Becker’s Payer Issues Podcast

In this episode, Howard Weiss, Vice President of Government Affairs at EmblemHealth, discusses how payer provider collaboration, community based programs, and value focused partnerships can improve affordability and outcomes. He also shares how consumer pressure, regulatory scrutiny, and responsible use of AI are shaping health plan strategy and margins in 2026.

In this episode, Chris Gay, CEO and Co-Founder of Evry Health, joins Jakob Emerson to discuss how technology, scale, and business model alignment can dramatically reduce prior authorization friction. He shares why Evry Health’s approach delivers faster decisions, lower denial rates, and a better patient and provider experience, and what the industry needs to change next.

In this episode, Ellen Sexton, Executive Vice President and Chief Growth Officer at Blue Shield of California, discusses the impact of major policy changes on Medicaid and commercial markets, how her team is preparing for uncertainty, and the strategies needed to support members, stabilize employer coverage, and advance innovation across California's health care landscape.

In this episode, Dr. Cynthia Brown, Medical Director and Clinical Lead for Women’s Health at Elevance Health, discusses Elevance Health’s expansion of doula services into select employer health plans, highlighting how doula support improves outcomes, reduces disparities, strengthens the care experience, and creates long-term value for mothers and babies.

In this episode, Steve Levin, CEO of Quest Analytics®, shares how health plans can prepare for 2026 as regulations evolve and market expectations shift. He unpacks what current network trends are signaling for plan strategy, why provider data accuracy and operational efficiency are becoming key competitive differentiators, and how leaders can adopt technology and AI in practical ways that drive real, measurable value.

This episodeis sponsored by Quest Analytics®.

In this episode, Dr. Saria Saccocio, Chief Medical Officer at Essence Healthcare, explains how strong provider partnerships, real time data, and a member centered approach drive the plan’s four and a half star performance. She also shares how addressing social needs and listening closely to members shapes future benefit design and care delivery.

In this episode, Steve Tringale, President of Mass General Brigham Health Plan, shares how the organization is expanding its product portfolio, entering the dual eligible market, and investing in integrated digital care management to better support members across all stages of life.

In this episode, Kevin Adams, CEO of HealthEdge, discusses how health plans can overcome legacy technology challenges through modernization, business process as a service (BPaaS), and AI-driven efficiency. He shares insights on building stronger operational foundations and how next-generation automation is reshaping payer operations. 

This episide is sponsored by HealthEdge.

In this episode, Rick Harbit of Blue Cross Blue Shield of North Carolina and Bob Tavernier of Quest Analytics discuss how payers are navigating financial pressures, advancing network adequacy 2.0, and using data and network intelligence to drive long-term success. 

This episode is sponsored by Quest Analytics.

Dr. Meera Atkins, Chief Medical Officer at Lyric.ai, shares how clinically informed AI can transform payment accuracy from a reactive process to a proactive, transparent partnership. She discusses the importance of trust, clinical validation, and equity in advancing value-based care and reducing administrative friction across the healthcare ecosystem.

This episode is sponsored by Lyric.ai.

In this episode, Marcy Tatsch, Executive Vice President and General Manager of Truven by Merative, shares insights into how employers and health plans can use data analytics to lower costs, improve outcomes, and design smarter benefit strategies in a challenging healthcare landscape.

This episode is sponsored by Merative.

In this episode, Shana Hoffman, President and CEO of Lucet, shares why behavioral health is the key to transforming patient outcomes and reducing costs. She discusses how Lucet is breaking down fragmentation, scaling integrated care, and achieving measurable results for patients and health plans. 

This episode is sponsored by Lucet.

In this episode, Vinay Kulkarni, Chief Information Officer at SCAN Group, discusses how AI, automation, and digital tools are transforming Medicare Advantage. He explains how these technologies improve care coordination, reduce administrative burden, and personalize care for seniors while maintaining high-quality, empathetic member experiences.

In this episode of Payer Issues, Rachel French, Chief Strategy and Partnerships Officer at MD Live by Evernorth, discusses the impact of point solution fatigue on the member experience, and how MD Live is redefining access with care that's connected, personalized, and provider-guided.

This episode is sponsored by MD Live by Evernorth.

This episode features Dave Raccagni, Vice President of Innovation, Market Insights, and Communications at Cigna Healthcare, Dental & Vision. He discusses Cigna Dental's partnership with Paytient to expand flexible, no-interest dental payment options for 13 million members, how the program improves preventive and critical care access, and its potential to drive long-term health and cost savings across broader areas of care.

On this episode, Mark Grippi, AmeriHealth Caritas Ohio Market President joins the podcast to discuss opening dialogue with members to improve care, the role of health risk assessments, and overcoming digital fatigue in healthcare.

This episode features Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan who discusses challenges with access to dental care in rural areas, strategies for addressing community needs, and insights on current events shaping the dental industry.

This episode features Heather Tamborino, CFO at EmblemHealth, who discusses the company’s $2 million investment in food security across New York City. She shares how EmblemHealth’s neighborhood care centers are addressing food insecurity, connecting social and medical care, and redefining health equity as both a mission and a strategic imperative.

This episode features Richard Greene, President of Clever Care Health Plan, discussing how the organization is growing through a unique model that combines Eastern and Western medicine, invests in culturally tailored community centers, and builds sustainable relationships with providers and members across California.

This episode features Colleen Briggs, President of the Blue Cross NC Foundation and Vice President of Corporate Responsibility at Blue Cross NC. She discusses the Feed Your Health initiative, how food-based interventions are improving outcomes for members with diabetes, and what it takes to move these programs from pilot to sustainable, systemwide solutions.

In this episode, Michael Carson, President and CEO of Wellcare, a Centene company, shares how his diverse career and mission-driven approach shape Wellcare’s Medicare strategy. He highlights the unique needs of dual eligible members, the importance of integrated care, and the push to improve consumer experience across healthcare.

In this episode, Dan Kueter, CEO of UnitedHealthcare's Employer & Individual business, talks about new tools like the UHC Store, the impact of AI on healthcare navigation, and how employers and members are adapting to rising costs and evolving therapies.

In this episode, Steven Berkow, Senior Advisor for Value-based Care at InterSystems, and Robert Tennant, Executive Director of the Workgroup for Electronic Data Interchange, discuss the evolving landscape of ePrior authorization. They share insights on regulatory changes, industry collaboration, and what healthcare leaders should know as the 2027 compliance date approaches.

This episode is sponsored by InterSystems.

In this episode, Zack Myers, National General Manager at SCAN Health Plan, discusses the organization’s expansion into new markets, its nonprofit approach to provider partnerships, and how innovative models like iSNPs are improving care and independence for seniors.

In this episode, Brendan Harris, president of UPMC for You and state programs, shares how initiatives like the Pathways to Work program and Neighborhood Centers are addressing social determinants of health, supporting Medicaid members, and strengthening local communities.

In this episode, Mack McGee, Chief Marketing Officer at CareFirst BlueCross BlueShield, shares how the organization earned top marks for customer experience in Forrester’s 2025 rankings and discusses the importance of trust, personalization, and simplifying healthcare interactions for members.

In this episode, Scott Burton, Market President at Providence Health Plan, shares insights on the growing interest in ICRAs, strategies to manage rising employer health costs, and how Providence is balancing innovation with long-term sustainability in a shifting insurance landscape.

In this episode, Jay Deady, President of Price Optimization at Zelis, discusses why fragmented pricing operations create inefficiencies for health plans and how integrated solutions, advanced technology, and personalization are paving the way for a more connected financial experience across healthcare.

This episode is sponsored by Zelis.

This episode features Cereasa Horner, Director of Policy and Payment Integrity at CERIS, who shares insights on the evolving payer oversight landscape. She discusses the challenges of maintaining consistency across state and federal guidelines, the role of AI and predictive compliance modeling, and strategies for payers to stay proactive in a dynamic regulatory environment.

This episode is sponsored by CERIS.

In this episode, Bill Harlan, Vice President of Behavioral Health at Point32Health, shares how his team is addressing access challenges, supporting members through navigation services, and building innovative partnerships to improve mental health care delivery.

In this episode, Dan LaVallee and Dr. Brandy Hershberger of UPMC share how the health system is creating innovative apprenticeship programs to support Medicaid members and employees in pursuing meaningful careers. They discuss workforce development, grant funding, and how these programs are shaping the future of healthcare talent pipelines.

In this episode, Alan Cohen, Co-founder and Chief Product Officer at Centivo, joins the podcast to share his perspective on escalating healthcare costs, premium increases, and the risks facing the ACA market. He also explains how Centivo partners with high-performing providers to deliver cost-effective, sustainable coverage for employers and their employees.

In this episode, Dr. Nathan Crock of Premera Blue Cross shares how the AI-powered chatbot “Alice” is helping hundreds of customer service representatives quickly find accurate information, reducing call times, improving member satisfaction, and enhancing internal knowledge management.

In this episode, John Byrnes, Chief Operating Officer at Banner|Aetna, discusses how the organization is advancing value-based care through integrated technology, strong payer-provider collaboration, and personalized member support. He highlights key strategies driving improved health outcomes and sustainable cost management in Arizona.

In this episode, Karen Ignagni, Executive Chair, and Dr. Dan Knecht, Chief Medical Officer at EmblemHealth, discuss the launch of the first health plan covered lifestyle medicine program for early-stage Alzheimer’s. They explore how evidence-based interventions, community support, and integrated care are reshaping brain health and advancing equity in underserved populations.

In this episode, Jeff Yuan, Co-founder of Mending, discusses how his company is building an AI-native health insurer focused on reducing provider burden and improving patient access through direct primary care partnerships. He also shares insights on rebranding, early success in Maine and Oklahoma, and plans for thoughtful national expansion.

In this episode, Dawn Maroney, President of Alignment Health and CEO of Alignment Health Plan, shares her experience testifying before Congress on the future of Medicare Advantage and highlights key policy changes needed to protect access, expand rural care, and ensure member choice in a rapidly evolving healthcare landscape.

In this episode, Michael Hunn, CEO of CalOptima Health, joins Jakob Emerson to discuss how the organization is preparing for sweeping changes under the Federal Reconciliation Bill. He shares insights on preserving access to care, the importance of managed care partnerships, and how collaboration, communication, and innovation will be essential to maintaining Medicaid’s long-term sustainability.

This episode features Anthony J. Colistra, President of MD Live by Evernorth, discussing how virtual care has evolved, where consumer demand is headed, and how MD Live is using AI to personalize the patient experience, improve patient-provider communication, and streamline provider administrative tasks to give them more time to spend with patients.

This episode is sponsored by Evernorth.

In this episode, Alan Murray, President and CEO of MediDrive, shares how innovative, tech-enabled approaches to non-emergency medical transportation are closing care gaps, reducing no-show rates, and supporting more coordinated, patient-centered care—while also improving administrative efficiency and helping to lower system-wide costs.

This episode is sponsored by MediDrive.