Becker’s Payer Issues Podcast

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Tom Allen, Executive Medical Director, Behavioral Health, Blue Cross and Blue Shield. Dr. Allen shares how his team is advancing behavioral health outcomes through telehealth, data-driven insights, and deeper integration with primary care while addressing rising rates of mental health conditions with a focus on member experience and whole-person care.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Chris Wasel, President, Strategic Partnerships, Vantage Healthcare. He shares how Vantage is aligning value-based care, patient satisfaction, and care accessibility through innovative on-site services in skilled nursing and assisted living facilities across New England.

In this episode, Michelle Fullerton of Blue Cross Blue Shield of Michigan and Connie S. Ducaine of MyndYou, explore how AI is streamlining workflows, improving patient engagement, and helping care teams operate at the top of their licensure. They share real-world use cases, tips for integration, and insights on measuring value across efficiency, quality, and outcomes.This episode is sponsored by MyndYou.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Saria Saccocio, Chief Medical Officer, Essence Health. Saria shares how Essence Health is enhancing outcomes through physician-led value-based care, leveraging technology like AI and wearable health devices, and advancing health equity through deep community partnerships.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Shawn Shuman, Director, Medical Management, Peak Health. Shawn discusses how Peak Health is tackling healthcare access barriers, boosting member satisfaction, and addressing health equity through innovative care management strategies.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Harlon Pickett, President, Eagle Care Health Solutions. He shares how his organization is improving healthcare access, affordability, and quality through customized, membership-based models, while expanding care equity in rural and underserved communities.

In this episode, Kevin Barron, Deputy VP of Payer Relations at University Health, shares how his team is navigating increasingly aggressive payer tactics, implementing smarter contract oversight, and championing a mission-first approach to revenue cycle operations. He also explains why aligning contracting within RevCycle has delivered measurable results for patient care and financial performance.

In this episode, Carey Ketelsen, President of Virtix Health, joins Becker’s Healthcare to discuss how payers are navigating and accelerating value-based care (VBC) strategies in 2025. From increasing revenue projections to the role of AI and data analytics, Carey shares insights into the opportunities and challenges shaping payer-provider collaboration. Tune in to explore how health plans can align technology, readiness, and long-term strategy to thrive in a shifting care landscape.This episode is sponsored by Virtix Health.

Chris Gay, CEO of Evry Health, joins the podcast to discuss how his organization is enhancing the patient experience and advancing population health. He explores how innovative technology is being used to address persistent challenges in the payer space and improve health outcomes. Gay also shares insights into building a more efficient, patient-centered healthcare system through digital transformation.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Doug Henry, Enterprise Medical Director of Behavioral Health, Highmark Health. Dr. Henry shares how Highmark is improving access, outcomes, and satisfaction through strategic partnerships, data-driven innovation, and value-based care models that prioritize mental health as a pillar of total health.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Illan Shapiro Strygler, Chief Health Correspondent and Medical Affairs Officer and Senior Vice President, AltaMed Health Services. Dr. Shapiro shares how AltaMed leverages data, cultural understanding, and community connection to improve care quality, reduce costs, and advance health equity.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Kourtney Witten, Area Vice President Network Managing Partner Wisconsin, Advocate Health. Witten discusses how her organization is leveraging data, technology, and relationship-based care to reduce costs, close care gaps, and deliver high-quality, patient-centered outcomes across diverse populations.

In this episode, Becker's Healthcare speaks with Jim Blondin, Senior Director of Digital Product Strategy at Accredo Specialty Pharmacy, about the strategic benefits of integrating specialty pharmacy into EHR workflows. The discussion explores how this integration can reduce workflow friction, improve care coordination, and enhance both patient and provider experiences. Tune in for insights relevant to pharmacy leaders, CIOs, and healthcare executives navigating digital transformation.This episode is sponsored by Accredo Specialty Pharmacy.

In this episode, Joey Seliski of Allegheny Health Network and Pritee Subramany of Highmark Health discuss how consistent, accurate provider data is essential for improving care coordination, patient trust, and enabling AI-driven tools like virtual assistants and personalized provider recommendations.This episode is sponsored by Kyruus Health.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Brian Smolich, Vice President, Health Alliance Quality and Managed Care Operations, Carle Health. Dr. Smolich shares how his organization is balancing cost and quality, leveraging biosimilars, digital engagement tools, and provider collaboration to improve member outcomes and transform the care experience.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Brad Riley, Vice President, Analytics and Reporting, Longevity Health. Brad discusses how Longevity Health is leveraging predictive analytics, machine learning, and innovative provider partnerships to balance cost containment with high-quality care, while empowering staff with AI literacy for the future of managed care.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Paul Christopher Hiltz, President and CEO, NCH Healthcare System. Paul shares how a metrics-driven culture, strategic partnerships, and clinical excellence are guiding NCH’s efforts to improve care quality, reduce costs, and expand access through major initiatives like a new orthopedic hospital and heart institute.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Louis DeStefano, Senior Vice President of Growth at Oscar Health. He shares how Oscar is leveraging personalized plan designs, technology-driven engagement, and the growing potential of ICHRAs to improve affordability, satisfaction, and outcomes in the individual insurance market.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Alex Ding, Deputy Chief Medical Officer, Humana. Dr. Ding shares how Humana is bridging its payer and provider roles to advance health equity, enable clinicians, and drive value-based care transformation at scale, all while putting whole-person care and patient experience at the center.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Sufian Chowdhury, Chief Executive Officer of Kinetik. Sufian discusses how Kinetik is transforming non-emergency medical transportation (NEMT) through real-time data, interoperability, and plan-owned infrastructure to improve compliance, reduce fraud, and enhance member experience.This episode is sponsored by Kinetik.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Lila Benayoun, Chief Operating Officer, MetroPlusHealth. She shares how the organization is combining predictive analytics, personalized outreach, and community-based services to proactively manage care, improve member satisfaction, and address social determinants of health across New York City.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Mark Rich, Former President and current Board Member of Steward Health Care System LLC. Mark shares insights from the provider and ACO perspective on accelerating value-based care, aligning payer-provider collaboration, and leveraging actionable data to drive both affordability and improved outcomes.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Lawrence Hamilton, Executive Vice President, The Permanente Medical Group. Lawrence discusses the power of payer-provider alignment in delivering population health, advancing health equity across service lines, and using real-time patient feedback to enhance care experience and outcomes.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Dr. Aisha Rahim, Medical Director and Co-Lead, AI Governance Council, Johns Hopkins Health Plans (JHHP). Dr. Rahim discusses how JHHP is leveraging artificial intelligence to manage costs, close care gaps, advance health equity, and enhance member engagement across a diverse population.

In this episode, Dr. Jennifer Nuovo, Chief Medical Officer of Blue Shield of California’s Promise Health Plan, joins Jakob Emerson to discuss how her team is increasing access to preventive care, addressing health disparities, and building community trust through targeted outreach, innovative programs, and a focus on whole person care.

Stacy Edgar, Co-Founder and CEO at Venteur, joins the podcast to discuss how her organization is working to strike the right balance between affordability and quality in healthcare. She highlights initiatives that support new mothers in navigating their healthcare journey and emphasizes the importance of understanding and aligning with partners to drive meaningful outcomes.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health. She shares how Alignment uses AI-assisted care, culturally aware outreach, and a deep commitment to equity to deliver affordable, personalized care for seniors while preserving the human touch at every step.

This episode, recorded live at the Becker’s Hospital Review 15th Annual Meeting, features Nirnay Patel, EVP and GM of Benefits1™ and Chief Digital Officer at Simplify Healthcare. He shares how integrated benefits data, AI, and platform thinking are transforming payer operations and personalizing the member journey across Medicare, Medicaid, and commercial markets.This episode is sponsored by Simplify Healthcare.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health. She shares how Alignment uses AI-assisted care, culturally aware outreach, and a deep commitment to equity to deliver affordable, personalized care for seniors while preserving the human touch at every step.

In this episode of the Becker’s Healthcare Podcast, Lukas Voss is joined by Chad Kersting, Business Development Director, and Dr. Eric Gratias, National Physician Executive of Medical Benefit Services, both from EviCore by Evernorth. Together, they explore the evolving landscape of utilization management (UM) beyond prior authorization—highlighting common misconceptions, the challenge of underutilization, and the growing push toward preventive, personalized care. Tune in for real-world examples, emerging strategies, and a future-focused look at how UM can better serve both clinicians and patients.This episode is sponsored by Evernorth.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Samuel Wollner, Vice President, Strategy and Partnerships, EmblemHealth. He shares how EmblemHealth is advancing health equity, leveraging Net Promoter Score for improvement, and focusing on deep community engagement to transform care delivery across New York.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Rebekah Hughey, Medical Director at Highmark Wholecare. She shares how Highmark’s Living Health model streamlines care delivery, tackles health equity through maternal health and food access programs, and enhances member satisfaction through a patient-centered, tech-enabled approach.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Crissy Turino, Chief Plan Officer & Chief Operating Officer, CountyCare. Crissy shares how CountyCare is advancing health equity through housing and food access programs, while boosting member satisfaction and outcomes through value-based care and community engagement.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Catherine Tabaka, Chief Executive Officer, and Dr. Michael Cantor, Chief Medical Officer. They discuss how Matrix Medical Network’s in-home care model addresses gaps in the healthcare system by enabling whole-person care, improving coordination, and supporting better health outcomes at lower costs.This episode is sponsored by Matrix Medical Network.

In this episode of the Becker’s Payer Issues Podcast, Jakob Emerson speaks with Dr. Tracy Gayeski, Chief Health Officer at Catalight, a nonprofit organization dedicated to transforming care for individuals with autism and intellectual and developmental disabilities (I/DD). Dr. Gayeski discusses how Catalight is addressing affordability, individualized care at scale, and social determinants of health—all while preparing for the transformative role AI will play in the next two years. Tune in for a thoughtful exploration of what meaningful, sustainable, and person-centered care really looks like.This episode is sponsored by Catalight.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Raj Ronanki, Chief Executive Officer, Lyric. Here, he discusses the company's evolution, its focus on real-time, AI-powered payment integrity, the strategic acquisition of ClaimShark, and Lyric’s vision for enabling autonomous healthcare operations and greater transparency across the system.This episode is sponsored by Lyric.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Sachin Jain, President and Chief Executive Officer, SCAN Group. Dr. Jain discusses how SCAN is redefining member experience through human-centered care and highlights the urgent need for deeper payer-provider partnerships to drive true innovation and better outcomes in healthcare.

In this episode, Erfan Karim, Chief Clinical Operations Officer at NYC Health + Hospitals/Bellevue, discusses the critical role of Medicaid in public health, the impact of recent policy shifts, and how innovation in care delivery can help safeguard vulnerable communities. He also shares how personal experience drives his commitment to equitable access for all.

In this episode, Alan Silver, President of Centene’s ICHRA-focused Ambetter Health Solutions, joins the Jakob Emerson to discuss the rapid evolution of individual coverage HRAs, why large and small employers are embracing the model, and what it takes for insurers to succeed in this growing space.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Sheri Johnson, Vice President, Member Enrollment and Billing, UCare. Sheri discusses how member feedback led to meaningful changes in payment options—including credit card and pay-by-phone solutions—and how these innovations have significantly improved member satisfaction and engagement.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Sheri Johnson, Vice President, Member Enrollment and Billing, UCare. Sheri discusses how member feedback led to meaningful changes in payment options—including credit card and pay-by-phone solutions—and how these innovations have significantly improved member satisfaction and engagement.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Jarrod McNaughton, CEO of Inland Empire Health Plan. Jarrod shares how IEHP is aligning mission, culture, and bold innovation to drive health equity, improve quality through performance-based partnerships, and enhance member satisfaction with community-centered programs.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Dr. Eric Weil, Chief Medical Officer at MD Live by Evernorth. Dr. Weil discusses how MD Live is innovating virtual care through a focus on efficiency, prevention, and access—while emphasizing the critical role of quality and safety in transforming healthcare delivery. This episode is sponsored by Evernorth.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Peter Kuipers, CFO of Clover Health. Peter shares how Clover’s technology-first approach is enabling earlier chronic disease diagnosis, improving care quality, and driving down costs—while expanding access through a premium-free PPO model and partnerships with other payers.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Stuart Langley, SVP, Client Services, Everise & Sadie Rizzuto, Vice President, Enterprise Technology Solution Implementation, Humana. They discuss the power of predictive models, AI, and automation in improving member engagement, reducing friction in claims, and advancing proactive care and provider collaboration.This episode is sponsored by Everise.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Angie Kalousek, Senior Director, Clinical Strategy and Programs at Blue Shield of California. Angie shares how her organization is innovating in value-based care, virtual delivery, and health equity initiatives to balance affordability, quality, and access for diverse member populations.

In this episode of the Becker’s Healthcare Podcast, Erika Spicer Mason speaks with Brian Workinger and Lauree Handlon of The Craneware Group about how AI and data-driven insights are helping providers navigate increasingly complex payer contracting and reimbursement environments. The conversation covers predictive modeling, payer transparency, and preparing for shifts in Medicare Advantage participation, all within the broader context of value-based care. Tune in to hear how hospitals can leverage advanced analytics to drive smarter financial strategies and improve long-term sustainability.This episode is sponsored by Craneware.

In this episode, Jake Biscoglio, President of Commercial Business at Harvard Pilgrim Health Care, discusses the organization's expanded partnership with Progeny Health to support families for a full year after NICU discharge. He shares personal insights and industry strategies to improve outcomes through comprehensive, family-centered care.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Dr. Damanjeet Chaubey, Vice President of Clinical Affairs at Clover Health. Dr. Chaubey shares how Clover is leveraging AI-powered technology, proactive care models, and home-based strategies to improve outcomes, reduce costs, and redefine Medicare Advantage.

In this special episode recorded at Becker’s Annual Meeting 2025, leaders from Noom Health share how their platform is advancing whole-person care through behavior change and digital innovation. The conversation highlights how Noom leverages data, coaching, and psychology to support better health outcomes—particularly in chronic disease management and preventative care. Tune in to hear how scalable digital solutions are reshaping engagement and impact across the healthcare ecosystem.This episode is sponsored by Noom Health.