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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.

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.

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

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)

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)

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

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)

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)

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)

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)

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. 

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)

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)

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

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)