This episode, recorded live at the Becker’s Hospital Review 15th Annual Meeting, features Nirnay Patel, EVP and GM of Benefits1™ and Chief Digital Officer at Simplify Healthcare. He shares how integrated benefits data, AI, and platform thinking are transforming payer operations and personalizing the member journey across Medicare, Medicaid, and commercial markets. This episode is sponsored by Simplify Healthcare .
Jun 05, 2025•17 min
This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health. She shares how Alignment uses AI-assisted care, culturally aware outreach, and a deep commitment to equity to deliver affordable, personalized care for seniors while preserving the human touch at every step.
Jun 05, 2025•11 min
In this episode of the Becker’s Healthcare Podcast, Lukas Voss is joined by Chad Kersting, Business Development Director, and Dr. Eric Gratias, National Physician Executive of Medical Benefit Services, both from EviCore by Evernorth. Together, they explore the evolving landscape of utilization management (UM) beyond prior authorization—highlighting common misconceptions, the challenge of underutilization, and the growing push toward preventive, personalized care. Tune in for real-world examples,...
Jun 04, 2025•17 min
This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Samuel Wollner, Vice President, Strategy and Partnerships, EmblemHealth. He shares how EmblemHealth is advancing health equity, leveraging Net Promoter Score for improvement, and focusing on deep community engagement to transform care delivery across New York.
Jun 04, 2025•7 min
This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Rebekah Hughey, Medical Director at Highmark Wholecare. She shares how Highmark’s Living Health model streamlines care delivery, tackles health equity through maternal health and food access programs, and enhances member satisfaction through a patient-centered, tech-enabled approach.
Jun 03, 2025•8 min
This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Crissy Turino, Chief Plan Officer & Chief Operating Officer, CountyCare. Crissy shares how CountyCare is advancing health equity through housing and food access programs, while boosting member satisfaction and outcomes through value-based care and community engagement.
May 31, 2025•5 min
This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Catherine Tabaka, Chief Executive Officer, and Dr. Michael Cantor, Chief Medical Officer. They discuss how Matrix Medical Network’s in-home care model addresses gaps in the healthcare system by enabling whole-person care, improving coordination, and supporting better health outcomes at lower costs. This episode is sponsored by Matrix Medical Network ....
May 30, 2025•25 min
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...
May 29, 2025•22 min
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 .
May 29, 2025•17 min
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.
May 28, 2025•4 min
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.
May 28, 2025•7 min
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.
May 27, 2025•12 min
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.
May 27, 2025•5 min
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.
May 26, 2025•5 min
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.
May 23, 2025•10 min
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 .
May 22, 2025•13 min
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.
May 22, 2025•6 min
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 ....
May 21, 2025•16 min
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.
May 21, 2025•10 min
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 levera...
May 20, 2025•28 min
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.
May 19, 2025•15 min
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.
May 16, 2025•16 min
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 episod...
May 15, 2025•13 min
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.
May 14, 2025•7 min
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.
May 13, 2025•12 min
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 ....
May 13, 2025•9 min
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.
May 12, 2025•7 min
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.
May 09, 2025•16 min
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 valu...
May 08, 2025•20 min
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...
May 06, 2025•13 min
