumpRx is, and more.Become an Insider today to get access to our third trend report focusing on the influence of private equity in health care.Related Articles:Trump admin readies 'imminent' probe into other nations' drug pricing, raising new tariff threat: FT (FiercePharma)President Trump’s Executive Orders On Prescription Drug Prices: What The Evidence Says (Health Affairs Forefront)

19 min
Oct 17, 2025Episode 222
Government Shutdown: Health Policy Back in the Political Crossfire

Health Affairs' Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to take a look at the recent government shutdown, how health policy plays into it, HHS layoffs, the Affordable Care Act premium tax credits, the ACA marketplace, and more.Join us for this upcoming event:11/5: Health Benefits in 2025: Insights from the KFF Employer Health Benefits Survey (INSIDER EXCLUSIVE)Become an Insider today to get access to exclusive events and our upcoming third trend report.Related Articles:Judge pauses shutdown layoffs at more than 30 federal agencies (NPR)Medicare backs off plan to pause doctor payments amid shutdown (STAT)White House: Shutdown layoffs will be ‘north of 10,000’ (Politico)

19 min
Oct 10, 2025Episode 221
Future of Primary Care: Bright or Broken? w/ Troyen Brennan

Health Affairs' Jeff Byers welcomes Troyen A. Brennan of Harvard T.H. Chan School of Public Health and former CMO at CVS Health to the pod to discuss his new book, Wonderful and Broken: The Complex Reality of Primary Care in the United States. The conversation touches on themes within the book, including the current state of primary care, the diffusion of ideas in the health care space, the paradox of value-based care driven by Medicare Advantage, innovation in the Medicaid space, and what opportunities there could be to improve health care outcomes.

22 min
Oct 3, 2025Episode 220
Physician Autonomy in Decline: The Rise of Deprofessionalization w/ Yul Ejnes

Health Affairs' Jeff Byers welcomes Dr. Yul Ejnes of Brown University Health to the pod to discuss a recent Forefront article he authored about the trend of deprofessionalization in the health care workforce and potential antidotes to address these issues.Learn more about the topic of the health care workforce with a Health Affairs Insider trend report.Join us for this upcoming Insider exclusive events:10/15: Immigration Policies and Their Impact on Health CareBecome an Insider today to get access to our trend reports, events, and exclusive newsletters.Related Articles:Deprofessionalization: An Emerging Threat To The Physician Workforce (Health Affairs Forefront)The Health Care Workforce: A Challenge In Sustainability (Health Affairs)

16 min
Sep 26, 2025Episode 219
Make America Healthy Again...Again

Health Affairs' Jeff Byers welcomes Senior Editor Ellen Bayer back to the pod to discuss the release of a HHS' new strategy document focusing on childhood chronic disease as part of the Make America Healthy Again initiative, specifically the goals surrounding food, diet, and nutrition.Join us for these upcoming Insider exclusive events:9/29: Prior Authorization: Current State and Potential Reform10/15: Immigration Policies and Their Impact on Health CareBecome an Insider today to get access to our trend reports, events, and exclusive newsletters.Related Articles:Make Our Children Healthy Again Strategy ReportThe MAHA Report - Assessment DocumentPrevalence and Trends in Pediatric-Onset Chronic Conditions in the United States, 1999–2018 (Academic Pediatrics)Food, Nutrition, and Health Theme Issue from Health AffairsU.S. Seeks New Limits on Food Ads for Children (New York Times)

24 min
Sep 19, 2025Episode 218
An ACA Supreme Court Case May Have Created an HHS Power Paradox w/ Carmel Shachar

Health Affairs' Jeff Byers welcomes Carmel Shachar of Harvard Law School to the pod to discuss a recent Forefront article she co-authored that broke down the Kennedy v. Braidwood Management case focusing on access to preventive care and how the Supreme Court's framing of the relationship between the HHS Secretary and advisory bodies recommending preventive care might set a precedent worth noting.Join us for these upcoming Insider exclusive events:9/29: Prior Authorization: Current State and Potential Reform10/15: Immigration Policies and Their Impact on Health CareBecome an Insider today to get access to our trend reports, events, and exclusive newsletters.Related Articles:Braidwood's Double-Edged Sword and The Dismantling of Preventive Care (Health Affairs Forefront)Kennedy v. Braidwood Management, Inc.Kennedy v. Braidwood: The Supreme Court Upheld ACA Preventive Services but That’s Not the End of the Story (KFF)Insurance Coverage Without Cost Sharing for Preventive Health Care Restored by the Supreme Court (JAMA)

15 min
Sep 12, 2025Episode 217
The Downstream Effects of Politics & Policy on Health Decisions

Health Affairs' Jeff Byers welcomes Health Affairs's Akilah Wise to discuss the recent CDC executive changes, HHS staff culture clashes with Robert F. Kennedy, Jr., changes in federal vaccine recommendations, and research examples where health policy influences health care behavior. Health Affairs released a new theme issue focusing on insights from the opioids crisis. Subscribe to the journal to never miss out on an upcoming issue.Join us for these upcoming events:9/17: Lunch & Learn: The Current Opioids Policy Landscape & What’s Ahead (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)Become an Insider today to get access to our trend reports, events, and exclusive newsletters.Related Articles:Disparities In County COVID-19 Vaccination Rates Linked To Disadvantage And Hesitancy (Health Affairs)Guaranteed Cash Incentives Boosted COVID-19 Vaccinations Of Young Adults: Evidence From West Virginia (Health Affairs)HHS schedules next vaccine panel meeting after CDC director ousted (Politico)Concerned about federal vaccine policies, states are crafting their own (NPR)Modeling Reemergence of Vaccine-Eliminated Infectious Diseases Under Declining Vaccination in the US (JAMA)HHS employees demand RFK Jr. resign for ‘compromising the health of this nation’ (CNN)<a href="https://www.healthcaredive.com/news/kennedy-rfk-senate-he

22 min
Sep 5, 2025Episode 216
Supreme Court Upholds NIH’s Termination of $800M in Grants w/ Katie Keith

Health Affairs' Jeff Byers welcomes Katie Keith of Georgetown Law and Deputy Editor Chris Fleming to the pod to discuss the recent Supreme Court case, American Public Health Association et al. v. National Institutes of Health et al., that explores the lawfulness of the NIH's termination of nearly $800 million worth of grant funding for programs due to DEI association.This week, Health Affairs released a new theme issue focusing on insights from the opioids crisis. Subscribe to the journal to never miss out on an upcoming issue.Join us for these upcoming events:9/17: Lunch & Learn: The Current Opioids Policy Landscape & What’s Ahead (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)Become an Insider today to get access to our trend reports, events, and exclusive newsletters.Related Articles:Unpacking The Supreme Court’s Decision Over NIH Funding (Health Affairs Forefront)American Public Health Association et al. v. National Institutes of Health et al.A closely watched legal battle over NIH funding cuts could settle soon (STAT+)

15 min
Aug 29, 2025Episode 215
PBM Laws & State Reforms: Are Big Changes Coming?

Health Affairs' Jeff Byers welcomes Andrew Twinamatsiko of O'Neill Institute for National and Global Health Law back to the program to discuss pharmacy benefit managers, the laws around PBMs, the statutes in place from the Express Scripts Inc. v. Richmond case, and more.Next week, Health Affairs will be releasing a new theme issue focusing on insights from the opioids crisis. Subscribe to the journal to never miss out on an upcoming issue.Join us for these upcoming events:9/3: Theme Issue Briefing: Insights About The Opioid Crisis (FREE TO ALL)9/17: Lunch & Learn: The Current Opioids Policy Landscape & What’s Ahead (FREE TO ALL)Related Articles:Arkansas PBM law could spur lookalike restrictions (Axios)Express Scripts Inc et al v. Richmond et al (Judicial Publications)PBM lobby sues Arkansas over law requiring drug middlemen to sell pharmacies (Healthcare Dive)

15 min
Aug 22, 2025Episode 214
The Politics & Business of mRNA Vaccine Investment Cuts

Health Affairs' Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to take a look at recent news that HHS terminated 22 mRNA projects. The two explore the agency's reasoning, political and Wall Street reactions, and what it could mean for health care innovation.Join us for these upcoming events:8/26: Provider Prices in the Commercial Sector: Independent Dispute Resolution (FREE TO ALL)9/3: Theme Issue Briefing: Insights About The Opioid Crisis (FREE TO ALL)9/17: Lunch & Learn: The Current Opioids Policy Landscape & What’s Ahead (FREE TO ALL)9/23: Prior Authorization: Current State and Potential Reform (INSIDER EXCLUSIVE)Become an Insider today to get access to exclusive events like the ones highlighted above.Related Articles:HHS abandons mRNA vaccine research (BioPharma Dive)1 big thing: RFK Jr.'s anti-vaccine revolution (Axios)Moderna Stock Jumps as NIH Chief Tempers Administration’s Attack on mRNA (Barron's)750 HHS employees send signed letter to RFK Jr. asking him to stop spreading misinformation (ABC News)Industry frets Kennedy’s mRNA decision will curb cancer breakthroughs (Politico Pro)

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