Becker’s Payer Issues Podcast

In this episode, Jakob Emerson sits down with Rona Li, SCAN Group's Chief Development Officer, and Rob Scruggs, Chief Digital Officer, to discuss SCAN’s latest digital initiatives. They explore how investments in technology, including the upcoming SCAN member portal and mobile app, are revolutionizing member engagement, improving access to care, and enhancing personalized health experiences.

In this episode of the Becker’s Healthcare Podcast, host Erika Spicer Mason speaks with Visar Tasimi, Senior Vice President of Provider Success at Lucet, about the critical communication challenges in behavioral health. They discuss the growing demand for services, the role of primary care in care coordination, and key strategies for improving provider engagement. Tune in for expert insights on how health plans can better support behavioral health providers and enhance patient care. This episode is sponsored by Lucet Health.

In this episode, Rick Abbott, Senior Vice President of Employer Solutions and Innovation at Priority Health, discusses the evolving landscape of employer-sponsored healthcare. From tackling affordability challenges to leveraging digital health and virtual care, Rick shares insights on how Priority Health is driving innovation to improve access, quality, and cost efficiency for employers and members alike.

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 process.

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 staff and providers in today’s competitive healthcare landscape.

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 members stay connected and supported in their healthcare journey.

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 leaders to optimize their insourcing strategy. This episode is sponsored by CERIS.

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-centered approach even amidst operational challenges.

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 weight loss goals, emphasizing personalized and inclusive care strategies.

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-looking discussion on how healthcare leaders can drive greater collaboration, improve patient outcomes, and reduce costs. This episode is sponsored by Author Health.