Becker’s Payer Issues Podcast

In this episode, Dr. Sanjiv Shah, Chief Medical Officer, MetroPlusHealth, discusses how care management, provider partnerships, and timely information exchange have helped MetroPlusHealth earn consecutive four star Medicare Advantage ratings. He also shares strategies for closing care gaps, improving transitions after hospital stays, and preparing providers for digital quality reporting requirements.

In this episode, Dr. Alice Chen, Chief Health Officer at Centene, discusses how health plans can use evidence based prevention frameworks to improve outcomes, guide investments, and reduce waste. She shares lessons from food as medicine initiatives and explains why interventions must be supported by rigorous data, tailored to underserved populations, and proven effective before scaling.

In this episode, Ganesh Padmanabhan, CEO and Founder, Autonomize AI, discusses the risks of token maxing, reducing AI variability, and building scalable AI infrastructure for more consistent and accountable payer operations.

This episode is sponsored by Autonomize AI.

In this episode, Munjal Shah, Co-Founder & CEO of Hippocratic AI, discusses how healthcare AI can improve patient access and outcomes through rigorous safety testing, clinical safeguards and responsible deployment. 

This episode is sponsored by Hippocratic AI.

In this episode, Dan LaVallee, Associate Vice President of Community Engagement at UPMC Health Plan, discusses how an AI powered virtual reality simulator is helping EMT students build clinical readiness, confidence and communication skills. He shares how UPMC’s Freedom House program supports workforce development and how this training model could expand to other communities.

In this episode, Fiona Fang, CEO of Aetna Better Health of Florida, discusses Medicaid challenges, maternal and infant health, whole person care and efforts to help members maintain coverage. She also shares how data, community partnerships and targeted outreach can improve outcomes.

In this episode, Meredith Duncan, president and CEO of Texicare, discusses expanding access to affordable health coverage for small businesses, virtual care, provider network growth and the importance of building strong local relationships with providers and brokers.

In this episode, Ceci Connolly, President and CEO, Alliance of Community Health Plans (ACHP), discusses Medicare Advantage market disruption, plan exits, beneficiary impacts, and the need for risk adjustment reform to support sustainable coverage in local communities.

In this episode, Karen Ignagni, CEO, EmblemHealth, discusses the evolving Medicaid landscape, healthcare affordability, interoperability, and how health plans can use technology, AI, care management, and value-based care to better support members. She also shares insights on her return to the CEO role and EmblemHealth's ongoing transformation.

In this episode, Rick Gordon, Director of Government Programs at Milliman MedInsight, and Nicole Zilliox, Director of Clinical Products at Milliman MedInsight, discuss how Medicare Advantage plans can integrate quality, risk adjustment, clinical data and provider engagement to improve performance. They also explore data governance, audit readiness and proactive workflows for navigating evolving CMS requirements.

This episode is sponsored by Milliman MedInsight.