Becker’s Payer Issues Podcast

In this episode, Hayley Park, PharmD, Chief Pharmacy Officer at Blue Shield of California, discusses Pharmacy Care Reimagined, biosimilar adoption and strategies to lower prescription drug costs. She also explores pharmacy industry trends, California policy changes and the importance of aligning financial incentives with better patient outcomes.

In this episode, Kali Ihde, Director, Ventures & Innovation, Northwestern Medicine, discusses how AI voice agents helped schedule 252 lung cancer screenings from 1,700 calls in three days, including nine patients with positive findings. She shares lessons on patient safety, clinical trust, and selecting the right use cases to expand AI driven outreach and improve access to care. This episode is sponsored by Hippocratic AI.

In this episode, Jennifer St. Thomas, SVP Commercial and Medicare Markets at Mass General Brigham Health Plan, discusses the plan’s new Value HMO offering for large employers, designed to lower healthcare costs while preserving access to leading regional health systems.

In this episode, Marc Jeffreys, General Manager, Health, Gradient AI, discusses how AI can streamline group health underwriting while keeping human judgment at the center of decision-making. He explores risk assessment, model transparency, and what health plans should look for in AI partners.

In this episode, Dr. Patricia Henwood, EVP, Chief Clinical Officer at Jefferson Health, discusses the health system’s approach to AI integration, including its intent, integration, and impact framework, ambient AI results, and patient facing AI voice agents designed to improve care access, clinician efficiency, and patient experience. This episode is sponsored by Hippocratic AI.

In this episode, Dr. Sanjiv Shah, Chief Medical Officer, MetroPlusHealth, discusses how care management, provider partnerships, and timely information exchange have helped MetroPlusHealth earn consecutive four star Medicare Advantage ratings. He also shares strategies for closing care gaps, improving transitions after hospital stays, and preparing providers for digital quality reporting requirements.