Becker’s Payer Issues Podcast

In this episode, Jay Nakashima, President of eHealth Exchange, discusses how modern data standards and trusted networks are transforming payer provider information sharing, reducing reliance on fax and manual processes. He also shares where inefficiencies persist, how interoperability can lower administrative costs, and what policy changes could improve affordability and access.

In this episode, Howard Weiss, Vice President of Government Affairs at EmblemHealth, discusses how payer provider collaboration, community based programs, and value focused partnerships can improve affordability and outcomes. He also shares how consumer pressure, regulatory scrutiny, and responsible use of AI are shaping health plan strategy and margins in 2026.

In this episode, Chris Gay, CEO and Co-Founder of Evry Health, joins Jakob Emerson to discuss how technology, scale, and business model alignment can dramatically reduce prior authorization friction. He shares why Evry Health’s approach delivers faster decisions, lower denial rates, and a better patient and provider experience, and what the industry needs to change next.

In this episode, Ellen Sexton, Executive Vice President and Chief Growth Officer at Blue Shield of California, discusses the impact of major policy changes on Medicaid and commercial markets, how her team is preparing for uncertainty, and the strategies needed to support members, stabilize employer coverage, and advance innovation across California's health care landscape.

In this episode, Dr. Cynthia Brown, Medical Director and Clinical Lead for Women’s Health at Elevance Health, discusses Elevance Health’s expansion of doula services into select employer health plans, highlighting how doula support improves outcomes, reduces disparities, strengthens the care experience, and creates long-term value for mothers and babies.

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®.

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.

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.

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.

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.