ACA Subsidies, PBMs, and the Shifting Payer Landscape with Jakob Emerson

In this episode, Stephen Sukumaran, Director of the Long Acting Injectable (LAI) Program at Callen-Lorde Community Health Center, explains how his team streamlined insurance navigation, documentation, and care coordination by optimizing Electronic Health Record (EHR) workflows, leading to major improvements in patient access, efficiency, and long acting injectable HIV Pre-exposure Prophylaxis (PrEP) uptake.This episode is sponsored by Gilead Sciences.

In this episode, Ashutosh (Ash) K. Tewari, MD, Urologist and Prostate Cancer Specialist and Chairman of the Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai, discusses the rise in prostate cancer cases, strategies to reduce treatment-related side effects, and how mobile units are expanding outreach to improve patient access and early detection.

This episode features Neal ElAttrache, MD, orthopaedic surgeon and sports medicine specialist and Chairman of the Kerlan-Jobe Orthopaedic Foundation in Los Angeles, and Director Medical Services and Senior Orthopaedic Surgeon LA Rams and LA Dodgers. Here, he reflects on decades of caring for elite athletes, the evolution of surgical techniques that support faster and safer returns to play, and the role of mentorship, trust, and passion in shaping exceptional orthopedic care.

This episode recorded live at the 10th Annual Health IT + Digital Health + RCM Annual Meeting features Dr. Tim Calahan, CTO, Michigan Medicine. Here, he discusses how his organization is using AI, virtual care, and digital health tools to enhance clinical workflows and patient care. He also shares strategies for governance, operational planning, and staying focused on key technology initiatives while adapting to changing legislation and rising demands in healthcare.

In this episode, Brett Caplan, Director & Peter Winslow, Managing Consultant at Berkeley Research Group (BRG) discuss the growing pressures shaping payer provider negotiations, the rise in out of network strategies, and how BRG is helping health systems prepare for a more complex and contentious landscape.

In this episode, Stephen Rinaldi, SVP and Chief Revenue Officer at UNC Health, discusses the major headwinds shaping revenue cycle today, strategies for building strong future leaders, and how UNC Health is advancing revenue integrity and operational excellence heading into 2026.

In this episode, Pete November, President and CEO of Ochsner Health, reflects on his unconventional path from law to healthcare, the mentors who shaped his leadership, the family and routines that keep him grounded, and the pivotal risks that led him to lead one of the nation’s major health systems.

In this episode, Jakob Emerson, Associate News Director at Becker’s Healthcare, breaks down the latest debates over ACA premium tax credits, explores a potential Humana and Mark Cuban partnership, and highlights the policy and market forces reshaping the payer environment heading into the new year.

This episode recorded live at the 10th Annual Health IT + Digital Health + RCM Annual Meeting features Lisa Stephenson, Chief Nursing Informatics Officer, Cedars-Sinai Health System. Here, she shares strategies for integrating new technology, addressing operational challenges, and engaging clinicians to improve efficiency, patient experience, and staff satisfaction.

In this episode, Brian Berkowitz, Chief Product Officer at Lyric, discusses how AI, data, and trusted intelligence zones can reduce administrative friction, strengthen collaboration between payers and providers, and build a more transparent and efficient payment integrity ecosystem.This episode is sponsored by Lyric.ai.