Becker’s Payer Issues Podcast

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Trey Sutten, CEO and Co-Founder of Siftwell, Director of Clinical Solutions. Here, he explores how health plans can prepare for HR1 by identifying at risk members, leveraging data and community partnerships, and building proactive strategies to maintain coverage amid regulatory change.

This episode is sponsored by Siftwell.

In this episode, Dr. Lisa Shah, Executive Vice President and Chief Medical Officer of Twin Health, discusses how AI-powered digital twin technology is transforming care for chronic conditions and enabling personalized, real-time interventions. She also shares insights on payer trends, outcomes-based models, and new approaches to reducing reliance on medications while improving long-term health outcomes.

This episode is sponsored by Twin Health.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Dirk Soenksen, Chief Executive Officer of Ceresti Health, discussing why dementia is a major yet underrecognized cost driver and how it reshapes population health strategy. He highlights the critical role of family caregivers, the limitations of traditional care management, and how payer-focused models can improve outcomes while reducing costs.

This episode is sponsored by Ceresti Health.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Megan Zakrewsky, VP of Product Strategy, Veradigm, Director of Clinical Solutions. Here, she explores how prospective gap closure, interoperable data exchange, and EHR integrated workflows are helping independent providers act on payer insights in real time, reduce administrative burden, and improve outcomes across underserved and rural populations.

This episode is sponsored by Veradigm.

In this episode, Rob Andrews, Chief Executive Officer of the Health Transformation Alliance, joins the podcast to discuss the ongoing pressures and competition within Medicare Advantage. He shares insights on chronic care initiatives and the importance of collaboration and compromise between carriers and providers to improve outcomes and control costs.

In this episode, Brandy Thompson, Chief Executive Officer, Benefitbay, discusses the rapid growth of ICHRA models and why large employers are increasingly embracing choice driven benefits. She also shares how education, broker alignment, and evolving payer strategies are shaping the future of employer sponsored healthcare.

In this episode, Harlon Pickett, President of Eagle Care Health Solutions, joins the podcast to discuss the impact of direct primary care models on patient outcomes and cost. He shares how designing more effective networks and leveraging data can help create a more personalized and efficient healthcare experience.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Joseph Leach, Market President, Oscar Health. He discusses the growing trust gap in healthcare, how empowering consumers through tools like ICHRA and AI can improve outcomes, and why meeting members where they are is key to balancing cost and experience.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Dr. Benjamin Kornitzer, Chief Medical Officer, Aetna, discussing efforts to reduce administrative friction, streamline prior authorization, and improve care navigation for members and providers. He also shares how Aetna is leveraging AI, interoperability, and digital tools to enhance real time decision making, build trust, and deliver more personalized, efficient healthcare experiences.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Christina Ott, Chief Strategy Officer, Quartz, discussing how her organization is tackling rising costs by rethinking the payer role, improving care navigation, and reducing friction for members. She also shares insights on aligning digital investments and using AI to streamline workflows, enhance communication, and create a more seamless healthcare experience.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Robert Holzer, Strategy and Innovation Leader, Next Horizon Innovations, Martin Luethi, Chief Technology Officer, Quest Analytics, & Bob Tavernier, Solution Executive, Quest Analytics. The conversation explores how provider data has evolved from a compliance requirement into a strategic driver of AI readiness, network performance, regulatory alignment, and member trust, emphasizing the need for clean data, strong governance, and scalable infrastructure.

This episode is sponsored by Quest Analytics.

This episode recorded live at the Becker’s 16th Annual Meeting features Jennifer Jones, Director of Clinical Solutions, Noom. Here, she explores how GLP-1s should be viewed as part of chronic disease management rather than a pharmacy-only cost issue, and how payer strategies that combine medication access with behavior change programs can improve long-term clinical outcomes and deliver more sustainable ROI.

This episode is sponsored by Noom Health.

In this episode, Sundar Srinivasan, President – Health Plan & Life Sciences, NTT DATA, discusses how payer organizations are moving from AI pilots to scaled deployments, focusing on high impact use cases, operational transformation, and the importance of trust, governance, and measurable ROI.

This episode is sponsored by NTT DATA.

In this episode, Mike Stuart, President and CEO of Blue Shield of California, shares how his finance and provider background shapes a systems approach to improving health outcomes, strengthening provider partnerships, and addressing rising healthcare costs. He also discusses the growing impact of chronic disease and why collaboration across the healthcare ecosystem is critical to making care more affordable and accessible.

In this episode, Steve Yurjevich, Chief Executive Officer of Optum Insight’s Payer Market and a member of the American Heart Association Executive Leadership Team, joins the podcast to discuss rising healthcare costs and the growing adoption of AI across the payer landscape. He shares how the industry is shifting from pre-pay models to true avoidance strategies, focusing on preventing unnecessary care and improving overall system efficiency.

In this episode, Jeff Bak, President and Chief Executive Officer of Imagine360, joins the podcast to discuss improving health literacy for seniors and the role it plays in driving better outcomes. He shares how proactive care strategies and smarter use of utilization data can help create a more effective, patient-centered healthcare system.

In this episode, Rob Duffy, Chief Technology Officer at HealthEdge, explores how modern cloud infrastructure and deeply integrated AI can help health plans manage rising complexity, reduce administrative costs, and scale operations. He shares why platform consolidation and embedded AI are critical to staying competitive and sustaining performance in a rapidly evolving healthcare landscape.

This episode is sponsored by HealthEdge.

In this episode, Alexandra Anderson, Head of Health Plan Sales & Partnerships at Color, explores how proactive, personalized screening and integrated care pathways can improve early cancer detection and reduce total cost of care for cancer. She shares insights on Color's approach to identifying risk & closing screening gaps, increasing member engagement, and the importance of timely, proactive interventions along the cancer care continuum.

This episode is sponsored by Color.

In this episode, Pankhuri Sharma, Strategy and Operations Leader at Humana, joins the podcast to discuss gaps between population health strategy and real-world outcomes. She shares key priorities for effective population health programs and offers practical advice for emerging leaders navigating the evolving healthcare landscape.

In this episode, Charles Fan, President of Headspace, and Charlie Andres, Lead Actuary at Headspace, explore the drivers behind rising behavioral health costs and the growing impact of outpatient therapy. They discuss how integrated, prevention-focused care models and improved care pathways can help health plans manage costs while delivering better outcomes.

This episode is sponsored by Headspace.

In this episode, Marc Jeffreys, General Manager of Health at Gradient AI, discusses how insurers are moving from experimental AI to practical tools that support underwriting, pricing, and population health decisions. He also explains why connected intelligence across the risk lifecycle can improve pricing stability, strengthen employer relationships, and unlock clearer insights from complex data.

This episode is sponsored by Gradient AI.

In this episode, Kevin Knight, Chief Marketing Officer at Sidecar Health, joins the podcast to discuss making healthcare more intuitive and consumer-friendly. He shares how giving money back to consumers through tools like HSAs can improve engagement, and explains why competition and technology are key drivers of meaningful system-wide improvement.

In this episode, Jhana Spence, Senior Vice President of Strategy at CERIS, discusses the shift toward proactive payment integrity and what it means to “move left” in the claims lifecycle. She explores how health plans are leveraging data, analytics, and automation to reduce financial leakage, improve provider relationships, and build accuracy before payment goes out the door. 

This episode is sponsored by CERIS.

In this podcast, Steve Province, former CEO of a major MCO, joins Kendall Lockhart, Founder & CEO of Me+U Care, to unpack why “meeting people where they are” remains so hard in practice for many health plans, and what it will take to rebuild trust under growing HR1 pressures. A grounded, real world conversation about the human side of member retention.

This episode is sponsored by Me+U Care.

In this episode, Dr. Faisal Tai, board-certified psychiatrist and founder of PsychPlus, discusses how fragmented systems, limited connectivity, and misaligned incentives are driving gaps in behavioral health access and rising costs. He shares how vertically integrated care models, unified platforms, and better care coordination can improve outcomes, reduce ED utilization, and lower total cost of care at scale.

This episode is sponsored by PsychPlus.

In this episode, Gene German, Chief Technology Officer at Lyric, explores how small, domain-specific language models (SLMs) are driving measurable improvements in claims and payment integrity. He outlines how combining AI with human judgment can increase efficiency, reduce variability, and enhance accuracy across complex healthcare workflows. Gene also shares a practical roadmap for scaling AI, from identifying the right use cases to building the data, governance, and feedback systems needed for sustained impact.

This episode is sponsored by Lyric.ai.

In this episode, Gretchen Wagner, Associate Vice President - Risk Management, Humana, discusses how health plans are navigating cost pressures, workforce challenges, and rapid change by strengthening value-based partnerships and operational efficiency. She highlights the critical role of data interoperability, digital innovation, and analytics in improving member experience and long-term sustainability.

In this episode, Dr. Sameer Amin of L.A. Care Health Plan discusses how building durable community infrastructure, rather than short-term programs, supports continuity of care amid Medicaid enrollment shifts. He explains how investments in housing, food access, and care coordination can deliver measurable ROI while improving outcomes and reducing administrative burden.

In this episode, Brian Cheney, Division SVP of Sales Operations and Commercial Markets Growth at Health Care Service Corporation, discusses the launch of Unity Health Hub and how it helps employers navigate the growing number of digital health solutions. He explains how the platform integrates vetted vendors, improves member engagement, and delivers clearer data on outcomes and impact.

In this episode, Rhonda Randall, DO, Chief Medical Officer for UnitedHealthcare’s employer and individual business, discusses the company’s expansion of doula coverage to millions of members and the evidence behind its impact on maternal and infant health. She also explains how doulas support care teams and why employers are increasingly prioritizing better maternity care outcomes.

In this episode, Daniel J. Elliott, MD, MSCE, FACP, FAAP, Chief Medical Officer of Provider Experience at Centene Corporation, discusses how payers and providers can work together to address cost pressures, workforce challenges, and care coordination. He also shares perspectives on using AI, improving data sharing, and reducing friction in processes like prior authorization to strengthen the healthcare ecosystem.

In this episode, Krista Nelson, CEO of Optum Health, shares her vision for strengthening value based care through a more focused care delivery model, stronger clinician support, and expanded technology capabilities. She also discusses Medicare Advantage policy stability, the role of AI in reducing administrative burden, and how partnerships across the healthcare ecosystem can improve outcomes and patient experience.

In this episode, Dr. Kara Odom Walker, Chief Medical Officer for Aetna Medicaid, discusses a new collaboration with National Association of Community Health Centers to improve hypertension control in underserved communities. She shares how data, community partnerships, and addressing social drivers of health can help reduce disparities, prevent chronic disease complications, and improve outcomes for Medicaid members.

In this episode, Dawn Maroney, President of Alignment Health and CEO of Alignment Health Plan, joins the podcast to discuss how payer–provider relationships are evolving amid cost pressures and workforce shortages. She explores common gaps between strategy and execution, the importance of disciplined operational follow-through, and why healthy competition remains essential to driving innovation, value, and improved outcomes across the healthcare landscape.

In this episode, Jennifer L. Kowalski, Vice President of the Public Policy Institute at Elevance Health, discusses how rigorous research and data shape Medicare Advantage strategy, from supplemental benefits to dual eligible integration. She shares insights on affordability, care navigation, and how evidence based policy can strengthen value, access, and long term sustainability in the program.

In this episode, Karen Walker Johnson, Chief Executive Officer of Clever Care Health Plan, discusses how culturally competent, value based care is reshaping Medicare Advantage. She shares insights on strengthening provider trust, investing in community based engagement, and advocating for quality metrics that recognize cultural competence to improve outcomes and affordability.

In this episode, Jeff Bak, President and Chief Executive Officer of Imagine360, shares how alternative health plan models and reference based pricing can lower employer costs while improving the member experience. He discusses narrowing networks, building provider trust, correcting broker misconceptions, and delivering guaranteed savings in a high pressure cost environment.

In this episode, Emily Durfee, Partner of Corporate Venture Capital at Healthworx, discusses strengthening payer provider collaboration, accelerating responsible AI adoption, and using strategic investment to address regulatory uncertainty and the rising cost of care.

In this episode, Saria Saccocio, MD, MHA, Chief Medical Officer of Essence Healthcare, discusses the growing collaboration between payers and providers, the push for site neutral care and pharmacy cost reform, and the need for stronger investment in cardiometabolic and population health. She also shares how quality performance, member experience, and social determinants of health are shaping health plan strategy and margins heading into 2026.

In this episode, Michael Hunn, CEO, and Yunkyung Kim, COO, of CalOptima Health discuss preparing for Medicaid eligibility changes, preventing coverage losses, and supporting providers amid rising uncompensated care risks. They also share plans for a 2027 Covered California marketplace launch and reflect on building community trust through collaboration and mission driven leadership.