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This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to unpack the 2026 midterm election results and their potential implications for health policy. The conversation explores potential Democratic health care priorities, including reversing Medicaid cuts and ACA subsidy restoration, drug pricing initiatives, examining the role of prior authorization in coverage denials, and the prospects for broader coverage expansion at both the federal and state levels. Join Health Affairs Publishing on November 17 for an exclusive event with Jetson Leder-Luis, PhD of Boston University getting Insiders up to speed on fraud policies and what to watch in the health care industry moving forward. Sign up for Insider to get exclusive access to this event and our trend report focusing on the current prior authorization landscape. Related Links: MEMORANDUM TO THE LEADER (Politico)Americans’ Challenges with Health Care Costs (KFF)Battleground Issue Tracker (The Cook Political Report)Prior Authorization's Next Era: CMS Reform, AI, and Faster Approvals (Health Affairs This Week)TREND REPORT: The Current Prior Authorization Landscape (Health Affairs Insider)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

THIS SPONSORED PODCAST IS BROUGHT TO YOU BY THE COBRE ON OPIOIDS AND OVERDOSE AT RHODE ISLAND HOSPITAL. The US overdose crisis is changing. While opioid-related overdose deaths have begun to decline, researchers are seeing a growing role for stimulants, including cocaine and methamphetamine, in overdose risk. In this sponsored episode, Leslie Erdelack speaks with Dr. Jaclyn White Hughto from Brown University about what researchers are learning from the evolving overdose epidemic. They discuss findings from the POINTS (Preventing Overdoses Involving Stimulants) study, a CDC-funded project examining stimulant-involved overdoses in Massachusetts and Rhode Island. The conversation explores: How the US overdose epidemic has evolved, from prescription opioids to fentanyl and stimulant involvementWhy stimulant-involved overdoses differ from opioid overdosesThe rise of stimulant-only overdose deathsWhat researchers learned from interviews with people who use drugsMisconceptions about fentanyl contamination in the stimulant supplyHow people who use stimulants perceive and manage overdose riskThe role of fentanyl test strips, naloxone, and other harm-reduction toolsCommunity-driven strategies to improve overdose preventionChallenges surrounding Good Samaritan laws and emergency responseWhy surveillance data and public health monitoring remain criticalNew research examining potent stimulants and opportunities for earlier interventionDr. Hughto also discusses ongoing NIH-funded research aimed at understanding rising stimulant-only overdoses and identifying ways policymakers, clinicians, and communities can respond more effectively. RELATED LINKS: The Center of Biomedical Research Excellence on Opioids and OverdoseThe POINTS (Preventing Overdoses Involving Stimulants) study

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. How far can international reference pricing go in lowering prescription drug costs? Health Affairs Publishing's Jeff Byers welcomes Senior Editor Michael Gerber back to the pod to discuss the finalized GLOBE model for Medicare Part B drugs, the administration’s broader "most favored nation" strategy, the PhRMA lawsuit against CMS over the model, and what policy watchers should monitor in the months ahead. Join Health Affairs Publishing on November 17 for an exclusive event with Jetson Leder-Luis, PhD of Boston University getting Insiders up to speed on fraud policies and what to watch in the health care industry moving forward. Related Links: Health Affairs Moves Exclusively Online (Health Affairs Forefront)CMS Finalizes New Mandatory Drug Payment Model to Deliver Lower Drug Prices for Beneficiaries in Original Medicare Part BAdministration Finalizes Medicare Part B International Reference Pricing Model (Health Affairs Forefront)PhRMA Challenges CMS’ MFN Policy as Unlawful Overreach (PhRMA)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Why are so many Gen Z health care workers thinking about their next career move? Health Affairs Publishing's Jeff Byers welcomes Adele Webb of Workforce Edge to the pod to unpack new survey findings on health care workforce expectations, career advancement, and the strategies employers can use to retain emerging talent. Related Links: 2026 Healthcare Workforce Barometer (Workforce Edge)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Tara Bannow of Stat News to the program to discuss Quorum Health’s proposed transition from a for-profit to nonprofit hospital system, including the operational, financial, and policy implications of the move. The discussion explores Quorum’s history of debt and restructuring, where CHS fits into the story, the financial advantages of nonprofit status, and whether similar transitions could become a pathway for struggling investor-owned health care organizations. Related Links: A private equity-owned hospital chain is becoming a nonprofit. Is it just a bailout for investors? (STAT)Will the Rural Health Transformation Fund Deliver? (Health Affairs This Week)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

THIS SPONSORED PODCAST EPISODE IS BROUGHT TO YOU BY DrFIRST. In this sponsored episode, Dr. Colin Banas, chief medical officer at DrFirst, joins Health Affairs Publishing's Rob Lott to discuss prior authorization, why the process continues to create delays and administrative burden, and the future of prior authorization in the health care ecosystem. Colin Banas joined DrFirst in 2019 after spending 17 years as CMIO at VCU Health System, where he also practiced as an internal medicine hospitalist. He has testified before the U.S. Senate on health IT and meaningful use and previously served as a health IT Fellow at the ONC.  At DrFirst, Dr. Banas drives innovation in medication workflows, focusing on non-disruptive decision support that creates better experiences for providers and patients, including how AI can reduce clinical burnout and improve patient outcomes.  This conversation explores the root causes of prior authorization challenges, from fragmented workflows and outdated technology to the competing incentives facing providers and payers. Dr. Banas and Lott also discuss how automation, interoperability, and artificial intelligence are beginning to reshape prior authorization and help organizations reduce friction while maintaining appropriate oversight of care.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Trilliant Health’s Allison Oakes to discuss the findings of the organization’s 2026 Trends Shaping the Health Economy report and the pressures affecting the U.S. health care system. Together, they examine trends in affordability, insurance coverage, health care utilization, and payment policy that could shape the industry in the years ahead. Join Health Affairs Publishing on October 21 for an Insider exclusive event exploring risk adjustment, coding incentives, spending, and outcomes with Richard Kronick and Matthew Fiedler. Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. As Health Affairs Forefront celebrates its 20th anniversary, two of the publication's most influential contributors join Editor Chris Fleming for a conversation about the future of health policy.  Tim Jost and Katie Keith, whose rapid-response analyses have helped readers navigate some of the most consequential health policy developments of the last two decades, reflect on what lessons from the past may shape the next 20 years. The discussion explores the legacy of the Affordable Care Act, the policy lessons learned from reform and repeal efforts, and how recent legislative changes could reshape coverage and access in the years ahead. Jost and Keith also examine the challenges of controlling health care costs, the role of Congress in an increasingly polarized political environment, and the growing influence of courts and litigation on health policy outcomes. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Senior Editor Meg Winchester back to the pod to discuss the Trump administration's decision to terminate ACA marketplace coverage for more than 760,000 people as part of a broader effort to combat fraud, waste, and abuse. They examine how the disenrollments were carried out, the potential implications for consumers and insurers, and what the move could mean for the future stability of the ACA marketplaces. Join Health Affairs Publishing on October 21 for an Insider exclusive event exploring risk adjustment, coding incentives, spending, and outcomes with Richard Kronick and Matthew Fiedler. Related Links: Administration Cancels Coverage For More Than 760,000, Blocks New Agents And Brokers (Health Affairs Forefront)Withholding Medicaid Dollars Won’t Stop Fraud. It Will Hurt People (Health Affairs Forefront)The Troubling Termination Of 760,000 ACA Marketplace Members (Health Affairs Forefront)Semiannual Report to Congress (HHS)ACA Exchange Enrollment in 2026 (ASPE)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to discuss the evolving prior authorization landscape, including CMS efforts to streamline approvals, insurer responses, and emerging questions around AI-driven decision-making. A Health Affairs journal subscription directly connects you to the research shaping the future of health policy and health care. Until 10/14, purchase a two-year digital subscription to Health Affairs journal and receive a third year free with code ONEFREEYEAR. Sign up for Insider to get exclusive access to our trend report focusing on the current prior authorization landscape. Related Links: Medicare’s AI prior authorization pilot was rushed and full of problems, new documents reveal (Stat News)Prior authorization denials vary widely among insurers, first-of-its-kind data shows (Healthcare Dive)UnitedHealthcare cuts prior authorization from 1,700 codes (Healthcare Dive)TREND REPORT: The Current Prior Authorization Landscape (Health Affairs Insider)PR STUNT: UnitedHealth’s Big Prior Authorization Cut (Health Care Un-covered)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Allison Rizer, chief growth and innovation officer at ATI Advisory, about her recent Forefront article. They discuss upcoming 2027 Medicare-Medicaid integration requirements, how to measure if integration is valuable, and why decades of policy experimentation have produced mixed evidence. Related Links: We’ve Spent Decades Testing Medicare-Medicaid Integration. Why Don’t We Know If It Works? (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Jack Hoadley of Georgetown University to the pod to discuss the rapid growth of the No Surprises Act’s independent dispute resolution process and its estimated $22.4 billion cost over four years. They explore what’s driving the increase, why providers are winning most arbitration cases, and how the trend could affect health care affordability in the years ahead. Join Health Affairs Publishing on September 16 for an Insider exclusive event featuring a discussion on on AI, health care, and where the two are heading with Halle Tecco, Jonathan Ketcham, and Paige Nong. Related Links: Spending On IDR Process Pushes No Surprises Act Costs To More Than $22.4 Billion Over Just Four Years (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Dan Arnold of Brown University to discuss the rapid growth of Medicaid spending on autism treatment and the expanding role of private equity-backed providers in the applied behavior analysis (ABA) therapy market. He explores the drivers behind rising costs, emerging concerns about care quality and fraud, and the challenge of balancing oversight with continued access to services for families. Related Links: The Business Of Autism Treatment: Private Equity Implications For State Medicaid Programs (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. Health Affairs Publishing's Jeff Byers welcomes Erica Socker of Georgetown University to the pod to discuss her recent Forefront article that explores how the Medicare Advantage quality bonus program is working in the wake of a Clover Health-CMS lawsuit over star ratings. They discuss the court’s ruling, CMS’s policy response, and why the case could become a catalyst for broader reforms to a program that now distributes billions of dollars annually. Related Links: Medicare Advantage Quality Bonus Program: Court Decisions Spotlight Flaws (Health Affairs Forefront)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free. In this episode of Health Affairs This Week, David Betts, founder and board chair at StoryFlight Labs, shares how his ALS diagnosis inspired him to launch StoryFlight Labs and develop Talk To Me Goose, an AI-powered tool that helps people with speech-limiting conditions retain their voice and communicate with loved ones. He discusses how AI can empower patients, the need for faster healthcare innovation, and policy changes that could improve access to ALS treatments and support. Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.