Becker’s Payer Issues Podcast

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.

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 value-based care.

This episode is sponsored by Veradigm.

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 delivery for the future.

This is episode is sponsored by Headspace.

In this episode, Jeff Bak, President and CEO of Imagine360, discusses how his organization is innovating to make healthcare more affordable, equitable, and member-friendly. He shares insights on direct contracting, price protection, health equity efforts, and how better member engagement is driving improved outcomes.

In honor of Mental Health Awareness Month, Dr. Matthew Hurford, President and CEO of Community Care Behavioral Health at UPMC, discusses how UPMC is advancing mental health support across staff, providers, and communities. He highlights practical steps to move from awareness to action and addresses pressing challenges like youth mental health and social isolation.

In this episode of the Becker’s Payer Issues Podcast, Lukas Voss speaks with Whitney Eubanks, VP of Product Management at PointClickCare, about the sharp decline in Star Ratings across major health plans and what it means for the future of value-based care. Whitney unpacks the financial, operational, and patient care implications of slipping scores—and shares how real-time data and smarter care coordination can help plans close gaps, meet critical benchmarks, and regain their edge. Tune in for a candid conversation on what it really takes to reverse the trend and boost plan performance in a competitive landscape.

In this episode, Dr. Romilla Batra, SVP and Chief Medical Officer at Premera Blue Cross, discusses how she’s rethinking clinical strategy to align with the quintuple aim, reduce healthcare costs, and enhance equity. She also shares insights on empowering providers, removing barriers to care, and partnering with communities for better health outcomes.

In this episode, we explore how data analytics and clinical expertise can transform kidney health management for health plans. Joining the conversation is Joe Vattamattam, Founder and President of Healthmap Solutions, who shares insights on why tackling chronic kidney disease (CKD) and end-stage renal disease (ESRD) is crucial. Tune in to learn how Healthmap leverages technology, clinical support, and innovative strategies to improve outcomes for patients and providers.

This episode is sponsored by Healthmap Solutions.

In this episode of the Becker’s Healthcare Podcast, Lukas Voss sits down with Mark Johnson, Senior Vice President at CERIS, to explore how payment integrity can significantly reduce billing errors and financial waste in healthcare. With up to 80% of medical bills estimated to contain mistakes, Mark shares how technology, process modernization, and strategic payer initiatives are making a meaningful impact. Tune in for insights on how payers can improve accuracy, streamline operations, and drive value across the payment lifecycle.

This episode is sponsored by CERIS.

In this episode, Melissa Skottegaard, Chief Communications Officer and Chair of The Cigna Group Foundation, shares how the organization is tackling youth mental health, veteran housing insecurity, and health equity through a data-driven, employee-powered community engagement strategy designed for deeper, more focused impact.

In this episode of the Becker’s Healthcare Podcast, Brook and Jocelyne from Verifiable dive into the critical connection between provider network growth, payer collaboration, and the modernization of credentialing systems. They explore how outdated legacy systems hinder patient access and provider onboarding, and share actionable strategies for healthcare leaders to improve compliance, reduce delays, and prepare for upcoming NCQA changes. With real-world examples — including Midi Health's rapid nationwide expansion — this discussion offers a forward-looking roadmap for building more efficient, scalable, and patient-centered networks.

This episode is sponsored by Verifiable.

In this episode, Dr. Ruchi Talwar, Medical Director of Episodes of Care Population Health at Vanderbilt Health, joins Jakob Emerson to discuss how provider-led bundled payment programs are improving outcomes, reducing costs, and delivering value for both employers and patients. She shares insights into Vanderbilt’s innovative “My Health Bundles” and their real-world success in reshaping specialty care.

In this episode, Steve Tringale, President of Mass General Brigham Health Plan, discusses the evolving landscape of healthcare, the challenges and opportunities brought by change, and how the organization is leveraging AI and integrated care to improve member outcomes and experiences. He also shares insights into leadership in a time of rapid industry transformation.

In this episode of the Becker's Healthcare Podcast, Erika Spicer Mason speaks with Neetu Rajpal, CEO of Lilac Software, about the evolving role of AI—specifically agentic AI—in the healthcare payer space. Neetu shares how this emerging technology is being applied to streamline claims grievances, close care gaps, and support Medicare Advantage programs, all while emphasizing the importance of ethics, patient-centered design, and regulatory compliance.

This episode is sponsored by Lilac Software.

In this episode, Senthu Arumugam, Chief Commercial Officer at SCAN Health Plan, discusses the evolving Medicare Advantage landscape, the impact of market disruptions, and how technology and stability-driven strategies can improve member experiences.

In this episode, Dr. Ravi Kavasery, Chief Medical Officer at Blue Shield of California, joins Jakob Emerson to discuss the company’s ambitious goal of shifting 90% of eligible healthcare spending to pay-for-value models. Dr. Kavasery shares insights on the challenges of transitioning from fee-for-service, the importance of aligning incentives, and the innovative models shaping the future of healthcare affordability and quality.

In this episode, Dr. Steve Friedhoff, Senior VP of Healthcare Services at Blue Cross Blue Shield of North Carolina, discusses innovative initiatives addressing healthcare workforce shortages and expanding access to care. From supporting veterans transitioning into medical careers to investing in youth mental health programs, Dr. Friedhoff highlights how Blue Cross NC is shaping the future of healthcare in the state.

In this episode, Heather O’Sullivan, APRN, President and COO of Healthcare at Home at Mass General Brigham, discusses the rapid expansion of the Home Hospital model, its impact on patient outcomes, and the challenges of scaling home-based acute care. She shares insights on how this innovative approach is addressing hospital capacity issues, enhancing workforce satisfaction, and shaping the future of healthcare.

In this episode, Jane Brown, Vice President of Medicaid Strategic Support and Oversight at Aetna, discusses the evolving Medicaid landscape. She shares insights on improving connectivity, driving value-based care, and empowering both providers and beneficiaries through data and technology.

In this episode, Dr. Dirk Slaker, Chief Medical Officer at Sonder Health Plans, discusses the evolving Medicare Advantage landscape. He shares insights on addressing rising healthcare costs, improving care coordination, supporting caregivers, and how Sonder’s partnership with Cleo aims to enhance patient outcomes.

 In this episode of the Becker’s Payer Issues Podcast, Dr. Pooja Mittal, Vice President and Chief Health Equity Officer at Health Net, discusses key challenges and opportunities in healthcare today. She explores the impact of Medicaid funding, the role of telehealth in underserved communities, and how AI can drive better health outcomes.

In this episode of the Becker's Healthcare Podcast, Jakob Emerson is joined by Rob Duffy, CTO at HealthEdge, to discuss the evolving role of platform-based technology in healthcare. They explore how interoperability, regulatory changes, and change management strategies are shaping the future of health plans. Tune in for expert insights on overcoming technological silos, preparing for innovation, and navigating the complexities of the healthcare ecosystem.

This episode is sponsored by HealthEdge.

In this episode, Dr. Shantanu Agrawal, Chief Health Officer at Elevance Health, discusses the company’s innovative approach to addressing social determinants of health. He highlights the Elevance Health Foundation’s new impact investing program, its focus on behavioral health, and how insurers can drive meaningful change in communities.

In this episode, Sam Melamed, CEO of NCD, and Bret Voith, Chief Strategy Officer, discuss major regulatory shifts affecting ACA and Medicare Advantage. They explore how new policies may impact health plans, enrollment trends, and the growing demand for supplemental benefits like dental and vision coverage.

In this episode, Dr. Ken Cohen, Executive Director of Translational Research at Optum Health, discusses the impact of value-based care models on patient outcomes. He shares key findings from his recent research, including how Medicare Advantage patients in value-based arrangements receive superior care and how these benefits extend to traditional Medicare patients.

In this episode of the Becker’s Healthcare Podcast, host Lukas Voss is joined by Aarti Karamchandani, Chief Growth Officer at MacroHealth, to discuss how payers can drive continuous improvement in the healthcare ecosystem. They explore the role of price transparency data, interoperability, and robust data analysis in optimizing workflows, improving patient outcomes, and reducing costs. Tune in for key insights on overcoming challenges and implementing effective strategies for data-driven healthcare transformation.

This episode is sponsored by MacroHealth.

 In this episode of the Becker’s Healthcare Podcast, host Erika Spicer Mason explores how payer organizations can leverage compliance as a strategic advantage in their digital marketing efforts. David Chai, Senior Manager of Product Marketing at Freshpaint, shares insights on key industry trends, evolving consumer expectations around data privacy, and emerging tools that can help payers stay competitive.

This episode is sponsored by Freshpaint.

Katherine Barresi, Chief Health Services Officer at Partnership HealthPlan of California, shares insights on the current sphere of healthcare and highlights efforts to improve access to care. She also discusses how rapid advancements in technology are bringing innovative solutions to healthcare.

Brian Janssen, Chief Information Officer for Medicare at WPS Health Insurance, discusses the responsible use of AI in healthcare to improve patient outcomes and reduce costs. He highlights the opportunity to enhance healthcare literacy in response to events from 2024 and shares valuable advice for emerging healthcare leaders.

In this episode, Dr. Ken Cohen, Executive Director of Translational Research at Optum Health, discusses the impact of value-based care models on patient outcomes. He shares key findings from his recent research, including how Medicare Advantage patients in value-based arrangements receive superior care and how these benefits extend to traditional Medicare patients.

In this episode, Troy Shaffer, VP of Contact Center Operations at SCAN Health Plan, discusses the evolving healthcare landscape. He shares insights on leveraging technology for member engagement, balancing investments, and maintaining a personalized service approach while driving operational efficiency.

In this episode, Emily Porter, VP of External Affairs at Sidecar Health, discusses the latest executive order on price transparency, its impact on insurers and hospitals, and how Sidecar Health is using transparent pricing to empower consumers.

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.