Episodios

  • Rethinking Prior Authorization Through Technology and Alignment with Chris Gay of Evry Health
    Dec 30 2025

    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.

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    22 m
  • Ellen Sexton, Executive Vice President and Chief Growth Officer at Blue Shield of California
    Dec 11 2025

    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.

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    20 m
  • Expanding Access to Doula Care to Improve Maternal Health with Dr. Cynthia Brown
    Dec 10 2025

    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.

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    9 m
  • Health Plan Readiness for 2026: Network Trends, Data & AI
    Dec 4 2025

    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®.

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    20 m
  • Dr. Saria Saccocio, Chief Medical Officer at Essence Healthcare
    Nov 19 2025

    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.

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    17 m
  • Steve Tringale, President of Mass General Brigham Health Plan
    Nov 18 2025

    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.

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    20 m
  • Breaking Free from Legacy: Modernizing Health Plans with AI and BPaaS
    Nov 14 2025

    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.

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    25 m
  • How Payers are Preparing for 2026 and Beyond
    Nov 13 2025

    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.

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    15 m