Podnosis – Détails, épisodes et analyse

Fierce Healthcare hosted the second annual Fierce Health Payer Summit in November. Top leaders and decision-makers in the healthcare and payer industry convened in Austin, Texas, for two days of discussions.  

During the event, Fierce’s Emma Beavins interviewed several panelists on the show floor about what they think the ideal payer of the future looks like. In this episode, you’ll hear about improving the member experience, reforming prior authorization and leveraging AI. 

The speakers featured in this episode are:  

• Alex Azar, former Health & Human Services secretary

• Tanvi Patel, general manager and director of Amazon Pharmacy

• Michael Anne Kyle, associate professor of health policy at the University of Pennsylvania

• Ed DeVaney, president of employer & health plans at CVS Caremark

• Brian Kim, CEO of HighRoads 

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Heather Cox, president of insights and empowerment at Zelis, discussed the challenges of achieving interoperability in healthcare during a recent podcast. She highlighted technical issues, diverse stakeholder needs and data silos as key obstacles. Cox emphasized the importance of real-time, secure data for payer-member engagement and suggested APIs as a promising solution. She also advised health plans on choosing technology partners and advocated for a data-centric approach to improve patient care. Listen to the podcast to learn more.

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More than one million women reach menopause each year in the U.S. Menopause can bring on many unwanted symptoms and increase the risk of chronic conditions, affecting a woman’s health and quality of life. Yet many report feeling uncomfortable talking about this challenging transition in the workplace and with their healthcare providers. Many also struggle to find relief for their symptoms. Experts say employers and providers should be doing more to care for women in midlife.  

To close out October, Menopause Awareness Month, Fierce Healthcare’s Anastassia Gliadkovskaya sat down with Kathleen Green, M.D., an OBGYN at Maven Clinic. Like many other physicians, Green did not get formal training on menopause in medical school. She had to learn how to help women through this natural part of aging. In the episode, they discuss why the status quo is not working and what it will take to improve the system.  

To learn more about the topics in this episode:  

• HLTH24 Day 2: Halle Berry wants to change the dialogue on menopause
• HLTH24: Jill Biden announces $110M ARPA-H funding award, prods industry to invest in women's health
• Menopause care is still a largely untapped market. Here's why investors and startups should dive in
• Industry Voices—Menopause is making headlines. Are healthcare workers keeping up?

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In healthcare, the best solutions come from bringing different perspectives to the table. 

That’s the core idea behind Inlightened, a platform connecting innovators with a network of vetted experts, including clinicians, industry leaders, policymakers and more. 

In this week's episode of "Podnosis," Fierce Healthcare’s Emma Beavins chats with Inlightened CEO Shelli Pavone. She explains why diverse viewpoints are essential for tackling the industry’s toughest challenges and how building real engagement is the bedrock for innovation that fills gaps in the industry and can endure.

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In the last 30 years, HIV rates have gone down, in large part because of the game-changing prescription drug pre-exposure prophylaxis (PrEP), which reduces the risk of contracting HIV through sex by 99%. Since the FDA approved the drug in 2012, more people have started to use it, and HIV rates have steadily decreased. However, not everyone sees the same results.

The South had 53% of new HIV diagnoses in 2022 but represented only 39% of PrEP users in 2023. Regionally, Black people made up 48% of new HIV diagnoses in 2022, but only 22% of PrEP users in 2023.  

In a recent collaboration between Fierce Healthcare and new investigative LGBTQ-focused news outlet Uncloseted Media, Anastassia Gliadkovskaya and Sam Donndelinger dive into the HIV epidemic and how it disproportionately affects at-risk individuals in the South. Barriers like a lack of awareness, insurance coverage, and stigma contribute to inequitable access. 

Read the full story at FierceHealthcare.com or UnclosetedMedia.com. 

In this week’s episode of “Podnosis,” Gliadkovskaya and Donndelinger discuss the reporting process and introduce three patients impacted by the HIV epidemic who share their personal experiences.

To learn more about the topics in this episode: 

• 'I'm another statistic. I feel let down': How HIV prevention stays out of reach for many

• CMS proposes risk adjustment changes, broker fraud crackdown for 2026 plan year

• ‘A mixed bag’: Fifth Circuit rules on ACA preventive services legal case

• Blue Cross NC removes HIV drugs from costly price tiers 

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There are many complexities and challenges that can lead to inefficiencies and friction among payers, providers, and healthcare consumers in the payments landscape.

In this podcast episode, we sit down with Dylan Papa and Michael Bernabe to discuss fresh perspectives for healthcare payers on how to improve claims payments operations, meet digital demands, and enhance the healthcare payments experience for all.

Zelis built Zelis Advanced Payments Platform to cleverly address these challenges by managing all payments and communications in one intelligent hub, unlocking efficiencies, ensuring compliance, and delivering the modern and customized payments experience that providers need and members demand – now, and in the future.

In this interview, Papa and Bernabe discuss the significance of combining the fusion of centralizing all payment modalities, plus communications and additional advice to payers on how to effectively modernize for the future.

To find out more, tune in to the full episode or visit Zelis.com.

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Chronic kidney disease is a silent threat. It is one of the leading causes of death in the U.S., yet 90% of those affected are unaware they have it. The lack of widespread testing means many, particularly in the Black community, face rapid health deterioration, often landing in dialysis without warning.

In this episode, Geoff Martin, CEO of Healthy.io, joins Fierce Healthcare’s Emma Beavins to explore how his company is tackling this hidden crisis and changing the future of chronic kidney disease care. 

To learn more about the topics in this episode: 

• Healthy.io, National Kidney Foundation team up to promote early disease detection, using tech to reach at-risk people
• More than half of Americans are unfamiliar with chronic kidney disease, survey finds
• 'Podnosis': Changing the game on kidney care
• Humana finds value-based care leads to fewer hospital admissions for kidney patients

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With just a month left until the Nov. 5 presidential election, Fierce Healthcare's Heather Landi spoke with David Shulkin, M.D., to gain his insights on the future of healthcare policy.

Shulkin, a healthcare executive, served as the ninth Secretary of Veterans Affairs under the Trump administration. Notably, he was the only cabinet member retained from the Obama administration, after serving 18 months as the VA’s Under Secretary for Health.

In their conversation, Shulkin also reflected on his time as VA Secretary, including his decision to award Cerner a $10 billion, no-bid contract to replace the VA’s outdated medical records system.

To learn more about the topics in this episode: 

• VA extends EHR modernization contract with Oracle Health for 11 months
• VA pauses $16B Oracle Cerner EHR deployments indefinitely to address error-ridden early rollout
• Former VA secretary's latest venture, Override, emerges out of stealth to tackle chronic pain

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Certain cancer rates are on the rise, and outcome inequities remain a major public health concern. Getting into clinical trials is difficult, care is fragmented and treatments can be prohibitively expensive. Meanwhile, research for many cancers is underfunded. 

The American Cancer Society is on a mission to end cancer as we know it. Its venture capital and impact investment arm, BrightEdge, invests in early-stage companies developing therapeutics, diagnostics, devices and technologies that share in this goal. 

In this week’s episode of “Podnosis,” Fierce Healthcare’s Anastassia Gliadkovskaya chats with BrightEdge’s managing director Alice Pomponio about how the organization leans into its expertise in research, patient support and advocacy when working with entrepreneurs, what it looks for in emerging companies and how it measures their impact. 

To learn more about the topics in this episode: 

• What will it take to improve the future of cancer care? Clinicians, patients stress better collaboration and reimbursement
• American Cancer Society, Color Health team up to boost cancer screenings for employees
• American Cancer Society, ASCO join forces to create 'credible' online cancer information under one roof

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Employers hold significant power in the healthcare industry. About 60% of people under the age of 65 received insurance coverage through their employer last year, according to KFF. 

Kim Thiboldeaux stepped into the role of CEO at the Northeast Business Group on Health in early 2024. The organization's members provide coverage for millions of lives.

In this week's episode of "Podnosis," Thiboldeaux sits down with Fierce Healthcare Senior Writer Paige Minemyer to discuss her goals at the helm of NEBGH and the healthcare topics employers are watching most closely. 

To learn more about the topics in this episode: 

• NEBGH: Here's how employers can support cancer patients in the workplace
• Employers seek guidance on mental health benefits: survey
• New NEBGH guide aims to help employers tackle social determinants of health
• Emergency preparedness lessons for employers from COVID-19

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