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July 8, 2025 37 mins

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In this episode of Healthcare Trailblazers, host speaks with Dr. Boris Vabson, head of Medicare Advantage policy at CMMI (Center for Medicare & Medicaid Innovation). Dr. Vabson shares his fascinating journey from being born in the Soviet Union to becoming a Harvard health economist focused on dysfunctional healthcare systems. The conversation explores Medicare Advantage's evolution since 1965, current challenges including cost inefficiencies and prior authorization burdens, and CMMI's ambitious plans to transform the program. Dr. Vabson discusses the ongoing debate about Medicare Advantage overpayments, risk adjustment auditing using AI technology, and how CMMI plans to leverage its statutory flexibility to test innovative reforms that could be scaled nationwide. With recent leadership changes under Dr. Mehmet Oz at CMS, this timely discussion provides crucial insights into the future direction of Medicare Advantage policy affecting over 30 million Americans.

Timestamps:
00:00:00 - Introduction and Dr. Vabson's Background 

00:05:35 - Healthcare System Problems and Technology Solutions 

00:09:42 - Medicare Advantage Overview and Current Challenges 

00:18:25 - Policy Debates and Reform Efforts 

00:32:44 - CMMI's Future Plans for Medicare Advantage Transformation

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