Becker’s Payer Issues Podcast

In this episode, Steve Yurjevich, Chief Executive Officer of Optum Insight’s Payer Market and a member of the American Heart Association Executive Leadership Team, joins the podcast to discuss rising healthcare costs and the growing adoption of AI across the payer landscape. He shares how the industry is shifting from pre-pay models to true avoidance strategies, focusing on preventing unnecessary care and improving overall system efficiency.

In this episode, Jeff Bak, President and Chief Executive Officer of Imagine360, joins the podcast to discuss improving health literacy for seniors and the role it plays in driving better outcomes. He shares how proactive care strategies and smarter use of utilization data can help create a more effective, patient-centered healthcare system.

In this episode, Rob Duffy, Chief Technology Officer at HealthEdge, explores how modern cloud infrastructure and deeply integrated AI can help health plans manage rising complexity, reduce administrative costs, and scale operations. He shares why platform consolidation and embedded AI are critical to staying competitive and sustaining performance in a rapidly evolving healthcare landscape. This episode is sponsored by HealthEdge.

In this episode, Alexandra Anderson, Head of Health Plan Sales & Partnerships at Color, explores how proactive, personalized screening and integrated care pathways can improve early cancer detection and reduce total cost of care for cancer. She shares insights on Color's approach to identifying risk & closing screening gaps, increasing member engagement, and the importance of timely, proactive interventions along the cancer care continuum. This episode is sponsored by Color.

In this episode, Pankhuri Sharma, Strategy and Operations Leader at Humana, joins the podcast to discuss gaps between population health strategy and real-world outcomes. She shares key priorities for effective population health programs and offers practical advice for emerging leaders navigating the evolving healthcare landscape.

In this episode, Charles Fan, President of Headspace, and Charlie Andres, Lead Actuary at Headspace, explore the drivers behind rising behavioral health costs and the growing impact of outpatient therapy. They discuss how integrated, prevention-focused care models and improved care pathways can help health plans manage costs while delivering better outcomes. This episode is sponsored by Headspace.

In this episode, Marc Jeffreys, General Manager of Health at Gradient AI, discusses how insurers are moving from experimental AI to practical tools that support underwriting, pricing, and population health decisions. He also explains why connected intelligence across the risk lifecycle can improve pricing stability, strengthen employer relationships, and unlock clearer insights from complex data. This episode is sponsored by Gradient AI.

In this episode, Kevin Knight, Chief Marketing Officer at Sidecar Health, joins the podcast to discuss making healthcare more intuitive and consumer-friendly. He shares how giving money back to consumers through tools like HSAs can improve engagement, and explains why competition and technology are key drivers of meaningful system-wide improvement.

In this episode, Jhana Spence, Senior Vice President of Strategy at CERIS, discusses the shift toward proactive payment integrity and what it means to “move left” in the claims lifecycle. She explores how health plans are leveraging data, analytics, and automation to reduce financial leakage, improve provider relationships, and build accuracy before payment goes out the door. This episode is sponsored by CERIS.

In this podcast, Steve Province, former CEO of a major MCO, joins Kendall Lockhart, Founder & CEO of Me+U Care, to unpack why “meeting people where they are” remains so hard in practice for many health plans, and what it will take to rebuild trust under growing HR1 pressures. A grounded, real world conversation about the human side of member retention. This episode is sponsored by Me+U Care.

In this episode, Dr. Faisal Tai, board-certified psychiatrist and founder of PsychPlus, discusses how fragmented systems, limited connectivity, and misaligned incentives are driving gaps in behavioral health access and rising costs. He shares how vertically integrated care models, unified platforms, and better care coordination can improve outcomes, reduce ED utilization, and lower total cost of care at scale. This episode is sponsored by PsychPlus.

In this episode, Gene German, Chief Technology Officer at Lyric, explores how small, domain-specific language models (SLMs) are driving measurable improvements in claims and payment integrity. He outlines how combining AI with human judgment can increase efficiency, reduce variability, and enhance accuracy across complex healthcare workflows. Gene also shares a practical roadmap for scaling AI, from identifying the right use cases to building the data, governance, and feedback systems needed for sustained impact. This episode is sponsored by Lyric.ai.

In this episode, Gretchen Wagner, Associate Vice President - Risk Management, Humana, discusses how health plans are navigating cost pressures, workforce challenges, and rapid change by strengthening value-based partnerships and operational efficiency. She highlights the critical role of data interoperability, digital innovation, and analytics in improving member experience and long-term sustainability.

In this episode, Josh Lumbley, MD, Chief Quality Officer and Senior Vice President of Physician Operations at NorthStar Anesthesia, discusses the critical factors health system leaders should evaluate before transitioning anesthesia partners. He shares practical guidance on transition planning, staffing strategy, transparency, and how strong clinical partnerships ensure operating room stability and long term success. This episode is sponsored by NorthStar Anesthesia.

In this episode, Dr. Sameer Amin of L.A. Care Health Plan discusses how building durable community infrastructure, rather than short-term programs, supports continuity of care amid Medicaid enrollment shifts. He explains how investments in housing, food access, and care coordination can deliver measurable ROI while improving outcomes and reducing administrative burden.

In this episode, Brian Chaney, Division SVP of Sales Operations and Commercial Markets Growth at Health Care Service Corporation, discusses the launch of Unity Health Hub and how it helps employers navigate the growing number of digital health solutions. He explains how the platform integrates vetted vendors, improves member engagement, and delivers clearer data on outcomes and impact.

In this episode, Rhonda Randall, DO, Chief Medical Officer for UnitedHealthcare’s employer and individual business, discusses the company’s expansion of doula coverage to millions of members and the evidence behind its impact on maternal and infant health. She also explains how doulas support care teams and why employers are increasingly prioritizing better maternity care outcomes.

In this episode, Daniel J. Elliott, MD, MSCE, FACP, FAAP, Chief Medical Officer of Provider Experience at Centene Corporation, discusses how payers and providers can work together to address cost pressures, workforce challenges, and care coordination. He also shares perspectives on using AI, improving data sharing, and reducing friction in processes like prior authorization to strengthen the healthcare ecosystem.

In this episode, Krista Nelson, CEO of Optum Health, shares her vision for strengthening value based care through a more focused care delivery model, stronger clinician support, and expanded technology capabilities. She also discusses Medicare Advantage policy stability, the role of AI in reducing administrative burden, and how partnerships across the healthcare ecosystem can improve outcomes and patient experience.

In this episode, Dr. Kara Odom Walker, Chief Medical Officer for Aetna Medicaid, discusses a new collaboration with National Association of Community Health Centers to improve hypertension control in underserved communities. She shares how data, community partnerships, and addressing social drivers of health can help reduce disparities, prevent chronic disease complications, and improve outcomes for Medicaid members.