In this week's episode of “Podnosis,” we explore Blue Shield of California's plan to transform its pharmacy model. This includes a shift away from the traditional PBM relationship in favor of forming partnerships with five companies: Amazon Pharmacy, Abarca, Mark Cuban Cost Plus Drugs Company, CVS Caremark and Prime Therapeutics. 

Fierce's Paige Minemyer sat down with Blue Shield of California's Chief Operating Officer, Sandra Clarke, to discuss the new approach to pharmacy benefits. 

To learn more about the topics in this episode: 
PBMs under fire again as Senate introduces new bill
Blue Shield of California ditches CVS Caremark as PBM, unveils new pharmacy care model
Blue Shield of California bringing Wellvolution program to Medi-Cal plans

In this week's episode of “Podnosis,” we explore Blue Shield of California's plan to transform its pharmacy model. This includes a shift away from the traditional PBM relationship in favor of forming partnerships with five companies: Amazon Pharmacy, Abarca, Mark Cuban Cost Plus Drugs Company, CVS Caremark and Prime Therapeutics. 
Fierce's Paige Minemyer sat down with Blue Shield of California's Chief Operating Officer, Sandra Clarke, to discuss the new approach to pharmacy benefits. 
To learn more about the topics in this episode: 
<ul>
<li><a href="https://www.fiercehealthcare.com/payers/pbms-under-fire-again-senate-introduces-new-bill">PBMs under fire again as Senate introduces new bill</a></li>
<li><a href="https://www.fiercehealthcare.com/payers/blue-shield-california-seeks-bypass-pbms-and-overturn-current-drug-pricing-system">Blue Shield of California ditches CVS Caremark as PBM, unveils new pharmacy care model</a></li>
<li><a href="https://www.fiercehealthcare.com/payers/blue-shield-california-bringing-wellvolution-program-medi-cal-plans">Blue Shield of California bringing Wellvolution program to Medi-Cal plans</a></li>
</ul>

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

Podnosis

Podnosis: the pulse of the healthcare industry. Every week, journalists from Fierce Healthcare dive into some of the industry’s biggest trends. We talk to the experts about what’s important now so you can prep for the future. Hear about all things healthcare, from physician practices to hospital chains and insurance giants—and those that mix all three—plus the tech they use, disruptors looking to compete and people moving the sector forward. Follow Podnosis on Apple Podcasts, Spotify, Amazon or wherever you get your podcasts.

A look at Blue Shield of California's new pharmacy benefits model

Emergency departments are required by law to treat anyone who comes through the door. But the financial model behind that guarantee is under strain. 

In this episode of "Podnosis," Fierce Healthcare and Life Sciences Editor-in-Chief Ayla Ellison talks with Tony Cirillo, M.D., president of the American College of Emergency Physicians, about the business of emergency medicine—who pays, how much, and what happens when the math stops working.

To learn more about the topics in this episode: 
Without new financial support, emergency departments, physicians struggle to meet rising demand: RAND
Op-ed: What if the ER is the emergency?
Op-ed: Emergency physicians are holding the line, but we can't do it alone

Emergency departments are required by law to treat anyone who comes through the door. But the financial model behind that guarantee is under strain.&nbsp;
In this episode of "Podnosis," Fierce Healthcare and Life Sciences Editor-in-Chief Ayla Ellison talks with Tony Cirillo, M.D., president of the American College of Emergency Physicians, about the business of emergency medicine&mdash;who pays, how much, and what happens when the math stops working.
To learn more about the topics in this episode:&nbsp;
<ul>
<li><a href="https://www.fiercehealthcare.com/providers/without-new-financial-support-emergency-departments-physicians-struggle-meet-rising">Without new financial support, emergency departments, physicians struggle to meet rising demand: RAND</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/op-ed-what-if-er-emergency">Op-ed: What if the ER is the emergency?</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/op-ed-emergency-physicians-are-holding-line-we-cant-do-it-alone">Op-ed: Emergency physicians are holding the line, but we can't do it alone</a></li>
</ul>

Inside the economics of emergency medicine

Fierce Healthcare's Fierce 15 is one of our favorite projects each year. Now in its eighth year, the list highlights companies bringing new ideas and innovation to some of healthcare’s most persistent challenges.

In this episode, members of the Fierce Healthcare editorial team discuss the Fierce 15 of 2026 and the trends shaping this year’s honorees—from AI-powered clinical tools to companies tackling insurance denials, behavioral health integration and early cancer detection.

The conversation also looks at what these companies reveal about the direction of healthcare, including the growing role of AI, the push for accountability across the system and the different paths startups are taking to build sustainable businesses.

To learn more about the topics in this episode: 
Fierce Healthcare's Fierce 15 of 2026
Fierce Healthcare highlights Fierce 15 of 2026 honorees at NYSE

Fierce Healthcare's Fierce 15 is one of our favorite projects each year. Now in its eighth year, the list highlights companies bringing new ideas and innovation to some of healthcare&rsquo;s most persistent challenges.
In this episode, members of the Fierce Healthcare editorial team discuss the Fierce 15 of 2026 and the trends shaping this year&rsquo;s honorees&mdash;from AI-powered clinical tools to companies tackling insurance denials, behavioral health integration and early cancer detection.
The conversation also looks at what these companies reveal about the direction of healthcare, including the growing role of AI, the push for accountability across the system and the different paths startups are taking to build sustainable businesses.
To learn more about the topics in this episode:&nbsp;
<ul>
<li><a href="https://www.fiercehealthcare.com/special-reports/fierce-healthcares-fierce-15-2026">Fierce Healthcare's Fierce 15 of 2026</a></li>
<li><a href="https://www.fiercehealthcare.com/health-tech/fierce-healthcare-highlights-fierce-15-2026-honorees-nyse">Fierce Healthcare highlights Fierce 15 of 2026 honorees at NYSE</a></li>
</ul>

The Fierce Healthcare team on the Fierce 15 of 2026 

Healthcare earnings season is offering a mixed picture of the industry. 

In the latest episode of "Podnosis," Fierce Healthcare's Dave Muoio and Paige Minemyer break down the highlights from fourth-quarter earnings, where providers signaled growth while payers warned of financial headwinds amid a shifting policy landscape.

The episode also features an interview from the Lake Nona Impact Forum, where Fierce Healthcare’s Anastassia Gliadkovskaya spoke with Jeff DiLullo, head of Philips North America, about how health systems are thinking about AI, technology and the push to bring care closer to home.

To learn more about the topics in this episode: 
UnitedHealth Group was the most profitable payer in a difficult 2025 for the industry
After 2025's volumes shortfall, Universal Health Services says capacity, headcount investments will pay off in 2026
Community Health Systems' hospital divestiture streak likely isn't over
Tenet Health outperforms in Q4, projects solid 2026 despite ACA exchange headwinds
HCA Healthcare unveils bullish 2026 guidance despite $600M-$900M ACA exchanges hit
Lake Nona Impact Forum: There can't be longevity without tech
Philips to invest $150M in US manufacturing base, including ultrasound site expansion
Philips rolls out major AI upgrades for cardiac ultrasound platforms
Philips launches new point-of-care ultrasound system for critical care

Healthcare earnings season is offering a mixed picture of the industry.&nbsp;
In the latest episode of "Podnosis," Fierce Healthcare's Dave Muoio and Paige Minemyer break down the highlights from fourth-quarter earnings, where providers signaled growth while payers warned of financial headwinds amid a shifting policy landscape.
The episode also features an interview from the Lake Nona Impact Forum, where Fierce Healthcare&rsquo;s Anastassia Gliadkovskaya spoke with Jeff DiLullo, head of Philips North America, about how health systems are thinking about AI, technology and the push to bring care closer to home.
To learn more about the topics in this episode:&nbsp;
<ul>
<li><a href="https://www.fiercehealthcare.com/payers/unitedhealth-group-was-most-profitable-payer-difficult-2025-industry">UnitedHealth Group was the most profitable payer in a difficult 2025 for the industry</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/universal-health-services-projects-more-revenue-earnings-gains-2026">After 2025's volumes shortfall, Universal Health Services says capacity, headcount investments will pay off in 2026</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/community-health-systems-wraps-2025-narrow-gains-flagging-same-store-volumes">Community Health Systems' hospital divestiture streak likely isn't over</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/tenet-health-outperforms-q4-projects-solid-2026-despite-aca-exchange-headwinds">Tenet Health outperforms in Q4, projects solid 2026 despite ACA exchange headwinds</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/hca-healthcare-unveils-bullish-2026-guidance-despite-600m-900m-aca-exchanges-hit">HCA Healthcare unveils bullish 2026 guidance despite $600M-$900M ACA exchanges hit</a></li>
<li><a href="https://www.fiercehealthcare.com/health-tech/lake-nona-impact-forum-tech-key-longevity">Lake Nona Impact Forum: There can't be longevity without tech</a></li>
<li><a href="https://www.fiercebiotech.com/medtech/philips-invest-150m-us-manufacturing-base-including-ultrasound-site-expansion">Philips to invest $150M in US manufacturing base, including ultrasound site expansion</a></li>
<li><a href="https://www.fiercebiotech.com/medtech/philips-rolls-out-major-ai-upgrades-cardiac-ultrasound-platforms">Philips rolls out major AI upgrades for cardiac ultrasound platforms</a></li>
<li><a href="https://www.fiercebiotech.com/medtech/philips-launches-new-point-care-ultrasound-system-critical-care">Philips launches new point-of-care ultrasound system for critical care</a></li>
</ul>

A look at Blue Shield of California's new pharmacy benefits model

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