Becker’s Payer Issues Podcast

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.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Ty Wang, Co-Founder and Chief Executive Officer of Angle Health. Ty shares how Angle Health is using AI and human-centered advocacy to improve member experience, lower costs, and drive innovation in health plan delivery.

In this episode, Dorothy Seleski, President of Medi-Cal at Health Net, discusses the organization's $9 million investment in strengthening California’s physician workforce, with a focus on underserved communities, cultural representation, and long-term collaboration across sectors.

Bob Tavernier of Quest Analytics® and Karen Tachian of Health Care Service Corporation discuss network performance in health plans including key survey insights, challenges with data quality, and how payers can use network data to drive strategic goals. The conversation highlights the importance of competitive intelligence, compliance, and member access in building high-performing networks.This episode is sponsored by Quest Analytics.

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Eric Cannon, Chief Pharmacy Benefits Officer at SelectHealth. Eric shares how transparency, evidence-based care, and a personalized approach to member experience are key to driving better outcomes and reducing healthcare costs.

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Karina Lupercio, VP of Market Integration & Data, and Ann Marie Gomez, Sr. Director of Marketing at Healthcare Highways. They discuss how curated networks, culturally competent communication, and emerging technologies like AI are helping redefine healthcare access, affordability, and trust for members.

In this episode, we’re joined by Courtney Yeakel, Chief Product Officer, and Michael Moore, Chief Revenue Officer at Veradigm, to explore how technology is driving deeper collaboration between payers and providers. They share strategies for reducing administrative complexity, integrating risk adjustment and quality initiatives, and harnessing AI to improve patient outcomes. Tune in to hear how trusted partnerships, data transparency, and forward-thinking governance are shaping the future of value-based care.This episode is sponsored by Veradigm.

In this episode of the Becker’s Payer Issues Podcast, Erika Spicer Mason speaks with Dr. Jenna Glover, Chief Clinical Officer at Headspace, about how health plans can better address mental health challenges by moving away from one-size-fits-all models. Jenna shares how smart triage, proactive care, and precision-based strategies can lead to better outcomes, reduced costs, and more equitable access to support. Tune in to hear how health plans can take a leading role in reshaping mental healthcare delivery for the future.This is episode is sponsored by Headspace.

In this episode, Jeff Bak, President and CEO of Imagine360, discusses how his organization is innovating to make healthcare more affordable, equitable, and member-friendly. He shares insights on direct contracting, price protection, health equity efforts, and how better member engagement is driving improved outcomes.

In honor of Mental Health Awareness Month, Dr. Matthew Hurford, President and CEO of Community Care Behavioral Health at UPMC, discusses how UPMC is advancing mental health support across staff, providers, and communities. He highlights practical steps to move from awareness to action and addresses pressing challenges like youth mental health and social isolation.

In this episode of the Becker’s Payer Issues Podcast, Lukas Voss speaks with Whitney Eubanks, VP of Product Management at PointClickCare, about the sharp decline in Star Ratings across major health plans and what it means for the future of value-based care. Whitney unpacks the financial, operational, and patient care implications of slipping scores—and shares how real-time data and smarter care coordination can help plans close gaps, meet critical benchmarks, and regain their edge. Tune in for a candid conversation on what it really takes to reverse the trend and boost plan performance in a competitive landscape.Sponsored by PointClickCare.

In this episode, Dr. Romilla Batra, SVP and Chief Medical Officer at Premera Blue Cross, discusses how she’s rethinking clinical strategy to align with the quintuple aim, reduce healthcare costs, and enhance equity. She also shares insights on empowering providers, removing barriers to care, and partnering with communities for better health outcomes.

In this episode, we explore how data analytics and clinical expertise can transform kidney health management for health plans. Joining the conversation is Joe Vattamattam, Founder and President of Healthmap Solutions, who shares insights on why tackling chronic kidney disease (CKD) and end-stage renal disease (ESRD) is crucial. Tune in to learn how Healthmap leverages technology, clinical support, and innovative strategies to improve outcomes for patients and providers.This episode is sponsored by Healthmap Solutions.

In this episode of the Becker’s Healthcare Podcast, Lukas Voss sits down with Mark Johnson, Senior Vice President at CERIS, to explore how payment integrity can significantly reduce billing errors and financial waste in healthcare. With up to 80% of medical bills estimated to contain mistakes, Mark shares how technology, process modernization, and strategic payer initiatives are making a meaningful impact. Tune in for insights on how payers can improve accuracy, streamline operations, and drive value across the payment lifecycle.This episode is sponsored by CERIS.

In this episode, Melissa Skottegaard, Chief Communications Officer and Chair of The Cigna Group Foundation, shares how the organization is tackling youth mental health, veteran housing insecurity, and health equity through a data-driven, employee-powered community engagement strategy designed for deeper, more focused impact.

In this episode of the Becker’s Healthcare Podcast, Brook and Jocelyne from Verifiable dive into the critical connection between provider network growth, payer collaboration, and the modernization of credentialing systems. They explore how outdated legacy systems hinder patient access and provider onboarding, and share actionable strategies for healthcare leaders to improve compliance, reduce delays, and prepare for upcoming NCQA changes. With real-world examples — including Midi Health's rapid nationwide expansion — this discussion offers a forward-looking roadmap for building more efficient, scalable, and patient-centered networks.This episode is sponsored by Verifiable.

In this episode, Dr. Ruchi Talwar, Medical Director of Episodes of Care Population Health at Vanderbilt Health, joins Jakob Emerson to discuss how provider-led bundled payment programs are improving outcomes, reducing costs, and delivering value for both employers and patients. She shares insights into Vanderbilt’s innovative “My Health Bundles” and their real-world success in reshaping specialty care.

In this episode, Steve Tringale, President of Mass General Brigham Health Plan, discusses the evolving landscape of healthcare, the challenges and opportunities brought by change, and how the organization is leveraging AI and integrated care to improve member outcomes and experiences. He also shares insights into leadership in a time of rapid industry transformation.

In this episode of the Becker's Healthcare Podcast, Erika Spicer Mason speaks with Neetu Rajpal, CEO of Lilac Software, about the evolving role of AI—specifically agentic AI—in the healthcare payer space. Neetu shares how this emerging technology is being applied to streamline claims grievances, close care gaps, and support Medicare Advantage programs, all while emphasizing the importance of ethics, patient-centered design, and regulatory compliance. This episode is sponsored by Lilac Software.

In this episode, Senthu Arumugam, Chief Commercial Officer at SCAN Health Plan, discusses the evolving Medicare Advantage landscape, the impact of market disruptions, and how technology and stability-driven strategies can improve member experiences.

In this episode, Dr. Ravi Kavasery, Chief Medical Officer at Blue Shield of California, joins Jakob Emerson to discuss the company’s ambitious goal of shifting 90% of eligible healthcare spending to pay-for-value models. Dr. Kavasery shares insights on the challenges of transitioning from fee-for-service, the importance of aligning incentives, and the innovative models shaping the future of healthcare affordability and quality.

In this episode, Dr. Steve Friedhoff, Senior VP of Healthcare Services at Blue Cross Blue Shield of North Carolina, discusses innovative initiatives addressing healthcare workforce shortages and expanding access to care. From supporting veterans transitioning into medical careers to investing in youth mental health programs, Dr. Friedhoff highlights how Blue Cross NC is shaping the future of healthcare in the state.

In this episode, Jane Brown, Vice President of Medicaid Strategic Support and Oversight at Aetna, discusses the evolving Medicaid landscape. She shares insights on improving connectivity, driving value-based care, and empowering both providers and beneficiaries through data and technology.

In this episode, Dr. Dirk Slaker, Chief Medical Officer at Sonder Health Plans, discusses the evolving Medicare Advantage landscape. He shares insights on addressing rising healthcare costs, improving care coordination, supporting caregivers, and how Sonder’s partnership with Cleo aims to enhance patient outcomes.

In this episode of the Becker’s Payer Issues Podcast, Dr. Pooja Mittal, Vice President and Chief Health Equity Officer at Health Net, discusses key challenges and opportunities in healthcare today. She explores the impact of Medicaid funding, the role of telehealth in underserved communities, and how AI can drive better health outcomes.

In this episode of the Becker's Healthcare Podcast, Jakob Emerson is joined by Rob Duffy, CTO at HealthEdge, to discuss the evolving role of platform-based technology in healthcare. They explore how interoperability, regulatory changes, and change management strategies are shaping the future of health plans. Tune in for expert insights on overcoming technological silos, preparing for innovation, and navigating the complexities of the healthcare ecosystem.This episode is sponsored by HealthEdge.

In this episode, Dr. Shantanu Agrawal, Chief Health Officer at Elevance Health, discusses the company’s innovative approach to addressing social determinants of health. He highlights the Elevance Health Foundation’s new impact investing program, its focus on behavioral health, and how insurers can drive meaningful change in communities.

In this episode, Sam Melamed, CEO of NCD, and Bret Voith, Chief Strategy Officer, discuss major regulatory shifts affecting ACA and Medicare Advantage. They explore how new policies may impact health plans, enrollment trends, and the growing demand for supplemental benefits like dental and vision coverage.

In this episode, Dr. Ken Cohen, Executive Director of Translational Research at Optum Health, discusses the impact of value-based care models on patient outcomes. He shares key findings from his recent research, including how Medicare Advantage patients in value-based arrangements receive superior care and how these benefits extend to traditional Medicare patients.

In this episode of the Becker’s Healthcare Podcast, host Lukas Voss is joined by Aarti Karamchandani, Chief Growth Officer at MacroHealth, to discuss how payers can drive continuous improvement in the healthcare ecosystem. They explore the role of price transparency data, interoperability, and robust data analysis in optimizing workflows, improving patient outcomes, and reducing costs. Tune in for key insights on overcoming challenges and implementing effective strategies for data-driven healthcare transformation.This episode is sponsored by MacroHealth.

In this episode of the Becker’s Healthcare Podcast, host Erika Spicer Mason explores how payer organizations can leverage compliance as a strategic advantage in their digital marketing efforts. David Chai, Senior Manager of Product Marketing at Freshpaint, shares insights on key industry trends, evolving consumer expectations around data privacy, and emerging tools that can help payers stay competitive.This episode is sponsored by Freshpaint.

Katherine Barresi, Chief Health Services Officer at Partnership HealthPlan of California, shares insights on the current sphere of healthcare and highlights efforts to improve access to care. She also discusses how rapid advancements in technology are bringing innovative solutions to healthcare.

Brian Janssen, Chief Information Officer for Medicare at WPS Health Insurance, discusses the responsible use of AI in healthcare to improve patient outcomes and reduce costs. He highlights the opportunity to enhance healthcare literacy in response to events from 2024 and shares valuable advice for emerging healthcare leaders.

In this episode, Troy Shaffer, VP of Contact Center Operations at SCAN Health Plan, discusses the evolving healthcare landscape. He shares insights on leveraging technology for member engagement, balancing investments, and maintaining a personalized service approach while driving operational efficiency.

In this episode, Emily Porter, VP of External Affairs at Sidecar Health, discusses the latest executive order on price transparency, its impact on insurers and hospitals, and how Sidecar Health is using transparent pricing to empower consumers.