Health Affairs This Week

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market, why traditional clinical trials often don’t work for ultra‑rare genetic conditions, and the new FDA draft guidance for rare disease drug development.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)

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)

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)

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 communications@healthaffairs.org.Join 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)

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

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)

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 physician fee schedule (Fierce Healthcare)Physicians will see Medicare payments rise in 2026 (AMA)Medicare proposes ‘efficiency’ pay cuts that would hit highly paid specialists the most (STAT News)

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

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)

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)

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)

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)

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)