Episodes
Dec. 4, 2025
Health Plan Readiness for 2026: Network Trends, Data & AI
In this episode, Steve Levin, CEO of Quest Analytics®, shares how health plans can prepare for 2026 as regulations evolve and market expectations shift. He unpacks what current network trends are signaling for plan strategy, why provider data accuracy and operational efficiency are becoming key competitive differentiators, and how leaders can adopt technology and AI in practical ways that drive real, measurable value. This episodeis sponsored by Quest Analytics®.
Nov. 19, 2025
Dr. Saria Saccocio, Chief Medical Officer at Essence Healthcare
In this episode, Dr. Saria Saccocio, Chief Medical Officer at Essence Healthcare, explains how strong provider partnerships, real time data, and a member centered approach drive the plan’s four and a half star performance. She also shares how addressing social needs and listening closely to members shapes future benefit design and care delivery.
Nov. 18, 2025
Steve Tringale, President of Mass General Brigham Health Plan
In this episode, Steve Tringale, President of Mass General Brigham Health Plan, shares how the organization is expanding its product portfolio, entering the dual eligible market, and investing in integrated digital care management to better support members across all stages of life.
Nov. 14, 2025
Breaking Free from Legacy: Modernizing Health Plans with AI and BPaaS
In this episode, Kevin Adams, CEO of HealthEdge, discusses how health plans can overcome legacy technology challenges through modernization, business process as a service (BPaaS), and AI-driven efficiency. He shares insights on building stronger operational foundations and how next-generation automation is reshaping payer operations. This episide is sponsored by HealthEdge.
Nov. 13, 2025
How Payers are Preparing for 2026 and Beyond
In this episode, Rick Harbit of Blue Cross Blue Shield of North Carolina and Bob Tavernier of Quest Analytics discuss how payers are navigating financial pressures, advancing network adequacy 2.0, and using data and network intelligence to drive long-term success. This episode is sponsored by Quest Analytics.
Nov. 10, 2025
How AI is Transforming the Payer Strategy
Dr. Meera Atkins, Chief Medical Officer at Lyric.ai, shares how clinically informed AI can transform payment accuracy from a reactive process to a proactive, transparent partnership. She discusses the importance of trust, clinical validation, and equity in advancing value-based care and reducing administrative friction across the healthcare ecosystem. This episode is sponsored by Lyric.ai.
Nov. 7, 2025
From Data to Dollars: Strategies to Curb Rising Healthcare Costs
In this episode, Marcy Tatsch, Executive Vice President and General Manager of Truven by Merative, shares insights into how employers and health plans can use data analytics to lower costs, improve outcomes, and design smarter benefit strategies in a challenging healthcare landscape. This episode is sponsored by Merative.
Nov. 4, 2025
The Future of Integrated Care, and What Leaders Need to Do Now to Achieve This at Scale
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.
Oct. 30, 2025
Leveraging AI and Digital Transformation to Improve Medicare Advantage with Vinay Kulkarni
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.
Oct. 29, 2025
Reimagining Access: Aligning Technology, Strategy and the Member Experience
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.
Oct. 25, 2025
Expanding Access to Affordable Dental Care with Cigna Healthcare and Paytient
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.
Oct. 23, 2025
Mark Grippi, AmeriHealth Caritas Ohio Market President
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.
Oct. 22, 2025
Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan
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.
Oct. 21, 2025
How EmblemHealth is Fighting Food Insecurity and Advancing Community Health
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.
Oct. 20, 2025
Inside Clever Care Health Plan’s Growth: Blending Cultures, Community, and Value-Based Care
This episode features Richard Greene, President of Clever Care Health Plan, discussing how the organization is growing through a unique model that combines Eastern and Western medicine, invests in culturally tailored community centers, and builds sustainable relationships with providers and members across California.
Oct. 19, 2025
How Blue Cross NC Is Scaling Food as Medicine to Improve Health and Lower Costs
This episode features Colleen Briggs, President of the Blue Cross NC Foundation and Vice President of Corporate Responsibility at Blue Cross NC. She discusses the Feed Your Health initiative, how food-based interventions are improving outcomes for members with diabetes, and what it takes to move these programs from pilot to sustainable, systemwide solutions.
Oct. 1, 2025
Leading Medicare Innovation and Supporting Dual Eligibles with Michael Carson
In this episode, Michael Carson, President and CEO of Wellcare, a Centene company, shares how his diverse career and mission-driven approach shape Wellcare’s Medicare strategy. He highlights the unique needs of dual eligible members, the importance of integrated care, and the push to improve consumer experience across healthcare.
Sept. 25, 2025
Innovating Consumer Choice and Cost Management at UnitedHealthcare with Dan Kueter
In this episode, Dan Kueter, CEO of UnitedHealthcare's Employer & Individual business, talks about new tools like the UHC Store, the impact of AI on healthcare navigation, and how employers and members are adapting to rising costs and evolving therapies.
Sept. 17, 2025
Charting the Path for Electronic Prior Authorization
In this episode, Steven Berkow, Senior Advisor for Value-based Care at InterSystems, and Robert Tennant, Executive Director of the Workgroup for Electronic Data Interchange, discuss the evolving landscape of ePrior authorization. They share insights on regulatory changes, industry collaboration, and what healthcare leaders should know as the 2027 compliance date approaches. This episode is sponsored by InterSystems.
Sept. 15, 2025
Zack Myers, National General Manager at SCAN Health Plan
In this episode, Zack Myers, National General Manager at SCAN Health Plan, discusses the organization’s expansion into new markets, its nonprofit approach to provider partnerships, and how innovative models like iSNPs are improving care and independence for seniors.
Sept. 11, 2025
Driving Community Impact Through Medicaid Innovation at UPMC
In this episode, Brendan Harris, president of UPMC for You and state programs, shares how initiatives like the Pathways to Work program and Neighborhood Centers are addressing social determinants of health, supporting Medicaid members, and strengthening local communities.
Sept. 10, 2025
Mack McGee, Chief Marketing Officer at CareFirst BlueCross BlueShield
In this episode, Mack McGee, Chief Marketing Officer at CareFirst BlueCross BlueShield, shares how the organization earned top marks for customer experience in Forrester’s 2025 rankings and discusses the importance of trust, personalization, and simplifying healthcare interactions for members.
Sept. 1, 2025
Navigating Rising Health Costs and Alternative Coverage Models
In this episode, Scott Burton, Market President at Providence Health Plan, shares insights on the growing interest in ICRAs, strategies to manage rising employer health costs, and how Providence is balancing innovation with long-term sustainability in a shifting insurance landscape.
Aug. 29, 2025
Breaking Down Silos in Health Plan Pricing Operations
In this episode, Jay Deady, President of Price Optimization at Zelis, discusses why fragmented pricing operations create inefficiencies for health plans and how integrated solutions, advanced technology, and personalization are paving the way for a more connected financial experience across healthcare. This episode is sponsored by Zelis.