Becker’s Payer Issues Podcast

In this episode, we explore how data analytics and clinical expertise can transform kidney health management for health plans. Joining the conversation is Joe Vattamattam, Founder and President of Healthmap Solutions, who shares insights on why tackling chronic kidney disease (CKD) and end-stage renal disease (ESRD) is crucial. Tune in to learn how Healthmap leverages technology, clinical support, and innovative strategies to improve outcomes for patients and providers.This episode is sponsored by Healthmap Solutions.

In this episode of the Becker’s Healthcare Podcast, Lukas Voss sits down with Mark Johnson, Senior Vice President at CERIS, to explore how payment integrity can significantly reduce billing errors and financial waste in healthcare. With up to 80% of medical bills estimated to contain mistakes, Mark shares how technology, process modernization, and strategic payer initiatives are making a meaningful impact. Tune in for insights on how payers can improve accuracy, streamline operations, and drive value across the payment lifecycle.This episode is sponsored by CERIS.

In this episode, Melissa Skottegaard, Chief Communications Officer and Chair of The Cigna Group Foundation, shares how the organization is tackling youth mental health, veteran housing insecurity, and health equity through a data-driven, employee-powered community engagement strategy designed for deeper, more focused impact.

Jocelyn Wood, a Senior Solutions Consultant at Verifiable with nearly 20 years in healthcare, joins the discussion on the pressing need to upgrade outdated legacy systems in the sector. She highlights how these systems impede patient access and delay provider onboarding. The conversation also delves into the vital role of payer-provider collaboration, offering strategies for healthcare leaders to enhance efficiency. With insights from real-world examples like Midi Health's expansion, it provides a roadmap for building patient-centered, scalable networks.

In this episode, Dr. Ruchi Talwar, Medical Director of Episodes of Care Population Health at Vanderbilt Health, joins Jakob Emerson to discuss how provider-led bundled payment programs are improving outcomes, reducing costs, and delivering value for both employers and patients. She shares insights into Vanderbilt’s innovative “My Health Bundles” and their real-world success in reshaping specialty care.

In this episode, Steve Tringale, President of Mass General Brigham Health Plan, discusses the evolving landscape of healthcare, the challenges and opportunities brought by change, and how the organization is leveraging AI and integrated care to improve member outcomes and experiences. He also shares insights into leadership in a time of rapid industry transformation.

Neetu Rajpal, CEO and co-founder of Lilac Software, discusses the transformative impact of agentic AI in healthcare payers. She reveals how AI can streamline claim processing and close care gaps, especially in crucial areas like breast cancer screenings. Neetu emphasizes the importance of ethics, addressing bias in AI training, and ensuring patient-centered design. The conversation also dives into the balance between innovation and trust in healthcare technology, highlighting the need for regulatory compliance as we navigate this evolving landscape.

In this episode, Senthu Arumugam, Chief Commercial Officer at SCAN Health Plan, discusses the evolving Medicare Advantage landscape, the impact of market disruptions, and how technology and stability-driven strategies can improve member experiences.

In this episode, Dr. Ravi Kavasery, Chief Medical Officer at Blue Shield of California, joins Jakob Emerson to discuss the company’s ambitious goal of shifting 90% of eligible healthcare spending to pay-for-value models. Dr. Kavasery shares insights on the challenges of transitioning from fee-for-service, the importance of aligning incentives, and the innovative models shaping the future of healthcare affordability and quality.

In this episode, Dr. Steve Friedhoff, Senior VP of Healthcare Services at Blue Cross Blue Shield of North Carolina, discusses innovative initiatives addressing healthcare workforce shortages and expanding access to care. From supporting veterans transitioning into medical careers to investing in youth mental health programs, Dr. Friedhoff highlights how Blue Cross NC is shaping the future of healthcare in the state.