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® (https://questanalytics.com/).

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 (https://healthedge.com/).

In this episode, Rick Harbit of Blue Cross Blue Shield of North Carolina and Bob Tavernier of Quest Analytics discuss how payers are navigating financial pressures, advancing network adequacy 2.0, and using data and network intelligence to drive long-term success. This episode is sponsored by Quest Analytics (https://questanalytics.com/).

Dr. Meera Atkins, Chief Medical Officer at Lyric.ai, shares how clinically informed AI can transform payment accuracy from a reactive process to a proactive, transparent partnership. She discusses the importance of trust, clinical validation, and equity in advancing value-based care and reducing administrative friction across the healthcare ecosystem.This episode is sponsored by Lyric.ai (https://www.lyric.ai/).

In this episode, Marcy Tatsch, Executive Vice President and General Manager of Truven by Merative, shares insights into how employers and health plans can use data analytics to lower costs, improve outcomes, and design smarter benefit strategies in a challenging healthcare landscape.This episode is sponsored by Merative (https://www.merative.com/).

In this episode, Shana Hoffman, President and CEO of Lucet, shares why behavioral health is the key to transforming patient outcomes and reducing costs. She discusses how Lucet is breaking down fragmentation, scaling integrated care, and achieving measurable results for patients and health plans. This episode is sponsored by Lucet (https://lucethealth.com/).

In this episode, Vinay Kulkarni, Chief Information Officer at SCAN Group, discusses how AI, automation, and digital tools are transforming Medicare Advantage. He explains how these technologies improve care coordination, reduce administrative burden, and personalize care for seniors while maintaining high-quality, empathetic member experiences.

In this episode of Payer Issues, Rachel French, Chief Strategy and Partnerships Officer at MD Live by Evernorth, discusses the impact of point solution fatigue on the member experience, and how MD Live is redefining access with care that's connected, personalized, and provider-guided.This episode is sponsored by MD Live by Evernorth (https://www.mdlive.com/).

This episode features Dave Raccagni, Vice President of Innovation, Market Insights, and Communications at Cigna Healthcare. He discusses Cigna’s partnership with Paytient to expand flexible, no-interest dental payment options for 13 million members, how the program improves preventive and critical care access, and its potential to drive long-term health and cost savings across broader areas of care.

On this episode, Mark Grippi, AmeriHealth Caritas Ohio Market President joins the podcast to discuss opening dialogue with members to improve care, the role of health risk assessments, and overcoming digital fatigue in healthcare.

This episode features Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan who discusses challenges with access to dental care in rural areas, strategies for addressing community needs, and insights on current events shaping the dental industry.

This episode features Heather Tamborino, CFO at EmblemHealth, who discusses the company’s $2 million investment in food security across New York City. She shares how EmblemHealth’s neighborhood care centers are addressing food insecurity, connecting social and medical care, and redefining health equity as both a mission and a strategic imperative.

This episode features Richard Greene, President of Clever Care Health Plan, discussing how the organization is growing through a unique model that combines Eastern and Western medicine, invests in culturally tailored community centers, and builds sustainable relationships with providers and members across California.

This episode features Colleen Briggs, President of the Blue Cross NC Foundation and Vice President of Corporate Responsibility at Blue Cross NC. She discusses the Feed Your Health initiative, how food-based interventions are improving outcomes for members with diabetes, and what it takes to move these programs from pilot to sustainable, systemwide solutions.

In this episode, Michael Carson, President and CEO of Wellcare, a Centene company, shares how his diverse career and mission-driven approach shape Wellcare’s Medicare strategy. He highlights the unique needs of dual eligible members, the importance of integrated care, and the push to improve consumer experience across healthcare.