Becker’s Payer Issues Podcast

In this engaging discussion, Rick Harbitt from Blue Cross Blue Shield of North Carolina and Bob Tavernier of Quest Analytics delve into how payers are tackling upcoming financial pressures. They explore Network Adequacy 2.0, emphasizing the need to align with member needs while ensuring quality and cost-efficiency. Bob highlights leveraging data analytics to optimize networks and drive informed decision-making. Together, they offer insights on long-term planning, telehealth access, and prioritizing initiatives amidst budget constraints.

Dr. Meera Atkins, Chief Medical Officer at Lyric.ai and board-certified OB-GYN, discusses how clinically informed AI can revolutionize payment accuracy in healthcare. She highlights the shift from reactive to proactive strategies in payer-provider relationships, emphasizing the importance of trust and clinical validation. Dr. Atkins explains how AI can reduce administrative burdens and enhance value-based care while ensuring equity and ongoing governance. She offers practical pilot suggestions for healthcare organizations to harness AI effectively.

Join Marcy Tatsch, Executive VP and General Manager at Truven by Merative, as she dives into the complexities of rising healthcare costs. With a wealth of experience in healthcare analytics, Marcy discusses key drivers like aging and chronic diseases. She highlights innovative solutions such as GLP-1 drugs and data-centric strategies that can save employers millions. Marcy emphasizes the importance of sophisticated data use for crafting smarter benefit strategies while enhancing care quality. It's a data-driven approach to navigating today's healthcare landscape!

In this episode, Shana Hoffman, President and CEO of Lucet, shares why behavioral health is the key to transforming patient outcomes and reducing costs. She discusses how Lucet is breaking down fragmentation, scaling integrated care, and achieving measurable results for patients and health plans. This episode is sponsored by Lucet.

In this episode, Vinay Kulkarni, Chief Information Officer at SCAN Group, discusses how AI, automation, and digital tools are transforming Medicare Advantage. He explains how these technologies improve care coordination, reduce administrative burden, and personalize care for seniors while maintaining high-quality, empathetic member experiences.

In this episode of Payer Issues, Rachel French, Chief Strategy and Partnerships Officer at MD Live by Evernorth, discusses the impact of point solution fatigue on the member experience, and how MD Live is redefining access with care that's connected, personalized, and provider-guided.This episode is sponsored by MD Live by Evernorth.

This episode features Dave Raccagni, Vice President of Innovation, Market Insights, and Communications at Cigna Healthcare, Dental & Vision. He discusses Cigna Dental's partnership with Paytient to expand flexible, no-interest dental payment options for 13 million members, how the program improves preventive and critical care access, and its potential to drive long-term health and cost savings across broader areas of care.

On this episode, Mark Grippi, AmeriHealth Caritas Ohio Market President joins the podcast to discuss opening dialogue with members to improve care, the role of health risk assessments, and overcoming digital fatigue in healthcare.

This episode features Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan who discusses challenges with access to dental care in rural areas, strategies for addressing community needs, and insights on current events shaping the dental industry.

This episode features Heather Tamborino, CFO at EmblemHealth, who discusses the company’s $2 million investment in food security across New York City. She shares how EmblemHealth’s neighborhood care centers are addressing food insecurity, connecting social and medical care, and redefining health equity as both a mission and a strategic imperative.