Health Affairs This Week

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)

Health Affairs' Jeff Byers welcomes Stacie Dusetzina of Vanderbilt University Medical Center and David Simon of the University of Connecticut back to the pod to the current state of drug prices, how proposed tariffs may impact the pharmaceutical industry, that Pfizer deal, what consumers can expect if tariffs are added to prescription drugs, what exactly TrumpRx is, and more.Become an Insider today to get access to our third trend report focusing on the influence of private equity in health care.Related Articles:Trump admin readies 'imminent' probe into other nations' drug pricing, raising new tariff threat: FT (FiercePharma)President Trump’s Executive Orders On Prescription Drug Prices: What The Evidence Says (Health Affairs Forefront)

Health Affairs' Jeff Byers welcomes Senior Editor Kathleen Haddad back to the pod to take a look at the recent government shutdown, how health policy plays into it, HHS layoffs, the Affordable Care Act premium tax credits, the ACA marketplace, 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 exclusive events and our upcoming third trend report.Related Articles:Judge pauses shutdown layoffs at more than 30 federal agencies (NPR)Medicare backs off plan to pause doctor payments amid shutdown (STAT)White House: Shutdown layoffs will be ‘north of 10,000’ (Politico)

Health Affairs' Jeff Byers welcomes Troyen A. Brennan of Harvard T.H. Chan School of Public Health and former CMO at CVS Health to the pod to discuss his new book, Wonderful and Broken: The Complex Reality of Primary Care in the United States. The conversation touches on themes within the book, including the current state of primary care, the diffusion of ideas in the health care space, the paradox of value-based care driven by Medicare Advantage, innovation in the Medicaid space, and what opportunities there could be to improve health care outcomes.