A Health Podyssey

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Do Provider-Owned Health Plans Lower Healthcare Costs? New Evidence on Vertical Integration | Mitchell Mead Oct 27, 2026

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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.

Hospital systems are increasingly becoming both providers and insurers, but what does that mean for healthcare prices?

In this episode of A Health Podyssey, host Rob Lott speaks with University of Michigan's Mitchell Mead about his new Health Affairs research examining whether provider-sponsored health plans negotiate healthcare prices differently than traditional insurers.

Drawing on hospital price transparency data and national health system datasets, Mead explains how vertically integrated payer-provider organizations have grown since the Affordable Care Act and why Medicare Advantage has become a major driver of that trend. The discussion explores the finding that provider-sponsored health plans negotiated lower prices for 44 of 46 healthcare services studied.

The conversation also examines what these findings mean for policymakers grappling with healthcare affordability, consolidation, antitrust oversight, and the future of vertically integrated healthcare organizations.

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The Real Savings From Generic Drugs: What Medicare Part D Data Reveals | CBO's Scott Laughery Oct 20, 2026

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This episode is brought to you by Semafor Healthcare.

Health Affairs Publishing’s Rob Lott speaks to Scott Laughery of the Congressional Budget Office about new research examining how generic drug entry affects net prescription drug prices and spending in Medicare Part D.

Their conversation explores the often-hidden role of rebates, how generic competition reshapes drug markets, and what newly available data reveal about savings after loss of exclusivity.

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Why Prior Authorization Still Frustrates Everyone: DrFirst's Colin Banas on What's Changing | SPONSORED Oct 15, 2026

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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.

Diagnosing Dementia: Confidence Gaps Across the Health Care Workforce Oct 13, 2026

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This episode is brought to you by Semafor Healthcare.

Health Affairs Publishing’s Rob Lott speaks to Sumedha Gupta of Indiana University about new research on the dementia care workforce and how clinician experiences vary across provider types. They examine what those differences could mean for access, diagnosis, and care as dementia prevalence increases in the years ahead.

Order the October 2026 issue of Health Affairs.

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Building Forefront: 20 Years of Shaping Health Policy Conversations Oct 07, 2026

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This episode is brought to you by Semafor Healthcare.

This month marks a major milestone for Health Affairs. In October 2006, the Health Affairs Blog was launched as a new experiment in health policy dialogue. Twenty years later, that platform has evolved into Health Affairs Forefront, publishing hundreds of articles annually and serving as a leading venue for evidence-based analysis, commentary, and debate.

On this special anniversary episode of A Health Podyssey, host Rob Lott sits down with Chris Fleming, Editor of Forefront, to reflect on two decades of growth, innovation, and influence. Together, they discuss the origins of the publication, its transformation from a fledgling blog into a respected policy forum, and the editorial principles that have guided its success.

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Dr. Alister Martin on the Future of Public Health in New York City Oct 06, 2026

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This episode is brought to you by Semafor Healthcare.

A Health Podyssey host Rob Lott chats with Dr. Alister Martin, commissioner of the New York City Department of Health and Mental Hygiene, about his path from emergency medicine to public health leadership, his vision for improving health outcomes across New York City, and how the city's lessons in public health can be applied to other locales.

Their conversation explores the local response to federal health policy changes, efforts to protect Medicaid coverage and reduce medical debt, and the public health challenges shaping New York City's future.

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How Much Do Americans Really Pay for Health Care? Sep 29, 2026

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This episode is brought to you by Semafor Healthcare.

Health Affairs Publishing’s Rob Lott speaks to Irene Papanicolas of Brown University about her recent paper examining how Americans contribute to health care financing through taxes, premiums, and out-of-pocket spending. The conversation explores differences in those contributions across income groups and insurance status, and considers the implications for health care affordability and financing policy.

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Medicare Advantage Risk Adjustment: Why CMS's Payment Cuts Didn't Raise Premiums Sep 22, 2026

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This episode is brought to you by Semafor Healthcare.

What happens when Medicare Advantage plans receive lower payments under a new risk adjustment model?

Health Affairs Publishing’s Rob Lott speaks to Niru Ghoshal-Datta of the University of California, Berkeley about his recent paper exploring CMS’s updated Medicare Advantage risk adjustment model. They discuss how the policy change reduced payments to Medicare Advantage plans, had little effect on premiums and cost sharing, and led to modest reductions in some supplemental benefits

Order the September 2026 issue of Health Affairs.

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How Remote WIC Benefits Increased Enrollment Sep 15, 2026

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This episode is brought to you by Semafor Healthcare.

Health Affairs Publishing’s Rob Lott speaks to Emily Dore of Tufts University School of Medicine about her recent paper exploring COVID-era WIC policy flexibilities, increased program participation, and what those findings mean for the future of safety net programs.

Order the September 2026 issue of Health Affairs.

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Medicaid Funding Fight: $52 Billion on the Chopping Block Sep 09, 2026

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This episode is brought to you by Semafor Healthcare.

Health Affairs Publishing’s Rob Lott speaks to Debra Lipson, health policy analyst and consultant, about her recent paper that explores how new federal limits on Medicaid state directed payments could force significant Medicaid spending cuts in many states, potentially reshaping provider funding and access to care.

Order the September 2026 issue of Health Affairs.

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