Navigating Payer Challenges and Out-of-Network Policies with Jakob Emerson

In this episode, Joshua Weber, PharmD, MBA-HCM, CSP, BCMTMS, 340B ACE, Senior Director, St. Luke's Health System, highlights the organization’s future-ready pharmacy transformation, including paperless workflows, AI-enabled prior authorizations, EHR-integrated benefits investigations, and expanded specialty drug access for 5,000 more patients.

In this episode, Airica Powell-Steed, Ed.D, MBA, RN, CSSMBB, FACHE, FAAN, IASSC - Interim Executive Vice President and Chief Operating Officer, Loretto Hospital Network, shares hard-earned lessons leading safety net hospitals through financial distress and workforce exhaustion, emphasizing people-centered change management and community-driven transformation.

This episode of the Becker’s Healthcare Podcast features Scott Sagehorn, Vice President and General Manager of the Smart Care Business Unit at Stryker Medical, discussing how interoperability at scale is enabling smarter, more connected care. He shares his perspective on the evolution of digital health problem-solving, the real-world impact of ambient intelligence and automation, and what it takes to build interoperable ecosystems that reduce complexity, help enhance safety and support data-driven decision-making across health systems.This epsiode is sponsored by Stryker.

In this episode, Dr. Prathibha Varkey, President of Mayo Clinic Health System, shares why culture and people are central to successful transformation and turnaround efforts. She discusses practical leadership behaviors, signs of cultural strain, and how intentional, patient centered alignment drives sustainable performance and resilience.

In this episode, John Meier, CEO of Aurora Charter Oak Behavioral Health Hospital, discusses his career path, key trends shaping behavioral health, and the impact of new California nursing staffing ratios. He also shares leadership lessons, optimism for expanded access to care, and what it takes to lead through rapid change.

In this episode, Thomas Carey, PharmD, Senior Director, Pharmacy Services, UW Northern Illinois, shares how the organization elevated its Med to Bed discharge program using multidisciplinary coordination, driving a nearly 30% reduction in 30-day readmissions. He also discusses agility in 340B compliance, leveraging learners, and the future of pharmacy growth through technology, automation, and workforce investment.

In this episode,Caswell Samms III, Executive Vice President and CFO of Nemours Children’s Health, discusses financial priorities for 2026, including purposeful growth, Medicaid reimbursement pressures, and strategic investments in maternal care and virtual health. He also shares how CFOs must lead with agility, clinical insight, and mission focus in an uncertain healthcare landscape.

In this episode, Jakob Emerson, Associate News Director at Becker’s Healthcare, breaks down the latest trends in the payer landscape, including pharmacy benefit management, health system cost pressures, and Anthem’s new 10% penalty on out-of-network claims. He also highlights the recent debate between Mark Cuban and PBM leaders on industry transparency and rising pharmaceutical costs.

In this episode,  Scott Becker outlines the eight biggest issues shaping U.S. healthcare as the industry heads into 2026, including physician shortages, rising costs, payer power, and more.

This episode recorded live at the 10th Annual Health IT + Digital Health + RCM Annual Meeting features Nabile M. Safdar, Chief AI Officer, Emory Healthcare. He discusses how Emory is leveraging AI across clinical, operational, and patient-facing applications, and shares strategies for governance, adoption, and safely integrating advanced AI tools into healthcare workflows.