Becker’s Payer Issues Podcast

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.

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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.

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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.

This episode of the Becker's Healthcare Podcast dives into the critical issue of payment integrity with Debra Hamer, Director of Product at CERIS. We discuss why proactive strategies are essential in the fight against fraud, explore new innovations, and look towards the future of this evolving landscape.This episode is sponsored by CERIS.

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In this episode, Dr. Wyatt Decker, Executive Vice president and Chief Physician for Value-Based Care and Innovation at UnitedHealth Group, shares insights on the transition to value-based care, its impact on patient outcomes, and the challenges facing healthcare providers. Tune in for a deep dive into how UnitedHealth Group is leading efforts to reshape the U.S. healthcare system.

In this episode, Piyush Khanna, Vice President of Clinical Services at CareFirst BlueCross BlueShield, joins the podcast to discuss the importance of timely data from provider networks. He shares insights on quality reporting requirements, operational challenges, and how advancements in data exchange are shaping the future of healthcare delivery.

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In this episode, Rushil Desai, President and CEO of Aetna Better Health of Illinois, discusses key trends in Medicaid managed care, including the integration of behavioral health and social needs, the impact of digital health solutions, and the future of value-based care. He also shares insights into the innovative programs improving access and equity for Illinois' most vulnerable populations.

In this episode, George Halvorson, Chair and CEO of the Institute for InterGroup Understanding and former CEO of Kaiser Permanente, shares insights on the evolution of Medicare Advantage, its success in delivering quality care, and its role in shaping the future of healthcare. Halvorson delves into key topics like capitation, healthcare cost management, and the ongoing challenges facing the Medicare system.

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In this episode, Chronis Manolis, Senior Vice President, Pharmacy and Chief Pharmacy Officer at UPMC Health Plan, shares his perspective on the evolving pharmacy and drug access landscape. He discusses the challenges surrounding rising drug costs, GLP-1 medications, and the future of pharmacy benefit management in a complex healthcare environment.

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In this episode, Laura Dyrda speaks with Joanne McFall, Market President of Keystone First and AmeriHealth Caritas Pennsylvania. Joanne shares her insights on post-pandemic Medicaid unwinding, rising healthcare costs, and the role of managed care in addressing social factors like housing and food insecurity to improve health outcomes.

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In this episode, Joe Glinka, Director of PA HealthChoices at Highmark Whole Care, delves into the complexities of managing Medicaid in Pennsylvania, addressing issues like rising healthcare costs, the impact of social determinants on health, and the innovative community initiatives Highmark is undertaking to support vulnerable populations.

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In this episode, Dr. Lisa Saul, UnitedHealthcare’s National Medical Director of Maternal Child Health, discusses the key findings from the 2024 Maternal and Infant Health Disparities Data Brief. Dr. Saul highlights persistent disparities in health outcomes and shares how UnitedHealthcare is working to improve maternal and infant care through community engagement and collaborative efforts.

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In this episode, Karen Walker Johnson, interim CEO at Clever Care, discusses her career journey in healthcare, Clever Care's mission to serve vulnerable populations, and the company’s culturally tailored approach to Medicare Advantage.

In this episode, Fred Turner, CEO of Curative, shares the journey of scaling the company from a COVID-19 testing powerhouse to a disruptive force in the commercial health plan space. He discusses Curative's unique no-deductible model, the importance of early patient engagement, and the challenges of entering a highly regulated industry dominated by a few major players.

In this episode, Dr. John Kim, Chief Medical Officer for Alignment Health's West Coast Markets, discusses the significant social barriers affecting senior healthcare, including transportation, economic insecurity, and loneliness. He shares how Alignment Health is tailoring benefits and programs to meet the evolving needs of seniors, emphasizing the importance of holistic care and support.

In this episode, Ananya Banerjee, Chief Commercial Officer at Aledade, Inc., discusses the challenges of healthcare access, cost management, and physician independence, while highlighting Aledade's impact on rural communities and the future of value-based care.

Tune in for today's industry updates.

Tune in for today's industry updates.

In this episode, Dr. Robert Groves, Executive Vice President & Chief Medical Officer of Banner/Aetna, discusses the evolving healthcare landscape, the impact of cost pressures, and the innovative approaches Banner/Aetna is taking to improve care delivery. Discover how community-driven programs and advancements in AI are shaping the future of patient care.

In this episode, Boyd Faust, Chief Strategy Officer at GoHealth Urgent Care and newly elected member of the Urgent Care Association Board of Directors, discusses the critical role of value-based care, strategic payer partnerships, and patient engagement in the evolving urgent care landscape.