Payment integrity is top of mind as insurers face growing pressure to eliminate fraud, waste and abuse. Successful programs require investment in technology and expertise to analyze trends and identify abnormalities. The team at Optum Insight works closely with insurers across the healthcare system to examine this data

In this episode of "Podnosis," Fierce Healthcare senior writer Paige Minemyer sits down with Steve Yurjevich, CEO of the payer market at Optum Insight, to discuss the challenges and solutions in this space.

To learn more about the topics in this episode: 
'Well-intentioned, poorly executed waste': How tech companies aim to reduce billions in wasteful spending
New Mountain Capital merges Apixio, Varis and The Rawlings Group in $3B deal
CMS sets up real-time medical fraud center with DOGE; Federal contractor rolls out commercial tool
Industry Voices—We need to fight fraud the right way

Payment integrity is top of mind as insurers face growing pressure to eliminate fraud, waste and abuse. Successful programs require investment in technology and expertise to analyze trends and identify abnormalities. The team at Optum Insight works closely with insurers across the healthcare system to examine this data
In this episode of "Podnosis," Fierce Healthcare senior writer Paige Minemyer sits down with Steve Yurjevich, CEO of the payer market at Optum Insight, to discuss the challenges and solutions in this space.
To learn more about the topics in this episode:&nbsp;
<ul>
<li><a href="https://www.fiercehealthcare.com/payers/how-payers-and-providers-should-think-about-payment-integrity">'Well-intentioned, poorly executed waste': How tech companies aim to reduce billions in wasteful spending</a></li>
<li><a href="https://www.fiercehealthcare.com/health-tech/new-mountain-capital-merges-apixio-varis-and-rawlings-group-3b-deal">New Mountain Capital merges Apixio, Varis and The Rawlings Group in $3B deal</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/cms-sets-real-time-medical-fraud-center-doge-federal-contractor-rolls-out-commercial-tool">CMS sets up real-time medical fraud center with DOGE; Federal contractor rolls out commercial tool</a></li>
<li><a href="https://www.fiercehealthcare.com/payer/industry-voices-we-need-to-fight-fraud-right-way">Industry Voices&mdash;We need to fight fraud the right way</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.

Rethinking payment integrity 

The COVID-19 pandemic spotlighted burnout in healthcare. While not new, the challenge was compounded by the toll of caring for patients on the frontlines. Burnout rates have swelled since then, and addressing them is not simple.

A recent Johnson & Johnson survey of more than 1,500 surgeons across five countries found that half experience burnout, and 43% have seriously considered leaving surgery.

To understand the implications of the findings, Senior Writer Anastassia Gliadkovskaya speaks with Africa Wallace, M.D., vice president of medical affairs, surgery and medtech at Johnson & Johnson.

She also speaks with Angela Chaudhari, M.D., associate professor and vice chair of faculty affairs at Northwestern University Feinberg School of Medicine. Chaudhari discusses a clinician peer support initiative she directs at Northwestern and the role it plays in mitigating burnout.

To learn more about the topics in this episode: 
Nearly all doctors suffer burnout, survey finds, but many cautiously hopeful that AI could help
5 years later: A look back at the COVID-19 pandemic and how healthcare has changed

The COVID-19 pandemic spotlighted burnout in healthcare. While not new, the challenge was compounded by the toll of caring for patients on the frontlines. Burnout rates have swelled since then, and addressing them is not simple.
A recent Johnson &amp; Johnson survey of more than 1,500 surgeons across five countries found that half experience burnout, and 43% have seriously considered leaving surgery.
To understand the implications of the findings, Senior Writer Anastassia Gliadkovskaya speaks with Africa Wallace, M.D., vice president of medical affairs, surgery and medtech at Johnson &amp; Johnson.
She also speaks with Angela Chaudhari, M.D., associate professor and vice chair of faculty affairs at Northwestern University Feinberg School of Medicine. Chaudhari discusses a clinician peer support initiative she directs at Northwestern and the role it plays in mitigating burnout.
To learn more about the topics in this episode:&nbsp;
<ul>
<li><a href="https://www.fiercehealthcare.com/providers/nearly-all-doctors-suffer-burnout-survey-finds-many-cautiously-hopeful-about-use-ai">Nearly all doctors suffer burnout, survey finds, but many cautiously hopeful that AI could help</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/five-years-covid-19-pandemic-how-has-healthcare-changed">5 years later: A look back at the COVID-19 pandemic and how healthcare has changed</a></li>
</ul>

Clinicians are burnt out. Peer support can help

Rare diseases, defined in the U.S. as conditions affecting fewer than 200,000 people, can take years, if not decades, to diagnose. About 10,000 rare diseases affect 30 million Americans, and half of those patients are children.

What if rare diseases could be identified early and treated proactively before they progress? That is becoming more possible thanks to advances in genetic testing. One company, GeneDx, is on a mission to address diagnostic challenges through faster, more affordable genome testing.

To explain the evolution of this technology, how it is changing lives and where it may go in the future, Senior Writer Anastassia Gliadkovskaya speaks with GeneDx CEO Katherine Stueland.

To learn more about the topics in this episode: 
RNA sequencing spots 40% more cancer mutations in children than standard genetic tests: study
Regeneron, Illumina and more back Truveta for 10M genome sequencing project
Survey: Many rare disease patients struggle to navigate care

Rare diseases, defined in the U.S. as conditions affecting fewer than 200,000 people, can take years, if not decades, to diagnose. About 10,000 rare diseases affect 30 million Americans, and half of those patients are children.
What if rare diseases could be identified early and treated proactively before they progress? That is becoming more possible thanks to advances in genetic testing. One company, GeneDx, is on a mission to address diagnostic challenges through faster, more affordable genome testing.
To explain the evolution of this technology, how it is changing lives and where it may go in the future, Senior Writer Anastassia Gliadkovskaya speaks with GeneDx CEO Katherine Stueland.
To learn more about the topics in this episode:&nbsp;
<ul>
<li><a href="https://www.fiercebiotech.com/medtech/rna-sequencing-spots-40-more-cancer-mutations-children-than-standard-genetic-tests-study">RNA sequencing spots 40% more cancer mutations in children than standard genetic tests: study</a></li>
<li><a href="https://www.fiercebiotech.com/medtech/jpm25-regeneron-illumina-and-more-back-truveta-10m-genome-sequencing-project">Regeneron, Illumina and more back Truveta for 10M genome sequencing project</a></li>
<li><a href="https://www.fiercehealthcare.com/providers/pantherx-survey-many-rare-disease-patients-struggle-navigate-system">Survey: Many rare disease patients struggle to navigate care</a></li>
</ul>

The evolving state of exome and genome sequencing

In this sponsored episode of Podnosis, CVS Caremark Senior Vice President and Chief Growth Client Success Officer James Margiotta joins host Chris Hayden for an in‑depth look at the rapidly changing pharmacy benefits landscape. Drawing on more than 35 years across payer, PBM, pharmacy and healthcare delivery roles, Margiotta shares what employers and plan sponsors need most in 2026 and beyond: strategic partnership, transparency, affordability and a seamless member experience.

The conversation explores how accelerating drug costs, GLP‑1 utilization, specialty spend and biosimilars are forcing a new, more integrated approach to benefit design. Margiotta highlights how CVS Caremark is leading with technology, AI, clinical rigor and deep connections to the provider ecosystem—helping plan sponsors navigate disruption while improving outcomes and reducing friction for members.

Tune in to learn what meaningful transparency looks like, which cost‑management strategies actually work, and how data and digital innovation are redefining the future of pharmacy benefits.

In this sponsored episode of Podnosis, CVS Caremark Senior Vice President and Chief Growth Client Success Officer James Margiotta joins host Chris Hayden for an in‑depth look at the rapidly changing pharmacy benefits landscape. Drawing on more than 35 years across payer, PBM, pharmacy and healthcare delivery roles, Margiotta shares what employers and plan sponsors need most in 2026 and beyond: strategic partnership, transparency, affordability and a seamless member experience. The conversation explores how accelerating drug costs, GLP‑1 utilization, specialty spend and biosimilars are forcing a new, more integrated approach to benefit design. Margiotta highlights how CVS Caremark is leading with technology, AI, clinical rigor and deep connections to the provider ecosystem&mdash;helping plan sponsors navigate disruption while improving outcomes and reducing friction for members. Tune in to learn what meaningful transparency looks like, which cost‑management strategies actually work, and how data and digital innovation are redefining the future of pharmacy benefits.

James Margiotta explains how CVS Caremark is advancing transparency, tech integration and smarter cost strategies for evolving pharmacy benefits.

Rethinking payment integrity

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