In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners welcome Dr. Steven Farmer, former senior leader at the Center for Medicare and Medicaid Innovation (and Adam’s husband).

Between playful banter and sharp commentary, the trio dives into the serious business of healthcare regulation: why the U.S. system remains unaffordable, how payment models shape medical practice, and what it really takes to shift toward value-based care. From international adventures to bundled payments, Dr. Farmer shares his unique journey through medicine, policy, and innovation—sprinkled with equal parts humor and frustration.

If you’ve ever wondered how regulation, incentives, and a little bit of “gaming the system” affect the care you receive, this is the episode for you.