Becker’s Payer Issues Podcast

In this episode, Jennifer Schirmer, VP of Growth and Community Engagement and interim VP of Duals Program Integration at Blue Shield of California Promise Health Plan, breaks down the sweeping Medicaid changes under HR1 and their impact on California’s Medi-Cal…

In this episode, Elizabeth Crawley, Vice President for Clinical and Care Management Solutions at EXL, explores how AI driven workflows and agentic automation are transforming prior authorization. She discusses balancing efficiency with clinical oversight, scaling decision support across the enterprise,…

In this episode, Sheri Johnson, former Vice President of Member Enrollment and Billing at UCare, shares insights on how payer and provider relationships are evolving under cost and workforce pressure, where strategy and operations often misalign, and why AI is…

In this episode, Ty Wang, Co-Founder and Chief Executive Officer at Angle Health, shares how his team is rethinking health plan infrastructure to move beyond transactional payer provider relationships. He discusses modernizing operations with AI, improving transparency for employers and…

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…

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…

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…

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…