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Cigna sues FTC over PBM report + more
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Chronis Manolis, Senior Vice President, Pharmacy and Chief Pharmacy Officer at UPMC Health Plan
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. -
Joanne McFall, Market President of Keystone First and AmeriHealth Caritas Pennsylvania
In this episode, Laura Dyrda speaks with Joanne McFall, Market President of Keystone First and AmeriHealth Caritas Pennsylvania. Joanne shares her insights on post-pandemic Medicaid unwinding, rising healthcare costs, and the role of managed care in addressing social factors like housing and food insecurity to improve health outcomes. -
Best health plans in 2024, per NCQA + more
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'Great disruption' looms for MA + more
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Biden expands mental health parity law + more
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Joe Glinka, Director of PA HealthChoices at Highmark Whole Care
In this episode, Joe Glinka, Director of PA HealthChoices at Highmark Whole Care, delves into the complexities of managing Medicaid in Pennsylvania, addressing issues like rising healthcare costs, the impact of social determinants on health, and the innovative community initiatives Highmark is undertaking to support vulnerable populations. -
Addressing Maternal and Infant Health Disparities: Insights from Dr. Lisa Saul of UnitedHealthcare
In this episode, Dr. Lisa Saul, UnitedHealthcare’s National Medical Director of Maternal Child Health, discusses the key findings from the 2024 Maternal and Infant Health Disparities Data Brief. Dr. Saul highlights persistent disparities in health outcomes and shares how UnitedHealthcare is working to improve maternal and infant care through community engagement and collaborative efforts. -
Karen Walker Johnson on Leading Clever Care's Unique Approach to Healthcare
In this episode, Karen Walker Johnson, interim CEO at Clever Care, discusses her career journey in healthcare, Clever Care's mission to serve vulnerable populations, and the company’s culturally tailored approach to Medicare Advantage. -
Fred Turner, CEO of Curative
In this episode, Fred Turner, CEO of Curative, shares the journey of scaling the company from a COVID-19 testing powerhouse to a disruptive force in the commercial health plan space. He discusses Curative's unique no-deductible model, the importance of early patient engagement, and the challenges of entering a highly regulated industry dominated by a few major players. -
Dr. John Kim, Chief Medical Officer for Alignment Health's West Coast Markets
In this episode, Dr. John Kim, Chief Medical Officer for Alignment Health's West Coast Markets, discusses the significant social barriers affecting senior healthcare, including transportation, economic insecurity, and loneliness. He shares how Alignment Health is tailoring benefits and programs to meet the evolving needs of seniors, emphasizing the importance of holistic care and support. -
Ananya Banerjee, Chief Commercial Officer at Aledade, Inc.
In this episode, Ananya Banerjee, Chief Commercial Officer at Aledade, Inc., discusses the challenges of healthcare access, cost management, and physician independence, while highlighting Aledade's impact on rural communities and the future of value-based care. -
Centene to cut Part D broker payments + more
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UnitedHealth eyes Surgery Partners purchase + more
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Dr. Robert Groves, Executive Vice President & Chief Medical Officer of Banner/Aetna
In this episode, Dr. Robert Groves, Executive Vice President & Chief Medical Officer of Banner/Aetna, discusses the evolving healthcare landscape, the impact of cost pressures, and the innovative approaches Banner/Aetna is taking to improve care delivery. Discover how community-driven programs and advancements in AI are shaping the future of patient care. -
Boyd Faust, Chief Strategy Officer at GoHealth Urgent Care
In this episode, Boyd Faust, Chief Strategy Officer at GoHealth Urgent Care and newly elected member of the Urgent Care Association Board of Directors, discusses the critical role of value-based care, strategic payer partnerships, and patient engagement in the evolving urgent care landscape. -
Prioritizing Patient Access and Experience: In-Home Care with Matrix Medical Network
This episode of the Becker's Healthcare Podcast dives into the future of in-home care with Joseph Buchanan, SVP of Clinical Network at Matrix Medical Network, about how they prioritize high-quality care delivery in patients' homes. They discuss the importance of a clinician-led approach to in-home assessments and how it improves access, patient experience, and health equity for payers.This episode is sponsored by Matrix Medical Network. -
Humana settles Medicare fraud case for $90M + more
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Harris, Trump tread in ACA ambiguity + more
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Transforming Rural Healthcare: A Vision for Growth and Innovation with Dr. Tommy Ibrahim
In this episode, Dr. Tommy Ibrahim, President and CEO of Sanford Health Plan, discusses his journey from clinical practice to leading a health plan, the challenges and opportunities in rural healthcare, and his strategies for driving growth and innovation in a rapidly evolving industry.
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