Health Affairs engagement report
@Health_Affairs - 163K followers on X
Measured over 40 original posts from a 30-day window, last computed on October 24, 2026.
Engagement
A typical post picks up 3 interactions against 163K followers, an engagement rate of 0.002%. Measured over 40 original posts, its engagement rate beats 7% of 20,444 tracked accounts of a similar size. That is a reason to look at how the audience behaves - reply depth, saves, whether the followers are recent - rather than a conclusion about it on its own. Posts are seen about 826 times each, and 0.363% of those impressions turn into an interaction. That is about 0.508% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 1.3 post a day over the last 30 days, though only 43% of days saw any activity at all. Most posts go out around 12:00 UTC, and Thursday is the busiest day of the week. Of the 40 posts sampled, 40% carry an image or video and 100% link out. The account's strongest tracked post pulled 16 interactions, about 5.3x its own typical post.
Measured over 40 original posts from a 30-day window, last computed on October 24, 2026.
Compared with accounts its own size
Health Affairs's engagement rate beats 7% of the tracked X accounts closest to it in follower count (20,444 accounts, accounts of similar size (decile 8 of 10)). A percentile is spread evenly by construction, so 50 really is the middle of that group and 90 really is its top tenth.
On engagement per impression rather than per follower it beats 19% of the same group. When those two numbers disagree, the gap is about how far its posts travel rather than how people react to them.
Where this sits in the catalog
At 0.002%, Health Affairs sits below the 10th percentile of the 205,475 accounts in this comparison. That places it in the bottom 25% band, which runs below 0.024%.
Show the percentile table
| Percentile | Engagement rate |
|---|---|
| 10th percentile | 0.004% |
| 25th percentile | 0.024% |
| 50th percentile | 0.143% |
| 75th percentile | 0.678% |
| 90th percentile | 2.55% |
| 99th percentile | 82.4% |
This ruler is the whole measured catalog, not a size-matched group: it shows where the raw rate falls across every account we can measure, all of which are large. For a like-for-like comparison, read the size-band percentile above instead. See how the bands are built
Posting timing
This account posts most often around 12:00 UTC, and Thursday is its busiest day of the week. The bars below are the catalog-wide pattern, with this account's own busiest slot marked. They do not show how this account performs at each hour: we keep one aggregate per account, not one per hour, so that measurement does not exist in our data.
Show engagement by hour posted, utc as a table
| Hour (UTC) | Vs author median | Posts |
|---|---|---|
| 00:00 UTC | -1% | 89K |
| 01:00 UTC | -2% | 90K |
| 02:00 UTC | -3% | 88K |
| 03:00 UTC | -4% | 94K |
| 04:00 UTC | -5% | 76K |
| 05:00 UTC | -4% | 75K |
| 06:00 UTC | -5% | 86K |
| 07:00 UTC | -5% | 93K |
| 08:00 UTC | -4% | 108K |
| 09:00 UTC | -4% | 124K |
| 10:00 UTC | -3% | 129K |
| 11:00 UTC | -3% | 141K |
| 12:00 UTC | -3% | 154K |
| 13:00 UTC | -3% | 167K |
| 14:00 UTC | -4% | 173K |
| 15:00 UTC | -2% | 176K |
| 16:00 UTC | -3% | 171K |
| 17:00 UTC | -3% | 159K |
| 18:00 UTC | -2% | 149K |
| 19:00 UTC | -2% | 141K |
| 20:00 UTC | -1% | 131K |
| 21:00 UTC | 0% | 116K |
| 22:00 UTC | -2% | 100K |
| 23:00 UTC | -1% | 90K |
Show engagement by day of week as a table
| Day | Vs author median | Posts |
|---|---|---|
| Sunday | +5% | 393K |
| Monday | +1% | 483K |
| Tuesday | -2% | 520K |
| Wednesday | -3% | 472K |
| Thursday | -2% | 430K |
| Friday | -3% | 447K |
| Saturday | +2% | 393K |
Formats this account uses
Its own posting mix on the left, and what each of those formats does across every account we track on the right. Only formats where the effect clears our publish test appear here, so an empty row is a format we could not measure rather than one that does nothing.
| Format | This account | Catalog effect | 95% interval | Accounts behind it |
|---|---|---|---|---|
| Image or video | 40% of posts | +111% | +108% to +115% | 34K |
| Outbound link | 100% of posts | -41% | -42% to -40% | 32K |
| Typical length | - | +15% | +14% to +16% | 32K |
- 40% of this account's sampled posts carry an image or video. Across the catalog, posts with an image or video run 111% above the same accounts' other posts.
- 100% of its posts carry a link off X. Across the catalog, posts with an outbound link run 41% below the same accounts' other posts, so a large share of this account's output sits in the weakest bucket we measure.
- Its average post runs 281 characters, which falls in the over 280 characters band. Across the catalog, posts over 280 characters run 15% above the same accounts' other posts.
These are catalog-wide differences applied to this account's own posting mix, not a measurement of how each format performs for this account specifically. We keep one median per account, not one per format per account, so the second thing is not something this data can tell you.
Best tweets
- Oct 20, 20265.3x their median
CMS’s decision to no longer allow Medicaid 1115 waiver funding for workforce initiatives will challenge state efforts to recruit and retain safety-net clinicians. | Forefront Yara A. Halasa-Rappel, et al. | @ForHealthCnsltg https://t.co/keERPFIuvR
- Oct 19, 20264.0x their median
Equity and national performance are not competing goals. Improving outcomes in the population bearing the greatest prostate cancer burden is one pathway to improving the US’s overall cancer outcomes. | Forefront Taiwo Opeyemi Aremu | @WeAreTouro https://t.co/vaVUjjxFfQ
- Oct 6, 20263.7x their median
We can strengthen formulary decision making by enhancing governance, incorporating patient experience into evidence review, broadening how value is assessed, and evaluating whether patient participation meaningfully influences coverage decisions. | Forefront Marc M. Boutin, et al. | @IVI_health https://t.co/i8DofJHgG4
- Sep 15, 20263.7x their median
As states consider requiring employer contributions to fund Medicaid, policy makers can take steps to avoid unintended consequences and overcome potential barriers. | Forefront Kody Kinsley, et al. | @MilkenInstitute https://t.co/7c6IF8KkIK
- Sep 4, 20263.3x their median
If CMS is to write a template for other states, or if Congress is to buy this design at national scale, it is important to understand why these policies may fail to deliver expected outcomes. | Forefront @ZiziElsisi, et al. | @UW https://t.co/iLTEUNrEsg
- Oct 8, 20263.0x their median
HIPAA, which turned 30 years old in August, merits new attention, particularly because it is and will be the primary statutory vehicle for addressing today’s and tomorrow’s debates on artificial intelligence in medicine and health care affordability. | Forefront Chris Jennings, et al. | Jennings Policy Strategies Inc. https://t.co/2EOIOMWJO4
- Oct 23, 20262.7x their median
To appropriately hold participants accountable for population outcomes, value-based payment models must account for the factors that drive variation in outcomes outside of participant performance. | Forefront Danielle Browne, et al. | @UTSWMedCenter https://t.co/JzonwpPDSj
- Oct 20, 20262.7x their median
Reducing health care spending and improving population health needs a comprehensive approach to replace the current fragmented silo-based approaches. | Forefront Kirsten Axelsen | @DLA_Piper https://t.co/neWaiVgaF3
- Oct 13, 20262.7x their median
As the availability of post-market real-world evidence expands, more attention to its promise, limitations, and oversight in the context of accelerated approval is needed. | Forefront Peter J. Neumann, et al. | @TuftsMedicalCtr https://t.co/YxGScBaiBW
- Oct 21, 20262.3x their median
Anna Holdiman @UTHealthHouston and coauthors assess: ➡️ How delays in substance use disorder treatment are associated with homelessness ➡️ How those delays impact interaction with the criminal legal system 📖 https://t.co/E0IOgPtjhU https://t.co/ZKExRv0DVr
Ranked by total interactions across everything we have tracked for this account, which is a longer history than the 30-day window the rates above use. The multiple compares each post to this account's own median.
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Reading these numbers
A typical post picks up 3 interactions against 163K followers, an engagement rate of 0.002%. Measured over 40 original posts, its engagement rate beats 7% of 20,444 tracked accounts of a similar size. That is a reason to look at how the audience behaves - reply depth, saves, whether the followers are recent - rather than a conclusion about it on its own. Posts are seen about 826 times each, and 0.363% of those impressions turn into an interaction. That is about 0.508% of the follower count, which is the gap between an audience on paper and an audience in a timeline. Posting runs at about 1.3 post a day over the last 30 days, though only 43% of days saw any activity at all. Most posts go out around 12:00 UTC, and Thursday is the busiest day of the week. Of the 40 posts sampled, 40% carry an image or video and 100% link out. The account's strongest tracked post pulled 16 interactions, about 5.3x its own typical post.
- What is Health Affairs's engagement rate on X?
- Health Affairs (@Health_Affairs) has an engagement rate of 0.002%, based on the median interactions across 40 original posts from the last 30 days against 162,631 followers. Replies, reposts and quote-posts of other people are excluded from that sample.
- Is that a good engagement rate?
- At 0.002%, Health Affairs sits below the 10th percentile of the 205,475 accounts in this comparison. Those comparison accounts are all large ones, because our scanning cadence is weighted towards big accounts, so this is a ranking among peers of similar scale rather than a ranking across X.
- Does @Health_Affairs have real engagement?
- Its engagement rate beats 7% of the tracked X accounts closest to it in follower count (20,444 accounts), which puts it in the bottom 10% for its size group. Ranking inside a size band matters because engagement rate falls as accounts grow, so a raw rate would mostly re-measure the follower count. It is a starting point for a look at follower quality, not a verdict on it.
- When does @Health_Affairs post?
- Most posts go out around 12:00 UTC, and Thursday is its busiest day, at roughly 1.33 posts per day across the measured window.