Healthcare Costs, IDR and the No Surprises Act: David Merritt on What’s Driving Affordability Pressures

In this episode, Sheila Augustine, Director, Revenue Cycle, Nebraska Medicine, discusses how AI is helping identify missing charges, automate charge reconciliation and improve revenue cycle workflows while keeping staff engaged in the transformation. She also explores payer denials, Medicaid changes, succession planning and opportunities to further integrate AI across revenue cycle operations.

In this episode, Balaji Raman, MS, MBA, Enterprise Executive Director, Westchester Medical Center Health, discusses the rapid expansion of AI across the revenue cycle, Epic transformation, enterprise standardization and the importance of building strong processes before implementing new technology. He also shares leadership advice on listening, building relationships and creating an environment where teams can thrive.

In this episode, Tami McMasters Gomez, Executive Director, Mid-Revenue Cycle, UC Davis Medical Center, discusses leveraging AI and automation to address workforce shortages, strengthen coding and documentation, and improve financial integrity. She also shares her approach to AI governance, evolving revenue cycle roles and balancing innovation with human expertise.

In this episode, Michael Hassell, FACHE, Chief Executive Officer, Melissa Memorial Hospital, discusses rural healthcare sustainability, expanding specialty services and strengthening ambulance and behavioral health care. He also shares his perspective on revenue cycle management, workforce challenges and advocating for rural hospitals amid evolving healthcare policy.

In this episode, David Merritt, Senior Vice President of External Affairs at the Blue Cross Blue Shield Association, discusses rising healthcare costs, employer affordability pressures and the growing impact of the No Surprises Act’s IDR process. He also outlines potential reforms to curb excessive awards, increase transparency and slow premium growth.

In this episode, Shridar Ganesan, MD, Director, Center for Molecular Oncology at NYU Langone Health, discusses integrating genomic, clinical and radiographic data to improve cancer care and the role of AI in synthesizing complex patient information. He also explores the future of molecularly defined cancers, targeted therapies and the need to balance standard care with clinical research.

In this episode, Monica L. Baskin, PhD, Director of VCU Massey Comprehensive Cancer Center, joins the podcast to discuss the center’s Cancer Center Support Grant renewal and the work underway at Massey to advance cancer care and research. She also shares her experience as the first Black woman to be named director of an NCI-designated cancer center and the significance of that milestone.

In this episode, Dr. Sam Patel, healthcare business consultant and CEO of Astra Culture and Looped, discusses the growing gap between patient demand and healthcare capacity, including the rise of concierge and hybrid care models. He also explores how AI, telehealth and preventative care can improve efficiency and access while preserving the human connection at the heart of medicine.

In this episode, Hunter Foster, VP, Agency Operations and Strategy, benefitbay, explores the growing adoption of ICHRA and defined contribution models, including the demand for flexibility, predictability and employee choice. He also discusses successful implementation, broker adoption, AI's evolving role and what increased carrier participation could mean for the future of health benefits.

In this episode, Albert L. Wright, Jr., President and Chief Executive Officer of West Virginia University Health System, joins the podcast to discuss the 340B program and the role of alternative payment models in shaping healthcare delivery. He also shares insights on keeping communities healthy and strengthening the health system’s impact beyond traditional care.