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This is where health insurance leadership comes together.

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Becker's fourth annual spring payer issues roundtable brings

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together over 400

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payer and health plan executives and more than

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100 speakers to Chicago April.

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This year's event includes keynote conversations with the

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industry's top leaders and former president George w

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Bush. For the full agenda and event details,

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visit beckershospitalreview.com

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and click on the events tab in the

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upper right. We're looking forward to hosting you

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here in Chicago.

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Hello, everyone. Welcome to Becker's Healthcare Podcast. I'm

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Scott King. Thrilled today to be joined by

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a very special guest, Sareya Sacaccio,

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chief medical officer, Essence Healthcare. Sariya, how are

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you doing today?

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I am doing well, Scott. Thanks so much

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for the opportunity to join you today.

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It's gonna be great. We have a lot

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of big topics and and talking points to

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to get to here, but we're really looking

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forward to having you speak at our spring

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payer issues roundtable in April as well. Can't

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wait. So before we get to the questions

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and topics, Sariya, I wanted to ask just

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kind of about your background. If you could

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please share, you know, a little bit about

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your your journey into, health care with us.

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You bet, Scott. I'm a family physician by

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training, and I have worked across the gamut

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of clinical care, whether it was in solo

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practice, teaching residency programs, and academic institutions.

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I've served as a chief medical officer in

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several different health systems

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and have been on the health plan side

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of the industry for the last several years.

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I so enjoy the work that we do,

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serving our members and ensuring everybody gets the

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right care, right place, right time, and has

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the right experience

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on their journey for health.

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Thank you for sharing that. And you the

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the first topic I wanted to get to

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with your perspective

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is how are your relationships

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with providers changing? You know, obviously,

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both sides are facing regulatory pressures, but specifically

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when you you look at cost pressure and

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and work for for shortages.

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Well, first of all, I am so

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glad that we're starting with relationships.

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This is the most critical part of the

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work that we do. And at the end

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of the day, we're in this together.

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We are here to provide exceptional care to

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patients and those who deserve

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that access to care.

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And so while perhaps it hasn't changed, there

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certainly is a palpable shift and that shift

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would be a deepening

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of collaboration.

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I can't overemphasize

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just how important that is and there are

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a number of ways that we do that

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in our business and with our partners.

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First of all, it starts with real time

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data.

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Everybody needs this accurate data. This is what

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I hear asked for the most and the

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appreciation

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that we have been able to deliver

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down to the member level. The data that

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impacts the care that our health systems and

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providers deliver

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in a way that is actionable

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so that we can impact that health.

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And transparency of strategy. We roll up our

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sleeves together

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as partners to address the cost of care

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of what we do, whether it's determining

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the appropriate prior authorizations,

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our pharmacy spend and the challenges there, as

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we know, we've all struggled with that recently,

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or expanding products within our health

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plan. That is so important to us. And

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finally, I'll say

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this is the most important part of this

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relationship.

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It's listening first,

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being curious about the current workflows and expectations

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that exist

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with our health system providers

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so that we can align with the work

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already being done. Because this is what we

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know. Whether a health system has 17 different

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contracts or 27 contracts,

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we have got to be a part of

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the solution

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in developing efficiency

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and reliability

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so that care is delivered consistently regardless of

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who the health payer is.

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Yeah. You know, that's really interesting. I I've

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heard from a lot of people on the

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payer side that that relationship

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has changed. Like you said, it's got more

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collaborative.

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I've heard some some people say it's because,

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you know, they think that just both sides

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are up against so many regulatory pressures that

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both are just trying to figure out a

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way to get things done. But your perspective

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is interesting because you think it's coming from

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a a data perspective, a need for both

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sides to kinda share and utilize data. Is

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that right? Well, sure. It's a huge part

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of the equation here because without information,

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you can't drive a strategy that delivers results.

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That is critical in the work that we

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do. And the more information available,

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it's part of our responsibility to make sure

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it's delivered in a way that we can

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do something with it.

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Sariya, where do you see the biggest gap

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today between payer strategy and operational execution?

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Goodness. There are so many gaps, and I'll

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say it's so many solutions

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that have developed. I will say what is

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most heated

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at the moment and the two challenges that

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I'm seeing here is

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member access

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to resources that they need when they need

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it. What I mean by that is more

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ambulatory access. So Scott, it's rather interesting to

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me, not surprising as we're all trying to

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shore up margins these days after COVID,

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but we saw

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a significant

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departure in ambulatory

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services

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and access to resources to health care.

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So and I'll give my mother as an

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example. She's Medicare Advantage age and has her

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own plan she works with, and I say,

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mom, the first thing you gotta do is

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find out where you can receive these services

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at an ambulatory

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site. And here's why,

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it hits the pocketbook of every member and

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frankly at every health plan when services that

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can be delivered in an ambulatory space

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is turned around, the lights turned out, literally

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lights turned out, and shifted back to a

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hospital with a huge parking lot, an overwhelming

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pathway just to get to the site of

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service you need with a significant

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price tag.

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I do recognize having been on the health

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system side

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historically

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that that's where margins are often shored up,

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is in an inpatient facility

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structure.

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And we feel the pressure from an administration.

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We know there's a change. We've got to

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get to a point where regardless of the

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site of care, that the service delivered that's

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the same, cost the same. So that's one

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piece. The other,

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I'll talk a little bit specifically about pharmacy

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gap, the cost of medications

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and the member responsibility

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and the health plan responsibility.

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We have these pressures for the right reasons.

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I say that because

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we know this. Medications are too expensive today

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and they're too expensive for everyone. So those

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are two gaps that we have got to

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find solutions for and find them quickly.

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In terms of finding solutions, what's one investment

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or initiative you believe

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will will most reshape how health plans operate

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over the next two to three years?

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Well, I'm gonna shift gears and think more

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global

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when it comes to an overall investment. And

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as a family physician, I'm gonna think population

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health first. And, Scott, this is what we

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know. More people die of heart disease

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than any other condition,

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both men and women. We know this. And

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in the spirit

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of February is heart month and we are

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in February,

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cardiometabolic

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investment is critical

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to the future in the quality of life

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for all Americans.

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So it's not just the medications. That's a

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piece of it. We know a driver of

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cardiometabolic

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impact is obesity. It often starts there. In

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fact, it's starting in the pediatric

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space and where it used to be in

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adulthood that we had to be concerned. So

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across that age span, we have got to

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be thinking about the investment of lifestyle benefits.

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Do people have safe places to walk? Is

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it part of the workplace,

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the employer space?

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How are we involving behavioral health? We know

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when people are less active, when they have

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chronic conditions such as

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diabetes,

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heart disease,

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heart failure,

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they are more likely

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to suffer from depression, anxiety,

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and other mental health challenges that make it

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even harder for their over health to overall

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health to improve.

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And then finally, those medication barriers.

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First one that usually comes to mind for

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folks are those GLP one agonists,

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and that is because they help reduce,

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the weight,

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but they also increase the cost of care.

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Addressing the barriers in all of these spaces,

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investing in a comprehensive approach is something that

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we have to do in partnership

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across the entire industry.

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If you could change

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one regulatory

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or industry practice tomorrow to improve a 4,000,000,000

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access,

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what would it be and why?

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Well, I hinted at this just a moment

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ago. In fact, it was probably more than

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a hint. It was an obvious nudge. Site

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neutrality

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is what's frankly best for our patients

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and for overall Americans.

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Receiving

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the same care at the same price regardless

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of the address

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really matters to people and really matters to

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the increasing cost of care that we see

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today. The other is pharmacy,

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flattening the cost. How do we identify those

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biosimilars

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for these fantastic

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new life saving and life changing drugs

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for these diseases where people have struggled for

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so many years? We've got to be quicker

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to

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provide those biosimilars

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for generics to be available and for specialty

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cost drugs out of the gate. We have

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some therapies now that cost a million dollars

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a year.

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Now, as we know, fewer and fewer people

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will have access to health care

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and more people will be uninsured in 2026

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and onward.

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There will be more people who cannot afford

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that million dollar therapy. Again, that can be

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life saving, life changing. So those are the

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two things, site neutrality and pharmacy flattening of

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costs, and we would see a healthier America.

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A 100%. And there's certainly a lot more

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work to do with with pharmacy costs as

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you're alluding alluding to. Another thing is gonna

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be a big topic at our Spring Payer

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Issues Roundtable.

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The last thing I wanted to ask you,

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what issue

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do you think is putting the most pressure

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on health plan margins right now,

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and how are you responding differently, for 2026?

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Well, for us at Essence and for me

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as a clinician,

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it always ends with

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quality. Quality of care, so I think of

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star performance.

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There's a tremendous amount of pressure to maintain

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where we are. We're a four and a

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half star HMO plan. In fact, in all

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of our markets, we're the highest rated plan,

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very proud of that because that is the

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care that our members are receiving and can

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rely upon that they will receive by our

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providers. It's because that strong relationship and collaboration

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we have with our partners. Now that being

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said, the bar will continue to rise

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in a good way. I remind folks of

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this all the time.

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We should not be practicing medicine the way

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we did five years, ten years ago. We

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should get better year after year after year.

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What will continue to challenge us

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are the social conditions that people are experiencing,

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less money in their pocket,

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less,

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food on the table that's healthy for them

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in a way that people can afford these

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medications

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and their

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nourishment.

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That's really important. And the investment in services

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that close-up all of those gaps in care.

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So so many folks forget that

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STAR includes

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the gaps in care, the operations of the

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business, the improvement year over year, and that

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finally the experience.

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I mentioned my mother a moment ago, and

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I always consider what would Mimi do, how

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would Mimi feel if she was in a

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situation

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needed help to health care? And did she

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have someone to hold her hand

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through the process? And that's what we're here

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to do. That's what we should all be

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doing is holding the hands of our patients

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and ensuring they have an exceptional experience,

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know that they're taken care of and can

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receive the highest level of care, again, regardless

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of location, because at the end of the

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day, this is what we do and we

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do it together

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in health care.

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Saree, thank you so much for joining us

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on the podcast and for a great conversation.

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And, again, we're really looking forward to you

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speaking with us in April. Thank you, Scott.

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This is important work, and I am grateful

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to do it every day.