Becker’s Payer Issues Podcast

Steve Sutherland, Senior Vice President at CERIS, delves into the transformative power of AI and machine learning in healthcare payment integrity. He discusses how these technologies enhance claims processing by automating workflows and improving accuracy. Sutherland also highlights the challenges of AI integration, such as data inconsistencies and compliance issues. He emphasizes strategies for effective change management, including stakeholder engagement and training, to ensure successful technology adoption in the healthcare landscape.

In this episode, Jakob Emerson speaks with Guy A. Medaglia, President & CEO of Saint Anthony Hospital in Chicago, and Michael Shakman, Partner at Miller Shakman Levine and Feldman, about St. Anthony's transformative role in community healthcare and their ongoing lawsuit against the state of Illinois over Medicaid payment issues. Guy shares his unconventional journey into healthcare and personal motivation rooted in his upbringing, while Mike explains the complexities and current status of their legal fight for fair and transparent Medicaid reimbursements.

In this episode, Jakob Emerson interviews Krischa Winright, President of Medicare Advantage at Blue Cross Blue Shield of Michigan. They discuss Krischa's extensive background in healthcare, the unique needs of seniors in the Medicare Advantage market, and how BCBS Michigan is addressing these needs through innovative partnerships and strategies. Krischa also shares insights on the recent changes in Medicare Advantage star ratings and how her team is navigating industry headwinds to continue providing high-quality, affordable care to their members.

Tune in for today's industry updates.

Tune in for today's industry updates.

Tune in for today's industry updates.

In this thrilling episode, Stephen Anderson, VP of Provider Contracting & Network Administration at Blue Cross Blue Shield of Michigan, discusses the significance of GLP-1 medications and the importance of making them affordable and accessible for those in need. He also explores the future growth prospects for Blue Cross, highlighting factors driving up costs in the healthcare system and the strategies being implemented to manage these challenges.

In this episode of the Becker's Healthcare Podcast, Mariah Muhammad interviews Drew Thompson, Head of Sales and Growth at Northwell Direct. Drew discusses the challenges employers face with rising healthcare costs, the benefits of direct-to-employer healthcare models, and the importance of exploring alternative solutions like self-insurance and captive models to manage expenses and improve coverage.

Tune in for today's industry updates.

In this episode of the Becker's Healthcare Podcast, Laura Dyrda interviews Joanne Mizell, COO of Banner | Aetna, to discuss the joint venture's innovative efforts to transform healthcare and enhance patient experiences. They explore current trends and challenges in the industry, Banner | Aetna's focus on transparency and technology, and successful initiatives to improve member engagement and satisfaction.