Becker’s Payer Issues Podcast

In this episode, Paul Penzone, Vice President and Chief Community Relations Officer at Blue Cross Blue Shield of Arizona, joins the podcast to discuss AZBlue’s mission to support community healthcare needs. He shares insights on the company's initiative to erase medical debt, expand access to preventive care, and foster long-term health equity across Arizona.

In this episode, Matt Gibbs, Senior Vice President and Chief Pharmacy Officer at Blue Shield of California, joins Becker’s to discuss how the company is dismantling the traditional PBM model to bring cost transparency and flexibility to pharmacy care. He shares insights on specialty drug pricing, the role of biosimilars, and why health plans must take back control of their pharmacy management.

In this episode, Jakob Emerson sits down with Dr. Todd May, Vice President and Medical Director at Health Net, to discuss an innovative multi-payer value-based payment model in California. Dr. May shares insights on how major insurers are working together to improve primary care quality, advance health equity, and reshape provider reimbursement.

In this episode of the Becker's Payer Issues Podcast, Dr. Kate Goodrich, Chief Medical Officer at Humana, joins Jakob Emerson to discuss the challenges of the primary care shortage, the impact of value-based care, and Humana’s commitment to improving health outcomes through innovative care models.

In this episode, Jakob Emerson sits down with Michael Hunn, CEO of CalOptima, to discuss the organization's plans to offer coverage on California’s ACA exchange by 2027. They explore how this move aims to improve continuity of care for individuals transitioning in and out of Medi-Cal, the challenges faced by low-income residents in Orange County, and the key steps ahead in the regulatory approval...

Tune in for today's industry updates.

Tune in for today's industry updates.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Paige Brogan, Principal CalAIM at Blue Shield of California. Paige discusses Medi-Cal transformation through the CalAIM initiative, emphasizing value-based care, health equity, and innovative member engagement strategies to address whole-person needs.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Dr. Adrienne Moore, SVP of Finance at Banner Health. Dr. Moore discusses her top priorities, including the shift toward value-based care, addressing industry-wide cost pressures, and leveraging innovation to create a sustainable healthcare future.

​​This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Eric Witte, Chief Operating Officer of Genesis Orthopedics & Sports Medicine. Here, he shares insights on advancing value-based care strategies and the organization's commitment to improving access to care for patients from all backgrounds. Witte also discusses the challenges of recruiting staf...

In this episode, Pleasant Radford Jr., MBA, CHIE, Health Equity Officer at UCare, discusses initiatives to improve inclusivity in healthcare, including staff training on data usage and addressing members with correct pronouns. Learn about innovative steps toward building a more equitable healthcare environment.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Dennis Hillen, Senior Vice President at Oscar Health. Here, he discusses Oscar Health's low-cost, tech-first strategy and how the organization is tailoring its services to accommodate Spanish-speaking and Latino members. Hillen also highlights strategies for driving engagement and retention, ensuring...

In this episode, Jakob Emerson speaks with Patrick Quigley, CEO of Sidecar Health. Patrick shares insights about his unconventional journey into healthcare and how Sidecar Health is revolutionizing the health insurance industry with a consumer-first approach.

Health plans face crucial decisions when it comes to managing payment accuracy. This episode dives into the pros and cons of insourcing Payment Integrity solutions. We explore how control over operations translates to flexibility and cost management in a constantly evolving healthcare landscape. Industry expert Jhana Spence, Vice President of Strategy at CERIS, offers insights for health plan lead...

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Anne Groves, Market President at Arkos Health. Here, she emphasizes the importance of member engagement, ensuring individuals follow through with creating and adhering to their necessary health plans. Groves also encourages healthcare workers to stay focused on their mission, maintaining a patient-ce...

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Jordan Taggart, SVP of Payer & PBM Growth at Vida Health. Here, he discusses the importance of partnering with organizations that share Vida’s clinical philosophy to drive meaningful growth. Taggart also explores how Vida Health supports individuals from diverse backgrounds in achieving their wei...

In this episode of the Becker's Healthcare Podcast, Lukas Voss welcomes Dr. Katherine Hobbs, CEO of Author Health, to explore the evolving dynamics of payer-provider collaboration in healthcare. Dr. Hobbs shares insights on the impact of value-based care models, strategies for integrating mental health services, and overcoming barriers to data collection in behavioral health. Tune in for a forward...

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Pankhuri Sharma, Strategy & Operations Leader at Humana. Here, she discusses efforts to deliver more holistic population health services, with a focus on supporting vulnerable populations. Sharma also highlights the ongoing need to build patient trust as a critical area for improvement in advanci...

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Brad Riley, VP of Clinical Delivery at Longevity Health Plan. Here, he discusses how leveraging robust data sets can drive operational efficiency and improve decision-making. Riley also explores the challenges and limitations of generative AI technology in healthcare, emphasizing the need for cautiou...

Tune in for today's industry updates.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Krischa Winright, President of Medicare Advantage at Blue Cross Blue Shield of Michigan. Here, she discusses sustainable solutions for seniors on Medicare, focusing on providing seamless access to healthcare. Winright also examines market shifts in the post-COVID era and highlights the importance of...

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Mihir Kamdar, Chief Medical Officer at Tuesday Health. Here, he addresses the challenges of member experience that contribute to high healthcare costs and shares how his team is working to intervene earlier, reducing the need for costly end-of-life care. Kamdar also highlights strategies for improvin...

In this episode, Dr. Edward Juhn, Chief Quality Officer at Inland Empire Health Plan, shares how IEHP is tackling challenges within the Medicaid system through innovative technology, AI-driven solutions, and community-focused initiatives. Discover how IEHP is addressing provider shortages, advancing care quality, and fostering future healthcare leaders to better serve their vulnerable populations.

This episode, recorded live at the Becker’s Healthcare 2024 Fall Payer Issues Roundtable, features Scott D. Schweiger, VP of The Clinic by Cleveland Clinic. Here, he explores strategies for enhancing member engagement, encouraging patients to seek necessary care, and connecting them with programs tailored to their needs. Schweiger also discusses cost-reduction strategies aimed at making healthcare...

In this episode, Dr. Yolanda Lawson, Executive Medical Director for Maternal and Infant Health at Health Care Service Corporation, discusses innovative strategies to improve maternal and infant outcomes across diverse communities. From predictive data models to community-driven initiatives like Special Beginnings, Dr. Lawson highlights how HCSE is addressing disparities, leveraging technology, and...