Health Affairs This Week

Health Affairs

Health Affairs This Week places listeners at the center of health policy’s proverbial water cooler. Join host Jeff Byers, editors from Health Affairs Publishing, and guests as they discuss health policy’s most pressing news and trends.

  1. Oct 15 ·  Bonus

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

    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. 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  This conversation explores the root causes of prior authorization challenges, from fragmented workflows and outdated technology to the competing incentives facing providers and payers.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. Subscribe to Semafor Healthcare for free.

    Why Prior Authorization Still Frustrates Everyone: DrFirst's Colin Banas on What's Changing | SPONSORED
  2. Oct 2

    ACA Marketplace Turbulence: Fraud, Brokers, and Coverage Loss

    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 Meg Winchester back to the pod to discuss the Trump administration's decision to terminate ACA marketplace coverage for more than 760,000 people as part of a broader effort to combat fraud, waste, and abuse. They examine how the disenrollments were carried out, the potential implications for consumers and insurers, and what the move could mean for the future stability of the ACA marketplaces. Join Health Affairs Publishing on October 21 for an Insider exclusive event exploring risk adjustment, coding incentives, spending, and outcomes with Richard Kronick and Matthew Fiedler. Related Links: Administration Cancels Coverage For More Than 760,000, Blocks New Agents And Brokers (Health Affairs Forefront)Withholding Medicaid Dollars Won’t Stop Fraud. It Will Hurt People (Health Affairs Forefront)The Troubling Termination Of 760,000 ACA Marketplace Members (Health Affairs Forefront)Semiannual Report to Congress (HHS)ACA Exchange Enrollment in 2026 (ASPE)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

  3. Sep 25

    Prior Authorization's Next Era: CMS Reform, AI, and Faster Approvals

    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 the evolving prior authorization landscape, including CMS efforts to streamline approvals, insurer responses, and emerging questions around AI-driven decision-making. A Health Affairs journal subscription directly connects you to the research shaping the future of health policy and health care. Until 10/14, purchase a two-year digital subscription to Health Affairs journal and receive a third year free with code ONEFREEYEAR. Sign up for Insider to get exclusive access to our trend report focusing on the current prior authorization landscape. Related Links: Medicare’s AI prior authorization pilot was rushed and full of problems, new documents reveal (Stat News)Prior authorization denials vary widely among insurers, first-of-its-kind data shows (Healthcare Dive)UnitedHealthcare cuts prior authorization from 1,700 codes (Healthcare Dive)TREND REPORT: The Current Prior Authorization Landscape (Health Affairs Insider)PR STUNT: UnitedHealth’s Big Prior Authorization Cut (Health Care Un-covered)Sign up for Health Affairs' free newsletter to catch up on our new articles, podcasts, and events. Subscribe to Semafor Healthcare for free.

4.7
out of 5
25 Ratings

About

Health Affairs This Week places listeners at the center of health policy’s proverbial water cooler. Join host Jeff Byers, editors from Health Affairs Publishing, and guests as they discuss health policy’s most pressing news and trends.

You Might Also Like