Becker’s Payer Issues Podcast

40 Episodes
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By: Becker's Healthcare

The Becker's Payer Issues Podcast is the must-listen podcast exclusively created for health insurance executives. Two new 15-minute episodes are released weekly with the leaders who shape health insurance in America and the cost of care, policy and regula

Chris Gay, CEO of Evry Health
Yesterday at 10:00 AM

Chris Gay, CEO of Evry Health, joins the podcast to discuss how his organization is enhancing the patient experience and advancing population health. He explores how innovative technology is being used to address persistent challenges in the payer space and improve health outcomes. Gay also shares insights into building a more efficient, patient-centered healthcare system through digital transformation.


Doug Henry, Enterprise Medical Director of Behavioral Health, Highmark Health
Last Friday at 10:00 AM

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Doug Henry, Enterprise Medical Director of Behavioral Health, Highmark Health. Dr. Henry shares how Highmark is improving access, outcomes, and satisfaction through strategic partnerships, data-driven innovation, and value-based care models that prioritize mental health as a pillar of total health.


Illan Shapiro Strygler, Chief Health Correspondent and Medical Affairs Officer and Senior Vice President, AltaMed Health Services
Last Thursday at 10:00 AM

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Illan Shapiro Strygler, Chief Health Correspondent and Medical Affairs Officer and Senior Vice President, AltaMed Health Services. Dr. Shapiro shares how AltaMed leverages data, cultural understanding, and community connection to improve care quality, reduce costs, and advance health equity.


Kourtney Witten, Area Vice President Network Managing Partner Wisconsin, Advocate Health
Last Wednesday at 10:00 AM

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Kourtney Witten, Area Vice President Network Managing Partner Wisconsin, Advocate Health. Witten discusses how her organization is leveraging data, technology, and relationship-based care to reduce costs, close care gaps, and deliver high-quality, patient-centered outcomes across diverse populations.


Integrating Specialty Pharmacy into Electronic Health Record Workflows: Unlocking Enhanced Value
Last Monday at 9:00 PM

In this episode, Becker's Healthcare speaks with Jim Blondin, Senior Director of Digital Product Strategy at Accredo Specialty Pharmacy, about the strategic benefits of integrating specialty pharmacy into EHR workflows. The discussion explores how this integration can reduce workflow friction, improve care coordination, and enhance both patient and provider experiences. Tune in for insights relevant to pharmacy leaders, CIOs, and healthcare executives navigating digital transformation.


This episode is sponsored by Accredo Specialty Pharmacy.


How Accurate Provider Data Drives Better Care Access and AI Innovation
Last Monday at 10:00 AM

In this episode, Joey Seliski of Allegheny Health Network and Pritee Subramany of Highmark Health discuss how consistent, accurate provider data is essential for improving care coordination, patient trust, and enabling AI-driven tools like virtual assistants and personalized provider recommendations.


This episode is sponsored by Kyruus Health.


Dr. Brian Smolich, Vice President, Health Alliance Quality and Managed Care Operations, Carle Health
06/26/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Brian Smolich, Vice President, Health Alliance Quality and Managed Care Operations, Carle Health. Dr. Smolich shares how his organization is balancing cost and quality, leveraging biosimilars, digital engagement tools, and provider collaboration to improve member outcomes and transform the care experience.


Brad Riley, Vice President, Analytics and Reporting, Longevity Health
06/25/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Brad Riley, Vice President, Analytics and Reporting, Longevity Health. Brad discusses how Longevity Health is leveraging predictive analytics, machine learning, and innovative provider partnerships to balance cost containment with high-quality care, while empowering staff with AI literacy for the future of managed care.



Paul Christopher Hiltz, President and CEO, NCH Healthcare System
06/24/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Paul Christopher Hiltz, President and CEO, NCH Healthcare System. Paul shares how a metrics-driven culture, strategic partnerships, and clinical excellence are guiding NCH’s efforts to improve care quality, reduce costs, and expand access through major initiatives like a new orthopedic hospital and heart institute.


Louis DeStefano, Senior Vice President of Growth at Oscar Health
06/20/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Louis DeStefano, Senior Vice President of Growth at Oscar Health. He shares how Oscar is leveraging personalized plan designs, technology-driven engagement, and the growing potential of ICHRAs to improve affordability, satisfaction, and outcomes in the individual insurance market.


Dr. Alex Ding, Deputy Chief Medical Officer, Humana
06/18/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Alex Ding, Deputy Chief Medical Officer, Humana. Dr. Ding shares how Humana is bridging its payer and provider roles to advance health equity, enable clinicians, and drive value-based care transformation at scale, all while putting whole-person care and patient experience at the center.


Rebuilding NEMT: Creating a Modern, Scalable Transportation Model for Health Plans with Kinetik
06/17/2025

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Sufian Chowdhury, Chief Executive Officer of Kinetik. Sufian discusses how Kinetik is transforming non-emergency medical transportation (NEMT) through real-time data, interoperability, and plan-owned infrastructure to improve compliance, reduce fraud, and enhance member experience.


This episode is sponsored by Kinetik.


Lila Benayoun, Chief Operating Officer, MetroPlusHealth
06/16/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Lila Benayoun, Chief Operating Officer, MetroPlusHealth. She shares how the organization is combining predictive analytics, personalized outreach, and community-based services to proactively manage care, improve member satisfaction, and address social determinants of health across New York City.


Mark Rich, Former President and current Board Member of Steward Health Care System LLC
06/13/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Mark Rich, Former President and current Board Member of Steward Health Care System LLC. Mark shares insights from the provider and ACO perspective on accelerating value-based care, aligning payer-provider collaboration, and leveraging actionable data to drive both affordability and improved outcomes.


Lawrence Hamilton, Executive Vice President, The Permanente Medical Group
06/12/2025

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Lawrence Hamilton, Executive Vice President, The Permanente Medical Group. Lawrence discusses the power of payer-provider alignment in delivering population health, advancing health equity across service lines, and using real-time patient feedback to enhance care experience and outcomes.


Dr. Aisha Rahim, Medical Director and Co-Lead, AI Governance Council, Johns Hopkins Health Plans (JHHP)
06/11/2025

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Dr. Aisha Rahim, Medical Director and Co-Lead, AI Governance Council, Johns Hopkins Health Plans (JHHP). Dr. Rahim discusses how JHHP is leveraging artificial intelligence to manage costs, close care gaps, advance health equity, and enhance member engagement across a diverse population.


Improving Access to Preventive Care and Whole Person Health with Dr. Jennifer Nuovo
06/10/2025

In this episode, Dr. Jennifer Nuovo, Chief Medical Officer of Blue Shield of California’s Promise Health Plan, joins Jakob Emerson to discuss how her team is increasing access to preventive care, addressing health disparities, and building community trust through targeted outreach, innovative programs, and a focus on whole person care.


Stacy Edgar, Co-Founder and CEO at Venteur
06/09/2025

Stacy Edgar, Co-Founder and CEO at Venteur, joins the podcast to discuss how her organization is working to strike the right balance between affordability and quality in healthcare. She highlights initiatives that support new mothers in navigating their healthcare journey and emphasizes the importance of understanding and aligning with partners to drive meaningful outcomes.


Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health
06/06/2025

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.


Redefining Payer Strategy: From Benefit Design to Intelligent Care Delivery
06/05/2025

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.


Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health
06/05/2025

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.


Utilization Management That Works: Strategies, Stories & What’s Next
06/04/2025

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, emerging strategies, and a future-focused look at how UM can better serve both clinicians and patients.


This episode is sponsored by Evernorth.


Samuel Wollner, Vice President, Strategy and Partnerships, EmblemHealth
06/04/2025

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.


Dr. Rebekah Hughey, Medical Director at Highmark Wholecare
06/03/2025

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.


Crissy Turino, Chief Plan Officer & Chief Operating Officer, CountyCare
05/31/2025

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.


How In-Home Assessments Drive Better Outcomes with Catherine Tabaka & Dr. Michael Cantor of Matrix Medical Network
05/30/2025

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.


Redesigning Autism and I/DD Care: Insights from Catalight’s Chief Health Officer
05/29/2025

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 thoughtful exploration of what meaningful, sustainable, and person-centered care really looks like.


This episode is sponsored by Catalight.


Transforming Payment Integrity with AI: A Conversation with Raj Ronanki, CEO of Lyric
05/29/2025

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.


Dr. Sachin Jain, President and Chief Executive Officer, SCAN Group
05/28/2025

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.


Protecting Access and Advancing Care: Erfan Karim on Medicaid, Innovation, and Health Equity
05/28/2025

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.


Redefining Employer Coverage: Centene’s Alan Silver on the Future of ICHRA
05/27/2025

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.


Sheri Johnson, Vice President, Member Enrollment and Billing, UCare
05/27/2025

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.


Sheri Johnson, Vice President, Member Enrollment and Billing, UCare
05/26/2025

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.


Jarrod McNaughton, CEO of Inland Empire Health Plan
05/23/2025

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.


Inside MD Live: Improving Healthcare Access, Affordability & Outcomes
05/22/2025

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.


Peter Kuipers, CFO of Clover Health
05/22/2025

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.


Leveraging AI and Predictive Models to Improve Member Experience: Insights from Humana and Everise
05/21/2025

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.


Angie Kalousek, Senior Director, Clinical Strategy and Programs at Blue Shield of California
05/21/2025

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.


Transforming Reimbursement Strategy: How AI and Insights Are Powering Value-Based Care Readiness
05/20/2025

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 leverage advanced analytics to drive smarter financial strategies and improve long-term sustainability.


This episode is sponsored by Craneware.


Supporting Families Beyond the NICU: How Harvard Pilgrim Is Extending Postnatal Care with Jake Biscoglio
05/19/2025

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.