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.
Feb 28, 2025•15 min
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.
Feb 27, 2025•12 min
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.
Feb 26, 2025•17 min
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.
Feb 21, 2025•17 min
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.
Feb 20, 2025•24 min
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.
Feb 19, 2025•12 min
Tune in for today's industry updates.
Feb 07, 2025•9 min
Tune in for today's industry updates.
Jan 27, 2025•3 min
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.
Jan 22, 2025•7 min
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.
Jan 20, 2025•6 min
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.
Jan 20, 2025•9 min
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.
Jan 18, 2025•10 min
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.
Jan 17, 2025•8 min
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.
Jan 16, 2025•16 min
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 ....
Jan 15, 2025•12 min
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.
Jan 14, 2025•6 min
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.
Jan 13, 2025
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 outco...
Jan 13, 2025•17 min
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.
Jan 10, 2025
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.
Jan 09, 2025•8 min
Tune in for today's industry updates.
Jan 07, 2025•8 min
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.
Jan 06, 2025•11 min
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.
Jan 02, 2025•9 min
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.
Dec 27, 2024•10 min
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.
Dec 24, 2024•8 min
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.
Dec 21, 2024•13 min
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 .
Dec 20, 2024•19 min
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.
Dec 19, 2024•4 min
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.
Dec 17, 2024•10 min
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.
Dec 16, 2024
