Becker’s Payer Issues Podcast

In this episode, Eric C. Hunter, President and CEO of CareOregon, discusses how the organization is aligning with providers to improve quality and performance while managing cost pressures. He shares insights on leveraging AI, navigating regulatory challenges, and creating sustainable solutions for Medicaid and community health.

In this episode, Brandy Thompson, Chief Executive Officer of Benefitbay, shares where payer strategy continues to fall short in execution, what investments could reshape health plans, and how reducing administrative complexity can improve margins and access to care.

In this episode, Rob Andrews, Chief Executive Officer of the Health Transformation Alliance, discusses how employers and providers can work more closely to improve value, reduce middleman costs, and drive better outcomes. He shares perspectives on payer competition, transparency, GLP 1 cost pressures, and how technology and personalized medicine may reshape health plans in the years ahead.

In this episode, Melanie Fernando, President and CEO of Aetna Better Health of Illinois, discusses launching a virtual menopause partnership to close gaps in Medicaid women’s health, improve member engagement, and drive better outcomes through tailored, community based solutions.

In this episode, Alex Ding, MD, Enterprise Deputy Chief Medical Officer at Humana, discusses the findings from Humana’s latest Value-Based Care Report, including lower hospital admissions and emergency department visits among Medicare Advantage members in value based arrangements. He shares how deeper primary care continuity, stronger payer provider alignment, and reduced administrative burden are...

In this episode, Steve Sutherland, Senior Vice President of Information Systems at CERIS, shares how AI and machine learning are reshaping payment integrity across the full claims lifecycle. He discusses the shift toward prepayment solutions, the importance of governance and data quality, and how leaders can balance automation with accuracy, fairness, and trust. This episode is spon sponsored by C...

In this episode, Patrick Gilligan, President and CEO of Point32Health, shares how the New England based nonprofit is confronting rising medical and pharmacy costs while staying focused on members and employers as its true shareholders. He discusses the affordability crisis, aligning incentives with providers, and why redesigning care around the patient experience is essential to lowering costs and...

In this episode, Paul Markovich, President and CEO of Ascendiun, discusses his testimony before Congress, the push to eliminate PBM spread pricing and rebates, and why he believes the healthcare industry must confront its cost problem head on. He also shares how Ascendiun’s new structure, digital health record ambitions, and unbundled PBM model aim to build a system that is sustainably affordable...

In this episode, Thomas Graf, MD, Chief Medical Officer for Florida Blue, part of GuideWell, shares how the health plan is improving cancer care through a high-touch, tech-enabled navigation program for Medicare Advantage members. He discusses reducing variation, closing gaps between diagnosis and treatment, and achieving better outcomes, higher satisfaction, and lower costs by centering care arou...

In this episode, Lila Benayoun, Chief Operating Officer at MetroPlusHealth, shares how the organization is translating member affordability data into simpler plan design, predictable costs, and high-touch community support across New York City. She discusses addressing disparities through multilingual outreach, culturally competent services, and operational strategies that help members better unde...

In this episode, Tilak Mandadi, Executive Vice President of Ventures and Chief Experience and Technology Officer at CVS Health, shares how the company is investing in and building technology to simplify healthcare and drive better consumer engagement. He discusses CVS Health Ventures, interoperability, AI strategy, and the vision behind creating an open, consumer-centric platform that connects pay...

In this episode, Dr. Damanjeet Chaubey, Vice President of Clinical Affairs at Clover Health, shares how payer provider relationships are evolving under cost and workforce pressures and where plans often fall short in operational execution. She discusses technology enabled, PCP centric, and home based care models as critical levers for managing utilization, improving outcomes, and sustaining Medica...

In this episode, Craig Kurtzweil, Chief Data and Analytics Officer for UnitedHealthcare’s commercial business, shares insights from UnitedHealthcare’s latest employer health trends report, including rising costs among younger workers, more frequent catastrophic claims, and growing metabolic risks. He discusses how data driven strategies can help employers better target engagement, prevention, and...

In this episode, Brett Bingham, Chief Network Development Officer at Banner Plans and Networks, discusses how payers and providers are shifting toward collaboration amid cost pressures and workforce shortages. He shares where strategy is outpacing execution, why data and payment models matter for value based care, and how Banner is staying disciplined in its long term investments.

In this episode, Kristie Spencer, Vice President of Provider Partnerships at Elevance Health, shares how the company is aligning incentives, leveraging digital tools, and using AI to simplify workflows. She explains how effective partnerships and actionable data are driving better outcomes, affordability, and sustainability in value-based care.

In this episode, Howard Brill, Senior Vice President of Population Health and Quality at Monroe Plan for Medical Care, shares insights on value based contracting, rising cost pressures, and the persistent gap between strategy and execution in population health. He also discusses the role of data integration, AI, and regulatory practices in shaping affordability, access, and health plan performance...

In this episode, Rob Hitchcock, President and Chief Executive Officer of Select Health, discusses how payer provider collaboration, cultural change, and proactive care models are reshaping health plan strategy amid rising cost pressures. He shares perspectives on regulatory headwinds, Medicaid and Medicare reform, and more.

In this episode, Dr. Sachin Jain, President and CEO of SCAN Group, discusses his Forbes op-ed outlining 10 leadership resolutions and argues that healthcare’s biggest challenge is a lack of resolve, not innovation. He shares why speaking plainly, rejecting performative change, and focusing on real patient impact are essential to rebuilding trust in the industry.

In this episode, Erin Henderson Moore, President and CEO of Fidelis Care of New Jersey, shares how the plan is navigating Medicaid uncertainty through integration, member engagement, and upstream investment in behavioral health, housing, and LTSS. She discusses why data sharing, outcome based accountability, and enabling people to age at home will shape the next decade of government sponsored care...

In this episode, Linda Hines, Virginia’s Medicaid Market President at Humana, shares how school based partnerships are improving access to youth behavioral health services, especially in rural communities. She discusses workforce development, measurable outcomes, and why listening to families, providers, and youth is critical to long term success.

In this episode, Jack Hooper, CEO and Co-founder of Take Command, explains how individual coverage HRAs are reshaping employer sponsored benefits and why adoption is accelerating. He discusses cost control, employee choice, and what early success stories signal for the future of health insurance.

In this episode, Bethanie Stein, PharmD, Segment President of Pharmacy at Humana, discusses how employers are approaching GLP-1 coverage and why partnerships with manufacturers like Eli Lilly and Novo Nordisk matter now. She shares how CenterWell Pharmacy is using transparency, clinical oversight, and adherence focused models to expand access while managing costs.

In this episode, Dr. Alice Hm Chen, Executive Vice President and Chief Health Officer at Centene, discusses how the organization is improving maternal and child health outcomes across Medicaid, Medicare, and Marketplace populations. She shares insights on rural care challenges, evidence based interventions like midwifery and doulas, and how data and partnerships drive population health impact.

In this episode, Nick Gates, president of Priority Health, shares his leadership journey, the values shaping his approach, and how trust and community guide decision making. He also discusses digital transformation, multi state expansion, and priorities around affordability, access, and member experience.

In this episode, Heather Tamborino, Chief Financial Officer at EmblemHealth, discusses how payer provider collaboration, thoughtful use of AI, and data integration can improve outcomes while easing administrative burden. She also shares how rising pharmacy costs, PBM strategy, and transparency initiatives are shaping financial priorities for 2026.