Becker’s Payer Issues Podcast

In this episode, Halsey Wise, CEO, Lyric, discusses the importance of trust, truth and transparency in healthcare AI, including decision lineage, governed AI and keeping humans in the loop. He also explores how AI can reduce administrative waste, improve decision-making and strengthen trust among payers, providers and patients.

This episode is sponsored by Lyric.

In this episode, Cereasa Horner, Vice President of Payment Integrity and Governance at CERIS, discusses how health plans can adapt to accelerating regulatory changes, strengthen documentation and audit readiness, and improve alignment with providers. She also shares strategies for cross-functional collaboration, transparency and an education-first approach to payment integrity.

This episode is sponsored by CERIS.

In this episode, David Merritt, Senior Vice President of External Affairs at the Blue Cross Blue Shield Association, discusses rising healthcare costs, employer affordability pressures and the growing impact of the No Surprises Act’s IDR process. He also outlines potential reforms to curb excessive awards, increase transparency and slow premium growth.

In this episode, Jakob Emerson, Associate News Director, Becker’s Healthcare, discusses Centene’s exit from the commercial group markets in California and Oregon, rising employer health insurance costs and growing pressure on coverage. He also explores specialty drug spending, AI-driven administrative costs, payer consolidation and the evolving politics of health insurance.

In this episode, Hunter Foster, VP, Agency Operations and Strategy, benefitbay, explores the growing adoption of ICHRA and defined contribution models, including the demand for flexibility, predictability and employee choice. He also discusses successful implementation, broker adoption, AI's evolving role and what increased carrier participation could mean for the future of health benefits.

In this episode, Nathan Frank, Senior Vice President and Chief Digital and Technology Officer at Aetna, discusses how AI and digital tools are simplifying prior authorization, improving interoperability and enhancing member and provider experiences. He also shares Aetna’s approach to responsible AI, emphasizing human connection, trust and practical technology solutions that reduce administrative burden.

In this episode, Dr. Ali Khan, Chief Medical Officer, Aetna Medicare, discusses new findings showing how value-based care improves clinical outcomes, preventive care and hospital utilization for Medicare members. He also shares how Aetna is supporting providers with risk-based arrangements, interoperability and care coordination.

In this episode, Jakob Emerson, Associate News Director, Becker’s Healthcare, discusses the latest Medicare Advantage trends, including SCAN’s new partnership with Costco, insurer market exits, tighter margins, and fewer plan options for seniors. He also explores how changes to Part D subsidies could influence Medicare Advantage enrollment.

In this episode, Amanda Free, Anthem Blue Cross and Blue Shield of Georgia Commercial President, discusses improving healthcare affordability, expanding access in rural communities, strengthening value-based care partnerships and helping members make smarter choices about where and how they receive care.

In this episode, Munjal Shah, Co-founder & CEO of Hippocratic AI, discusses how agentic orchestration can coordinate teams of AI agents to achieve healthcare outcomes such as reducing readmissions, closing care gaps and improving patient follow-up. 

This episode is sponsored by Hippocratic AI.

In this episode, Jessica Lopez-Liggett, Commercial State Plan President for Anthem Blue Cross and Blue Shield in Indiana, discusses rising healthcare costs, simplifying the member and provider experience through technology, and expanding high-quality, lower-cost care through provider partnerships. She also shares why addressing social determinants of health and bringing employers, providers and community organizations together is critical to improving healthcare.

In this episode, Dr. Stanley Crittenden, Chief Medical Officer at Cigna Healthcare, discusses how AI-powered analytics and personalized care management are helping identify health risks earlier, improve outcomes and simplify healthcare navigation. He shares how Cigna is using technology to support clinicians, expand access to care and drive affordability while keeping human connection at the center.

In this episode, Katie Catlender, Chief Operating Officer at Point32Health, discusses the organization’s push to consolidate legacy digital platforms, reduce administrative costs and create a simpler experience for members and providers. She also shares how Point32Health is using AI responsibly to personalize care, reduce friction and build trust while keeping members at the center.

In this episode, Sarah Adkins, director of public policy with the Elevance Health Public Policy Institute, discusses research showing lower telehealth utilization among rural populations and the barriers driving the gap. She shares strategies for payers and healthcare leaders to expand digital infrastructure, tailor telehealth programs and improve access for underserved members.

In this episode, David Debono, MD, Oncology Medical Director at Carelon Health, shares how technology, clinical pathways, and data-driven insights are helping improve cancer care while supporting physicians, expanding access, and delivering more personalized treatment for patients.

In this episode, Dan LaVallee, Associate Vice President of Community Engagement at UPMC Health Plan, and Dr. Brandy Hershberger, Chief Nursing Officer and Vice President of Academic Affairs at UPMC, discuss how innovative apprenticeship programs, workforce partnerships, and community engagement are creating sustainable healthcare career pathways and strengthening the future workforce.

In this episode, Susan Mullaney, Chief Operating Officer at Blue Shield of California, discusses how stronger payer-provider partnerships, AI, value-based care, and pharmacy innovation can improve health outcomes, lower costs, and reshape care delivery for the future.

In this episode, Dr. Ben Kornitzer, Senior Vice President, Chief Medical Officer at Aetna, discusses how AI, real-time data exchange, and prior authorization reform can strengthen payer-provider partnerships and improve patient outcomes.

In this episode, Dr. Daniel Knecht, Chief Medical Officer, EmblemHealth, discusses how the organization's AI-powered Environmental Resilience Program helps identify and support members at risk during extreme heat events. He also shares how predictive outreach, clinical oversight, and addressing social determinants of health are shaping the future of population health management.

In this episode, Angel Ballew, Head of Pharmacy Clinical Programs and Services at Centene, discusses how the organization approaches GLP-1 coverage across Medicaid, Medicare, and marketplace plans while balancing clinical evidence, affordability, and member access. She also shares insights on utilization management, adherence strategies, and preparing for the next wave of indications for these rapidly evolving therapies.

In this episode, Dr. Ken Cohen, Chief Medical Officer at Optum Health, discusses new research on Medicare Advantage, social vulnerability, and how full-risk care models can improve quality, efficiency, and patient outcomes. He also shares insights on the infrastructure, technology, and strategies needed to advance value-based care.

In this episode, Margaret Anderson, President of Health Alliance Plan by Henry Ford Health, discusses the organization's rebrand, its strategy for deeper integration with Henry Ford Health, and how it's driving growth while improving affordability. She also shares insights on provider sponsored health plans, administrative efficiency, and the growing impact of gene therapies on the healthcare system.

In this episode, Karla Mills, Vice President of Product Innovation, Surescripts, discusses how health plans can use medication data as an early signal to identify risk, prioritize new members, and improve care management. She shares practical strategies for preparing ahead of enrollment surges and leveraging existing programs to drive better outcomes and operational performance. For more information, please check out our website: https://surescripts.com/who-we-serve/health-plans

In this episode, Kelly Munson, President and CEO of Independence Health Group, discusses the evolving Medicaid and ACA landscape, the impact of policy changes on coverage and affordability, and the role of managed care in improving health outcomes. She also shares insights on food as medicine, healthcare innovation, and leadership lessons from becoming the organization's first female CEO.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Liz Signorella, Senior Director of Payor Contracting, Clover Health. She discusses reducing administrative burdens for providers, leveraging AI and real-time data to support proactive care, and improving patient outcomes through stronger care coordination and earlier intervention.

In collaboration with Hippocratic AI.

In this episode, Morgan Kendrick, EVP and President, Commercial Health Benefits, Elevance Health, discusses the rising cost pressures facing employers and explores how balanced funding, self-funding, and multiple employer welfare arrangements can help improve affordability while simplifying healthcare benefits for businesses and their employees.

In this episode, Rhonda Randall, DO, Executive Vice President and Chief Medical Officer, UnitedHealthcare, Commercial Business, Board member of the United Health Foundation, discusses findings from the America’s Health Rankings 2026 Senior Report, highlighting encouraging gains in preventive care and physical activity alongside rising concerns around drug deaths, suicide, and food insecurity among older adults.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Sharon Williams, Chief Executive Officer, and Management Consultant, University of Michigan Health Plan. Sharon shares insights on balancing rising utilization costs with member experience, the role of technology and data integration in improving care coordination, and why expanding access to healthcare coverage is critical to building a healthier America.

In collaboration with Hippocratic AI.

In this episode, Carey Ketelsen, President of Virtix Health, joins the podcast to discuss how healthcare organizations are transforming risk adjustment through prospective outreach, AI-enabled workflows, and stronger payer-provider collaboration. She shares insights on improving documentation integrity, aligning incentives, and building patient-centered risk adjustment programs that support long-term success in value-based care.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Adam Park, Director of Network Development, Curative Health Plan, who discusses how Curative is redesigning employer-sponsored healthcare by removing financial barriers to care and investing in prevention. He also shares how AI is improving credentialing, prior authorization, and member support while helping create faster, more personalized healthcare experiences.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Cara Wahmann, Executive Director Clinical Oversight & Ops Support, HCSC,  who discusses how health plans are navigating rising complexity across regulation, digital transformation, and member expectations. She also shares insights on using interoperability and AI to reduce administrative friction, digitize clinical policies, and improve consistency, personalization, and outcomes across payer operations.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Patrick Stevenson, Vice President, Data and Technology, McLaren Health Plan. Patrick discusses how McLaren Health Plan is leveraging predictive analytics, AI, and proactive care strategies to improve member outcomes, streamline prior authorization, and better manage risk in today’s evolving payer landscape.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Garfield Collins, Co-Founder and Chief Administrative and Partnership Officer, Zing Health. Garfield shares how Zing Health is balancing affordability with high-touch member engagement, leveraging technology and AI to support chronically ill populations, simplify care navigation, and build long-term trust with members.

In collaboration with Hippocratic AI.

In this episode, Dave DeHommel, Senior Vice President and General Manager of Payer Solutions at Reveleer, discusses how Medicare Advantage plans can reduce RADV audit exposure through stronger clinical data infrastructure, prospective risk adjustment strategies, and year-round documentation readiness. Visit https://www.reveleer.com/solutions/radv-audit?utm_source=beckers&utm_medium=podcast&utm_campaign=260402--radv-b2g1 to learn more.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Patrick Stevenson, Vice President, Data and Technology, McLaren Health Plan. Patrick discusses how McLaren Health Plan is leveraging predictive analytics, AI, and proactive care strategies to improve member outcomes, streamline prior authorization, and better manage risk in today’s evolving payer landscape.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Rob Hitchcock, President and Chief Executive Officer, Select Health. Rob discusses the operational pressures facing payers today, including Medicare Advantage challenges and rising pharmaceutical costs, while sharing how Select Health is leveraging AI and end-to-end member insights to improve care coordination, trust, and the overall member experience.

In collaboration with Hippocratic AI.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Andy Higgins, Vice President, Product And Member Engagement, Clever Care Health Plan. Andy shares how Clever Care is building trust through culturally competent care, community-based member engagement, and AI-enabled support tools that enhance human interaction while improving quality outcomes and member experience.

In collaboration with Hippocratic AI.

In this episode, Rakesh Mathew, MS, MBA, CPHIMS, Interoperability Leader at Jefferson Health Plans, joins the podcast to discuss the financial pressures facing payers and how sustained losses can reduce competition and lead to market consolidation. He shares perspectives on improving affordability and access, and outlines how organizations can prepare for success in 2027 through stronger interoperability and strategic planning.

In this episode, Ilan Shapiro, MD, MBA, FAAP, FACHE, Chief Health Correspondent and Medical Affairs Officer and Senior Vice President at AltaMed Health Services, joins the podcast to discuss breaking language barriers in healthcare and closing gaps between patients and providers. He shares how improving communication and cultural understanding can lead to better access, stronger relationships, and improved health outcomes.

This episode recorded live at the Becker’s Spring 2026 Payer Issues Roundtable features Michael Roan, Market Lead, South Atlantic Markets, Oscar Health. He discusses innovative plan design, proactive care strategies, and how Oscar Health is leveraging AI and personalized member experiences to improve outcomes, reduce barriers to care, and support long-term health engagement.

In collaboration with Hippocratic AI.