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.

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.

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 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.

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 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.

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 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.

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 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.

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 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

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.

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)

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 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)

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' 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 Challenges
• Check out Halle's podcast, The Heart of Healthcare Podcast

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' 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)

Subscribe to Semafor Healthcare for free.