This episode of the Becker's Healthcare Podcast dives into the critical issue of payment integrity with Debra Hamer, Director of Product at CERIS. We discuss why proactive strategies are essential in the fight against fraud, explore new innovations, and look towards the future of this evolving landscape.

This episode is sponsored by CERIS.

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In this episode, Dr. Wyatt Decker, Executive Vice president and Chief Physician for Value-Based Care and Innovation at UnitedHealth Group, shares insights on the transition to value-based care, its impact on patient outcomes, and the challenges facing healthcare providers. Tune in for a deep dive into how UnitedHealth Group is leading efforts to reshape the U.S. healthcare system.

In this episode, Piyush Khanna, Vice President of Clinical Services at CareFirst BlueCross BlueShield, joins the podcast to discuss the importance of timely data from provider networks. He shares insights on quality reporting requirements, operational challenges, and how advancements in data exchange are shaping the future of healthcare delivery.

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In this episode, Rushil Desai, President and CEO of Aetna Better Health of Illinois, discusses key trends in Medicaid managed care, including the integration of behavioral health and social needs, the impact of digital health solutions, and the future of value-based care. He also shares insights into the innovative programs improving access and equity for Illinois' most vulnerable populations.

In this episode, George Halvorson, Chair and CEO of the Institute for InterGroup Understanding and former CEO of Kaiser Permanente, shares insights on the evolution of Medicare Advantage, its success in delivering quality care, and its role in shaping the future of healthcare. Halvorson delves into key topics like capitation, healthcare cost management, and the ongoing challenges facing the Medicare system.

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In this episode, Chronis Manolis, Senior Vice President, Pharmacy and Chief Pharmacy Officer at UPMC Health Plan, shares his perspective on the evolving pharmacy and drug access landscape. He discusses the challenges surrounding rising drug costs, GLP-1 medications, and the future of pharmacy benefit management in a complex healthcare environment.

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