Becker’s Payer Issues Podcast How Payers are Preparing for 2026 and Beyond
Nov 13, 2025
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.
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Prioritize Long-Term Over Short-Term
- Financial pressure forces payers to prioritize long-term three- to five-year strategies over short-term fixes.
- Rick Harbitt says CapEx is nearly non-existent through 2025, requiring smarter, disciplined choices.
Analytics As The Decision Engine
- Data and analytics are central to balancing compliance, profitability and performance.
- Bob Tavernier emphasizes using PMPM, MLR and claims data to target incremental investments.
Network Adequacy Moves Beyond Compliance
- Network Adequacy 2.0 shifts from minimum regulatory compliance to member-centered design.
- Rick Harbitt says plans now evaluate provider types, quality, capacity and competitive cost, not just distance.