The Healthcare Labyrinth

There is little question that affordability will dominate the 2026 midterms and that is most true on healthcare. Learn more on the issue as well as on the prospects for a possible Exchange subsidy compromise. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of afford...

A major study shows that investing in primary care and managing disease states could reap huge savings and improve outcomes. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is cl...

As always at the end of the year, I recap healthcare happenings and tell you my predictions for the new year – just don't hold me to them! About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, th...

Each year I help people make their open enrollment decisions. These stories tell us just how unaffordable healthcare is in America.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the sys...

Given all going on in healthcare, it is time to contemplate real reform.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare...

CMS issued some major regulatory proposals in its draft 2026 Medicare Advantage and Part D rule.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of chan...

CMS wants a much tougher MA Star ratings program and that could challenge plans and mean billions in lost revenue.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in...

A new study looking at what UnitedHealthcare pays its sister providers could bring scrutiny of vertical integration in healthcare.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the syst...

The drug price reform arena is active, with a major announcement on drug rebate reform and GLP-1 weight-loss drug price reductions.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the sys...

Donald Trump and the GOP may want another pass at repealing and replacing Obamacare. But they have never had a real plan.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is cle...

A judge has tossed the entire Risk Adjustment Data Validation rule, throwing CMS' plans to audit MA insurers for overcoding into great doubt.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and preventio...

Quiet Discussions On Capitol Hill On An Enhanced Subsidy Extension   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare polic...

We dive deep into the 2026 Medicare Advantage Star Ratings Results About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy...

Are President Trump and his healthcare policy advisors getting hoodwinked by Big Pharma on drug price reform? About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire n...

Special Needs Plans are growing explosively in Medicare Advantage, but understanding the operational risks is key.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in...

We are covering two topics in this edition – healthcare price disparity between the U.S. and other developed countries as well as the current health plan landscape.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on...

While the No Surprises Act has saved Americans from huge surprise bills, the law is fundamentally flawed and needs to be reformed.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the syst...

Notwithstanding my opposition to most of what is in the One Big Beautiful Bill, not everything in it was bad policy. After all, we do need accountability in government programs.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and li...

A combination of events come together to create a worrisome erosion of coverage in the next decade, driving up both the uninsured and underinsured counts.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness...

Given the major MA retrenchment in 2025, many are asking what will happen to offerings, geographies, and growth in 2026. I tell you.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the sy...

While outside forces contributed, health plans, especially the big ones, can blame their own mismanagement on the insurer meltdown.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the sys...

Direct Primary Care and other reforms could save employer coverage.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare poli...

A recent House hearing on Medicare Advantage shows what is in store for plans. It may not be good. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of chan...

CMS' Medicare Advantage (MA) program audits are getting tougher and more detailed every year.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change....

While justified, there is some question about whether the new RADV audits will be fair to MA plans. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of cha...