Becker’s Payer Issues Podcast

In this episode, Chris Wasel, President of Marketing & Strategic Partnerships at Vantage Healthcare, discusses Vantage’s 2025 initiatives, including ACO expansion, new CMS programs, and the challenges of collaboration in value-based care. Chris also shares insights on the impact of AI in healthcare and the need for long-term stability in payment models.

In this episode, Jakob Emerson sits down with Rona Li, SCAN Group's Chief Development Officer, and Rob Scruggs, Chief Digital Officer, to discuss SCAN’s latest digital initiatives. They explore how investments in technology, including the upcoming SCAN member portal and mobile app, are revolutionizing member engagement, improving access to care, and enhancing personalized health experiences.

In this episode of the Becker’s Healthcare Podcast, host Erika Spicer Mason speaks with Visar Tasimi, Senior Vice President of Provider Success at Lucet, about the critical communication challenges in behavioral health. They discuss the growing demand for services, the role of primary care in care coordination, and key strategies for improving provider engagement. Tune in for expert insights on how health plans can better support behavioral health providers and enhance patient care.This episode is sponsored by Lucet Health.

In this episode, Rick Abbott, Senior Vice President of Employer Solutions and Innovation at Priority Health, discusses the evolving landscape of employer-sponsored healthcare. From tackling affordability challenges to leveraging digital health and virtual care, Rick shares insights on how Priority Health is driving innovation to improve access, quality, and cost efficiency for employers and members alike.

In this episode, Paul Penzone, Vice President and Chief Community Relations Officer at Blue Cross Blue Shield of Arizona, joins the podcast to discuss AZBlue’s mission to support community healthcare needs. He shares insights on the company's initiative to erase medical debt, expand access to preventive care, and foster long-term health equity across Arizona.

In this episode, Matt Gibbs, Senior Vice President and Chief Pharmacy Officer at Blue Shield of California, joins Becker’s to discuss how the company is dismantling the traditional PBM model to bring cost transparency and flexibility to pharmacy care. He shares insights on specialty drug pricing, the role of biosimilars, and why health plans must take back control of their pharmacy management.

In this episode, Jakob Emerson sits down with Dr. Todd May, Vice President and Medical Director at Health Net, to discuss an innovative multi-payer value-based payment model in California. Dr. May shares insights on how major insurers are working together to improve primary care quality, advance health equity, and reshape provider reimbursement.

In this episode of the Becker's Payer Issues Podcast, Dr. Kate Goodrich, Chief Medical Officer at Humana, joins Jakob Emerson to discuss the challenges of the primary care shortage, the impact of value-based care, and Humana’s commitment to improving health outcomes through innovative care models.

In this episode, Jakob Emerson sits down with Michael Hunn, CEO of CalOptima, to discuss the organization's plans to offer coverage on California’s ACA exchange by 2027. They explore how this move aims to improve continuity of care for individuals transitioning in and out of Medi-Cal, the challenges faced by low-income residents in Orange County, and the key steps ahead in the regulatory approval process.

Tune in for today's industry updates.

Tune in for today's industry updates.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Paige Brogan, Principal CalAIM at Blue Shield of California. Paige discusses Medi-Cal transformation through the CalAIM initiative, emphasizing value-based care, health equity, and innovative member engagement strategies to address whole-person needs.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Dr. Adrienne Moore, SVP of Finance at Banner Health. Dr. Moore discusses her top priorities, including the shift toward value-based care, addressing industry-wide cost pressures, and leveraging innovation to create a sustainable healthcare future.

​​This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Eric Witte, Chief Operating Officer of Genesis Orthopedics & Sports Medicine. Here, he shares insights on advancing value-based care strategies and the organization's commitment to improving access to care for patients from all backgrounds. Witte also discusses the challenges of recruiting staff and providers in today’s competitive healthcare landscape.

In this episode, Pleasant Radford Jr., MBA, CHIE, Health Equity Officer at UCare, discusses initiatives to improve inclusivity in healthcare, including staff training on data usage and addressing members with correct pronouns. Learn about innovative steps toward building a more equitable healthcare environment.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Dennis Hillen, Senior Vice President at Oscar Health. Here, he discusses Oscar Health's low-cost, tech-first strategy and how the organization is tailoring its services to accommodate Spanish-speaking and Latino members. Hillen also highlights strategies for driving engagement and retention, ensuring members stay connected and supported in their healthcare journey.

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.