Why does almost 80% of America’s healthcare spend go to treating chronic disease while prevention barely receives a fraction of the $5 trillion health budget?

On this episode of The Policy Stack, Lisa Bari tries to get to the root of the problem with Dr. Anand Parekh, Chief Health Policy Officer at the University of Michigan School of Public Health and author of Prevention First: Policymaking for a Healthier America.

A veteran of two decades at HHS under George Bush and Barack Obama, Parekh explains what's actually being cut when the CDC loses 53% of its budget, why the wins from prevention are politically invisible, what the Supreme Court's ruling on ACA preventive services actually means for your next cancer screening, and why the ratio of social services to healthcare spending may be the single most predictive number in population health.

Brian Janssen reflects on running Medicare operations at WPS Health Solutions, processing 130+ million claims annually through an infrastructure that many healthcare professionals don't know exists. He shares why MACs are "the largest backbone of processing in the country that the healthcare world doesn't really know about," how regional variation matters when Flint, Michigan's environmental crisis affects local coverage decisions differently than in rural Kansas, and the challenge of innovating with AI while maintaining FISMA High security in physical data centers in systems that can't afford a single day of payment disruption.

Liza Health’s Duncan Reece reflects on decades in value-based care, from Medicare Health Support's failure to today's explosion of CMMI models launching simultaneously. He shares why MSSP's $10 billion in savings gets unfairly criticized against Medicare's $1.2 trillion spend, how Iora built its own EHR from scratch when nothing else worked for accountable care, and why the real unlock isn't payment models: it's separating necessary accountability from unnecessary complexity while technology costs plummet and AI adoption in healthcare outpaces every other industry.