Preparing for regulatory changes, investing in AI and technology and improving member experiences are among the top priorities for payer executives in the second half of 2025.
Becker’s checked in with 15 payer leaders to learn what tops their to-do list for the rest of the year.
Like what you see here? Join us at the November Payer Issues Roundtable in Chicago. Learn more here.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What’s your top priority for the second half of 2025?
Nishant Anand, MD. President and CEO at Altais (sister company to Blue Shield of California): My top priority for the second half of 2025 is operationalizing a next-generation technology stack — powered by AI — to enable more connected, efficient and human-centered care. We’re integrating electronic health records and ambient dictation (as examples) to streamline clinical workflows, reduce cognitive burden and unlock data-driven insights at the point of care. We are also looking at administrative tasks that can be more efficiently done with AI across the organization. These innovations aren’t just about modernization; they’re about creating the infrastructure needed to scale value-based care while restoring joy to the practice of medicine.
Abdou Bah and Daniel Knecht, MD. Chief Health Equity Officer and Chief Medical Officer, respectively, at EmblemHealth: We remain laser-focused on maximizing health outcomes while addressing emerging clinical and population health needs. We’re building out our unique, integrated care model that addresses health holistically: physical, emotional, social and environmental factors that shape overall well-being. We’re deepening care coordination, expanding personalized support services, and partnering with community-based organizations to meet our members and communities where they are.
Despite regulatory changes and an ever-evolving health care system, EmblemHealth remains clear-eyed and deeply committed to delivering affordable coverage and high-quality care that reflects the unique needs of those we serve.
Caroline Carney, MD. President, Behavioral Health and Chief Medical Officer at Magellan Health: My top priority for the remainder of 2025 is to approach any changes in government funded programs in a positive way that ensures that our members and patients continue to get the best service and have their needs met.
Rushil Desai. CEO of Aetna Better Health of Illinois: As we enter the second half of 2025, Aetna Better Health of Illinois is committed to improving the member and provider experience through new programs and technology focused on key healthcare priorities, including maternal and child health and behavioral health. We will stay agile in navigating state and federal legislation to effectively serve our members and partners. By continually integrating innovative technologies, expanding home healthcare services and enhancing provider enablement, we aim to simplify the healthcare journey and improve access. In the next six months, we will launch virtual solutions, including in-home care options, to further empower our members and positively impact their healthcare experiences.
Blair Fjeseth. President and CEO, Mountain Health Co-Op: Understanding the regulatory changes coming in 2026 — rate increases across the country.
Rob Hitchcock, President and CEO at Select Health (Intermountain Health): My top priority for the remainder of 2025 is to protect Medicaid and the individual market. If the proposed cuts to Medicaid happen and if the enhanced subsidies are not extended beyond 2025, then the number of uninsured will increase substantially causing people to utilize the emergency room to gain access to care. In turn, the hospitals will turn to the insurers for increased commercial rates which will then be passed on to the employers and ultimately the consumer.
Bethany Irvin. Senior Director, Pharmacy Partnerships and Transformation at Blue Shield of California: As Blue Shield of California started off the year with an ambitious new pharmacy supply chain, our goal since announcing this bold step has been to unbundle the traditional pharmacy benefit manager model and ensure all areas of it would run smoothly for our members. While we are still celebrating that we set out to do and start the work, the real fun comes now — from finessing what we currently have to continue to ensure quality, transparent and cost-effective options for members.
Karen Johnson. CEO at Clever Care Health Plan: As I think about the later half of the year, my top priority is: To heighten engagement of my key stakeholders (members, providers and our employees) in ways that result in an enhanced experience that drives improved health outcomes and superior business performance.
Sam Melamed. CEO at NCD: As a stand-alone dental and supplement benefit provider, we are closely watching the interaction between the regulatory and legislative environment and market dynamics impacting Medicare and ACA distribution. Finalization of the new marketplace regulations are a particular focus.
Monitoring embedded supplemental benefits and preparing for the potential for further pullback in benefits like dental and vision is a top priority.
Kenric Murayama, MD. Executive Vice President and Chief Health Officer at Hawaii Medical Service Association: As we enter the second half of 2025, we’re focused on improving the sustainability of our Medicare and Medicaid government lines of business. We are adapting our business strategies to address the unsustainable shortfalls in Medicare Advantage plans and the rising cost of care for the Medicare population. In addition, we are closely monitoring federal healthcare policy discussions and preparing for likely changes to Medicaid plans.
Harlon Pickett. President of Eagle Care Health Solutions: For the second half of 2025, my focus is on empowering employees to make informed healthcare decisions and ensuring the system supports them in doing so. Too often, even the best-intentioned employer health plans fail because employees don’t understand how to use them. Worse, many are conditioned to avoid care entirely due to cost or confusion. The result is delayed diagnoses, unmanaged chronic conditions, and, ultimately, higher costs for everyone involved.
We’re working to change that by implementing smarter navigation tools, proactive education campaigns, and benefit structures that encourage preventive and high-value care. For example, we recently partnered with an employer to roll out a custom onboarding campaign that guides employees through real-life scenarios, such as finding a low-cost imaging center or appealing a surprise bill, so they understand how to access the care they need without overpaying or getting lost in red tape.
We also launched a simplified benefit design that removes copays and out-of-pocket costs for primary care and mental health visits when employees use high-quality providers within a curated network. The result? Increased engagement and utilization, earlier interventions, and far fewer ER visits for avoidable issues. Empowered and educated employees are key to any successful cost-containment strategy, and it’s time the industry treats them as partners instead of passive users.
Jeff Russell. President and CEO at Blue Cross and Blue Shield of Nebraska: We continue to focus on ways to offer a more seamless and intuitive experience with our members and providers. To do this, we are expanding our digital capabilities to give our members more options to communicate with us, get the benefits information they need and help them live their best and healthiest life. We are also committed to reducing administrative burdens for providers and are partnering with them on solutions to streamline processes, including prior authorizations. In the end, our goal is to continue to balance access and affordability while making navigating the healthcare system easier for all involved.
Krischa Winright. President, Medicare Advantage at Blue Cross Blue Shield of Michigan: While the industry often focuses on star ratings, our priority is what those ratings are meant to reflect: real experiences, real outcomes and real lives. The second half of 2025 is about ensuring we continue to deliver an exceptional value to the individuals we serve.
At Blue Cross Blue Shield of Michigan, we believe Medicare Advantage should be a force for better aging. That’s why we’re focused on raising the bar in how we serve, how we communicate, and how we help members get the care they need without frustration or delay. Every improvement we make to the member experience is an investment in the health and dignity of the people we serve.
Janell Zuckerman. Network Development Director, Idaho Market at Select Health (Intermountain Health): Our goal at Select Health is to be the preferred payer in the markets we serve. A key priority is to deepen collaboration with our provider partners to advance value-based care initiatives and manage costs effectively. By strengthening these partnerships, we aim to align incentives and achieve better outcomes for all.
To succeed, we will work closely with providers to design and refine contracts that reward high-quality, cost-effective care. This includes exploring innovative payment structures, shared savings programs, and enhancing data sharing and actionable insights. We recognize the vital role that meaningful data plays in improving care delivery.
Additionally, we are committed to simplifying the payer experience for our providers. Our operational teams are focused on improving efficiency in claims payments and relationship management to ensure a seamless and productive partnership.