Becker’s Payer Issues Podcast

In this episode, Jakob Emerson speaks with Patrick Quigley, CEO of Sidecar Health. Patrick shares insights about his unconventional journey into healthcare and how Sidecar Health is revolutionizing the health insurance industry with a consumer-first approach.

Health plans face crucial decisions when it comes to managing payment accuracy. This episode dives into the pros and cons of insourcing Payment Integrity solutions. We explore how control over operations translates to flexibility and cost management in a constantly evolving healthcare landscape. Industry expert Jhana Spence, Vice President of Strategy at CERIS, offers insights for health plan leaders to optimize their insourcing strategy.This episode is sponsored by CERIS.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Anne Groves, Market President at Arkos Health. Here, she emphasizes the importance of member engagement, ensuring individuals follow through with creating and adhering to their necessary health plans. Groves also encourages healthcare workers to stay focused on their mission, maintaining a patient-centered approach even amidst operational challenges.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Jordan Taggart, SVP of Payer & PBM Growth at Vida Health. Here, he discusses the importance of partnering with organizations that share Vida’s clinical philosophy to drive meaningful growth. Taggart also explores how Vida Health supports individuals from diverse backgrounds in achieving their weight loss goals, emphasizing personalized and inclusive care strategies.

In this episode of the Becker's Healthcare Podcast, Lukas Voss welcomes Dr. Katherine Hobbs, CEO of Author Health, to explore the evolving dynamics of payer-provider collaboration in healthcare. Dr. Hobbs shares insights on the impact of value-based care models, strategies for integrating mental health services, and overcoming barriers to data collection in behavioral health. Tune in for a forward-looking discussion on how healthcare leaders can drive greater collaboration, improve patient outcomes, and reduce costs.This episode is sponsored by Author Health.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Pankhuri Sharma, Strategy & Operations Leader at Humana. Here, she discusses efforts to deliver more holistic population health services, with a focus on supporting vulnerable populations. Sharma also highlights the ongoing need to build patient trust as a critical area for improvement in advancing healthcare equity and access.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Brad Riley, VP of Clinical Delivery at Longevity Health Plan. Here, he discusses how leveraging robust data sets can drive operational efficiency and improve decision-making. Riley also explores the challenges and limitations of generative AI technology in healthcare, emphasizing the need for cautious and informed adoption.

Tune in for today's industry updates.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Krischa Winright, President of Medicare Advantage at Blue Cross Blue Shield of Michigan. Here, she discusses sustainable solutions for seniors on Medicare, focusing on providing seamless access to healthcare. Winright also examines market shifts in the post-COVID era and highlights the importance of strengthening partnerships with providers to enhance care delivery and outcomes.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Mihir Kamdar, Chief Medical Officer at Tuesday Health. Here, he addresses the challenges of member experience that contribute to high healthcare costs and shares how his team is working to intervene earlier, reducing the need for costly end-of-life care. Kamdar also highlights strategies for improving patient engagement to create more proactive and supportive care solutions.

In this episode, Dr. Edward Juhn, Chief Quality Officer at Inland Empire Health Plan, shares how IEHP is tackling challenges within the Medicaid system through innovative technology, AI-driven solutions, and community-focused initiatives. Discover how IEHP is addressing provider shortages, advancing care quality, and fostering future healthcare leaders to better serve their vulnerable populations.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Scott D. Schweiger, VP of The Clinic by Cleveland Clinic. Here, he explores strategies for enhancing member engagement, encouraging patients to seek necessary care, and connecting them with programs tailored to their needs. Schweiger also discusses cost-reduction strategies aimed at making healthcare more accessible and affordable for patients.

In this episode, Dr. Yolanda Lawson, Executive Medical Director for Maternal and Infant Health at Health Care Service Corporation, discusses innovative strategies to improve maternal and infant outcomes across diverse communities. From predictive data models to community-driven initiatives like Special Beginnings, Dr. Lawson highlights how HCSE is addressing disparities, leveraging technology, and fostering partnerships to create impactful change.

In this episode of the Becker's Healthcare Podcast, host Jakob Emerson is joined by Gianni Aiello, VP of Product at Verifiable, to explore the evolving landscape of network compliance in healthcare. They discuss the core components of successful compliance programs, barriers to effective implementation, and the role of digital transformation in addressing regulatory challenges.This episode is sponsored by Verifiable.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Abdou Bah, SVP of Medical Management and Chief Health Equity Officer at Emblem Health. Here, he discusses strategies for controlling and managing ongoing healthcare costs while addressing the invisible barriers that prevent patients from accessing the care they need. Bah highlights the importance of equity-focused solutions to improve patient outcomes and reduce disparities in healthcare.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Mitchell Gorodokin, VP of Business Development at Certify. Here, he shares strategies for enhancing workflow efficiency and offers advice for leaders on growing their businesses by improving existing systems and processes. Gorodokin also addresses the challenges of navigating changing compliance regulations across jurisdictions and explains how Certify effectively manages these complexities.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Dr. Daniel Beckles, Surgeon at Ochsner Health. Here, he discusses the importance of understanding patients' lifestyle choices and explores innovative ways to incentivize healthier behaviors, aiming to improve overall health outcomes and reduce long-term healthcare costs.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Wayne Pan, Medical Doctor at San Francisco Health Plan. Here, he discusses the transformative impact of improving patient experience and how it streamlines both internal and external processes. Pan emphasizes the value of maintaining a patient-centric focus to drive meaningful change and enhance healthcare delivery.

Tune in for today's industry updates.

Join us on the Becker’s Healthcare Podcast as we delve into the future of consumer-centric healthcare with Russell Van Gorp from Publicis Sapient. Discover how digital solutions, AI, and data interoperability are reshaping the payer space and learn valuable insights from other industries that can enhance healthcare delivery.This episode is sponsored by Publicis Sapient.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Edward Juhn, Chief Quality Officer at Inland Empire Health Plan. Edward shares strategies for improving member outcomes, addressing provider shortages, and leveraging technologies like AI and machine learning, all while emphasizing the importance of ethical data stewardship and member-centered care.

Tune in for today's industry updates.

In this episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, Aric Sharp, CEO of Value-Based Care at Clover Health, discusses how technology is revolutionizing value-based care, improving clinical outcomes, and streamlining workflows for physicians, particularly through the use of AI and data integration. He also shares insights on how Clover’s tech stack is setting new industry standards for care delivery.

Explore how Evernorth Health Services leverages technology and innovative models to meet 2024 healthcare goals with insights from Brendan Kerrigan.This episode is sponsored by Evernorth Health Services.

In this episode, Mike Jasperson, Senior Vice President of Provider Network and Health Plan Operations at Priority Health, shares insights into the organization's long-standing success in value-based care. He discusses Priority Health's innovative strategies, provider collaborations, and use of advanced technologies to improve patient outcomes, lower costs, and address social determinants of health across their growing markets.

In this episode recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, Harlon Pickett, President of Eagle Care Health Solutions, discusses his innovative approach to health plans that focus on zero-cost healthcare and improving member access. He shares insights on overcoming barriers to member engagement, the future of healthcare consumerism, and the importance of behavioral health in a digital age.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Erin Henderson Moore, President and CEO of Fidelis Care. Here, she discusses her five key priorities for Fidelis Care, focusing on a growth-centric approach to leadership. Erin also shares how she is driving innovation within the organization by leveraging AI to enhance services and streamline care.

In this episode, Jennifer Shermo, Chief Growth Officer at Security Health Plan, shares her insights on tackling healthcare challenges in rural communities, navigating Medicare Advantage trends, and leveraging innovation and collaboration to enhance care. Jennifer also discusses the future of healthcare leadership and the importance of adaptability in an evolving landscape.

Discover Evernorth Home-Based Care's mission and strategies to overcome industry challenges with John Young, Chief Strategy and Development Officer.This episode is sponsored by Evernorth.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Angela Perri, President, Medicare Products. Here, she discusses the significant barriers created by lack of access to care and emphasizes the center's commitment to people-first values. Angela also shares how their benefit design supports not only healthcare needs but also the behavioral, social, and community aspects that impact overall well-being.

Join us on Becker’s Healthcare Podcast as we speak with Yvette LeFebvre, Chief Medical Officer at Evernorth Health Services – Home-Based Care. Discover the biggest challenges and opportunities in engaging healthcare members, the strategies for improving quality while maintaining compliance. Tune in for an insightful conversation on transforming home-based healthcare.This episode is sponsored by Evernorth Health Services.

In this episode, Chris Wasel, President, Marketing & Strategic Partnerships at Vantage Healthcare shares insights into his background & scope of his current role, Vantage Healthcare’s growth strategy, what traits the most effective healthcare leaders will need to be successful in the coming years, and more.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Gary Rosenfield, Director, Medicaid Product & Strategy, United Concordia Dental. Here, he discusses strategies for overcoming community access barriers to connect people with essential services and providers. Gary also emphasizes initiatives for enhancing quality and clinical outcomes in home-based care.

Tune in for today's industry updates.

In this episode, Dr. Crystal Clark, the CMO for the Community Health Choices Program at UPMC Health Plan, discusses the vital role of addressing food insecurity and other social determinants of health. Dr. Clark shares insights on UPMC’s programs, including meal delivery, healthy food allowances, and community partnerships that are transforming healthcare access and promoting holistic well-being.

In this episode, Karen Downes, Senior Director or HR Technology and HR Operations at Prime Therapeutics, discusses the company's transformation, including the pivotal Magellan acquisition and how Workday technology has supported Prime’s talent and organizational changes.They explore commitment to transparency, avoiding conflicts of interest, and the role of modern technology and AI in driving strategic objectives and business growth.This episode is sponsored by Workday

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Eric Cannon, Chief Pharmacy Officer and General Manager of Select Health/Scripius. Here, he discusses how transparency can help drive down costs and improve the member experience. Eric also explores innovative approaches to helping members choose the best care through an e-commerce experience tailored to their needs.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Ty Wang, Co-Founder and CEO of Angle Health. Here, he discusses strategies for improving the member experience and shares insights on growing the business while keeping patient experience as the top priority. Ty also explores how Angle Health is leveraging AI and new technology to enhance service and care.

In this episode, Valerie Martinez, chief health equity officer, Blue Shield of California's Promise Health Plan, shares her journey in healthcare and her role in bridging clinical and managed care to promote health equity. Valerie discusses the critical initiatives she leads, including the integration of health equity across services, community resource centers, and mobile mammography clinics, to improve access and outcomes for California’s Medi-Cal population.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Dr. Jeremy Wigginton, Chief Medical Officer at Capital Blue Cross. Here, he shares his approach to improving member experience by addressing overutilization, enhancing health literacy, and integrating whole-person care. He highlights the role of technology in growth strategies and discusses Capital Blue Cross's move towards a fully integrated care model to foster better health outcomes.

This episode explores how payers can navigate the challenges and opportunities of alternative payment models in healthcare. Jakob Emerson speaks with Angie Adams, VP of Product Management at i3 Healthcare Solutions, about agility and technology for contract management, as well as key objectives for payers and the future of healthcare payer operations.This episode is sponsored by i3Healthcare Solutions.

In this episode, Margaux Currie, Senior Director of Commercial Medical Clinical Solutions and Strategy at Cigna Healthcare, shares her personal breast cancer journey and discusses Cigna's proactive approaches to early detection and personalized support for breast cancer patients. From awareness campaigns to individualized oncology nurse advocacy, Margaux outlines how Cigna is advancing care for those impacted by breast cancer.

In this episode, Dr. Manu Chaudhry, President of Capitol Dental Care, shares his unique perspectives on transforming dental care through integrated systems and a community-focused model. Dr. Chaudhry delves into the importance of AI in bridging humanistic care, the shift toward value-based care, and the role of collaborative teams in addressing the rising complexity of oral health.

Join Jakob Emerson from the Becker's Healthcare Podcast as he sits down with Catherine Tabaka, CEO of Matrix Medical Network, to explore the rising trend of in-home health assessments. Discover how technology and in-home care are reshaping patient services and what opportunities lie ahead for payer organizations.This episode is sponsored by Matrix Medical Network.

Tune in for today's industry updates.

Join Erika Spicer Mason as she engages in a conversation with Trina Histon, PhD, VP of Clinical Product Strategy at Woebot Health, about the innovative integration of digital mental health solutions in healthcare systems like Virtua Health. Discover how Woebot is transforming mental health support and the challenges of implementing such technology in existing healthcare frameworks.This episode is sponsored by Woebot Health.

Infermedica's Chief Commercial Officer, Amanda Bury, joins Becker's Healthcare to discuss how AI is revolutionizing healthcare. We explore how AI is influencing member experience, its impact on health systems, and the importance of responsible innovation in an era of rapid technological advancement. We also delve into maximizing ROI in digital health and ensuring patients benefit from this transformative technology.This episode is sponsored by Infermedica.

In this episode, Chris Palmieri, President and CEO of Commonwealth Care Alliance, discusses key insights from the healthcare landscape, including lessons from the Steward Health System crisis, areas ripe for innovation, and the critical alignment between nonprofit missions and private capital.

In this episode, Kristen Cerf, President and CEO of Blue Shield of California Promise Health Plan, discusses the plan's recent four-star NCQA rating and the innovative approaches that led to this achievement. She shares insights on the importance of preventative care, data-driven strategies, and impactful community partnerships aimed at improving healthcare access for Medicaid members across California.

In this episode, Kimberly Funderburk, President of Government, Education & Health Systems at Cigna Health Benefits, discusses her career journey and how Cigna is addressing the unique health challenges of public sector employees. She highlights strategies such as mental health first aid training, wellness centers for transit workers, and the integration of behavioral health services to support long-term engagement and well-being.