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

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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.

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Today's Featured Articles

Same Care, Different Score: Medicare’s Quality Bonuses Are About To Reprice On Data, Not Medicine ([link removed] )

Mika Newton

The Referral Was Never The Point: Rereading The Retreat From Social Needs ([link removed] )

Stephen Farber

Rethinking Justice, One Study At A Time ([link removed] )

Elizabeth Van Nostrand

part of our Health Affairs Reads series

Medicare Advantage Rebates Are Too Large To Be Financed By Reductions In Plans’ Medical Spending Alone ([link removed] )

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Laura Nolan et al. (April 2026)

Protecting Patients – Partners for Evidence-Based Solutions.

The No Surprises Act shields millions of patients from unexpected medical bills. Improving the system requires data-driven solutions to maintain critical consumer protections. Learn more at CIDRE.org ([link removed] ) .

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Prior Authorization's Next Era: CMS Reform, AI, and Faster Approvals ([link removed] )

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.

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Real-World Brinkmanship In Hospital-Insurer Negotiations ([link removed] )

In an ahead-of-print paper published this week, Jason D. Buxbaum and coauthors examine how public brinkmanship in hospital-insurer negotiations is most common among powerful market players, highlighting the role of local market dynamics in shaping costs and patient access.

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