Pankhuri Sharma, Strategy and Operations Leader at Humana

Summary

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Podcast Summary: Becker’s Healthcare Podcast

Guest: Pankhuri Sharma, Strategy and Operations Leader at Humana
Host: Scott King
Date: April 11, 2026
Episode Theme:
A deep dive into the current landscape of population health management, the operational and behavioral challenges in the payer space, and how health plans like Humana are working to close the gap between strategy and real-world outcomes.

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Episode Overview

Pankhuri Sharma, Strategy and Operations Leader at Humana, joins Scott King to discuss Humana’s approach to population health management. The conversation focuses on closing care gaps, leveraging data for timely interventions, operational challenges, advances in value-based care, member engagement, and qualities of effective healthcare leadership. Sharma provides practical insights and candid reflections based on her hands-on experience.

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Key Discussion Points & Insights

1. Introduction & Role at Humana

• Pankhuri Sharma’s Background [00:36]
  • Leads strategy and operations within Humana’s Clinical Strategy organization.
  • Mandate: Improve member health outcomes and experience, optimize costs.
  • Focus: “Helping make sure our members receive the right intervention at the right time, whether that's closing care gaps or improving chronic disease management.” (Pankhuri Sharma, 00:36)

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2. Gaps Between Population Health Strategy and Real-World Outcomes

• Major Progress and Persistent Gaps [01:35]
  • The industry has improved in identifying members needing support and building intervention programs.
  • Biggest gap: Actual behavior change among members.
    • “Population health works only if members are able and willing to take actions that improve their health... those behaviors happen in the context of people's everyday lives.” (Pankhuri Sharma, 01:44)
  • Social determinants: Transportation, work, caregiving can impede member engagement.
  • Importance of intentional engagement: Message, channel, and trust play key roles.
  • Emerging tools: “AI enabled communication and personalization” hold promise if applied thoughtfully. (02:53)

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3. The Role of Data in Population Health

• Data as a Critical Lever [03:10]
  • Data is essential for:
    • Understanding who needs help
    • Identifying when they need help
    • Selecting the right intervention
  • “All of those insights come from the data.” (Pankhuri Sharma, 03:41)

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4. Operational Challenges to Impact

• Timing and Coordination [03:58]
  • Data Delays:
    • Reliance on claims data, which often lags, can make interventions untimely.
    • “Population health is very sensitive to timing. If the need for the intervention is identified weeks or months after an event, the opportunity... gets smaller.” (Pankhuri Sharma, 04:33)
  • Coordination Barriers:
    • Multiple stakeholders (plans, providers, care teams, vendors) involved.
    • Fragmented data and misaligned operations can delay or miss outreach opportunities.

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5. Improving Outcomes Through Population Health Management & Value-Based Care

• Where Population Health Happens [05:34]
  • Two Arenas:
    • Clinical setting: Ongoing operational and workflow alignment with providers; trust in providers as key lever.
      • "The most effective programs are the ones... designed with the providers or care teams and fit naturally into their workflows.” (Pankhuri Sharma, 05:56)
    • Members’ Daily Lives: Sustained engagement is crucial; technology and thoughtful engagement are important.
      • “Decisions regarding diet and physical activity and preventative care happen when they're just leading their lives.” (Pankhuri Sharma, 06:50)
  • Value-based care is advancing provider alignment but requires continual evolution.

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6. Priorities for Health Plans Moving Forward

• Making Population Health Programs More Effective [07:36]
  • Key Priorities:
    1. Timely Action: Continue improving the speed and accuracy of translating insights into interventions.
    2. Strong Ecosystem Coordination: Ensure alignment across plans, providers, and partners.
    3. Evolving Member Engagement: Give members more “tools and pathways” for agency; members should be “in the driver’s seat” of their health. (Pankhuri Sharma, 08:35)
    • “Members need to be in the driver's seat here and we all should be very effective enablers for them to get to their most optimized health.” (Pankhuri Sharma, 08:44)

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7. Effective Leadership in Health Plans

• Traits and Focus Areas [09:18]
  • Collaboration Across Stakeholders: Providers and vendors are essential partners.
  • Balancing Innovation and Legacy Systems: Must integrate new approaches seamlessly.
  • “There is so much innovation... but all of that is happening in the background of the legacy systems. So how do we integrate things so that they are seamless?... That makes for an effective leader.” (Pankhuri Sharma, 09:27)

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Notable Quotes & Memorable Moments

• “Population health works only if members are able and willing to take actions that improve their health.” (Pankhuri Sharma, 01:44)
• “AI enabled communication and personalization… we could close this gap even further if we use these levers thoughtfully.” (Pankhuri Sharma, 02:53)
• “Population health is very sensitive to timing.” (Pankhuri Sharma, 04:33)
• “Members need to be in the driver's seat here and we all should be very effective enablers.” (Pankhuri Sharma, 08:44)
• “There is so much innovation that is happening, but all of that is happening in the background of the legacy systems. So how do we integrate things so that they are seamless?” (Pankhuri Sharma, 09:27)

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Timestamps for Key Segments

• [00:36] Introduction to Pankhuri Sharma & Role at Humana
• [01:35] Discussion of Gaps in Population Health Strategy vs. Outcomes
• [03:10] The Role of Data in Population Health Management
• [03:58] Operational Challenges: Timing and Coordination
• [05:34] Clinical Alignment & Member Engagement for Better Outcomes
• [07:36] Priorities for Improving Population Health Programs
• [09:18] What Makes an Effective Health Plan Leader

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Conclusion

Pankhuri Sharma provided candid, practical insights into the persistent challenges and forward-looking priorities in population health management. She emphasized the need for behavioral change, timely and data-driven interventions, real ecosystem coordination, and empowering members. Leadership, she suggests, demands collaboration across stakeholders and the integration of innovation into legacy environments. The episode delivers actionable ideas for payers and health plan leaders seeking to create real-world impact in population health.

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Transcript

[A]

Hello everyone. Welcome to Becker's Healthcare Payer podcast. I'm Scott King, joined by a very special guest, Ponkari Sharma, strategy and operations leader with Humana Ponkary. It's great to talk to you again. How are you?

[B]

I'm doing well, Scott, thank you. How are you doing?

[A]

I'm good. You know, we were just talking just a couple weeks here to our big spring payer event, but it's great to talk to you again and, and as always get your insights and, and before we do that for maybe someone or some of the audience that hasn't heard from you, I was just wondering if you could just kind of briefly, you know, introduce yourself and describe your work at Humana and aligning with your focus on population health management.

[B]

Sure. My name is Pankari Sharma and as you said, I'm a strategy and operations leader at Humana. I'm a part of Humana's Clinical Strategy. Org where our primary mandate is to improve our members health outcomes and member experience while optimizing the total cost of care. In my role, I lead initiatives at the intersection of strategy, analytics and operations and have a strong focus on population health management at a high level. My work is about helping make sure our members receive the right intervention at the right time, whether that's closing care gaps or improving chronic disease management.

[A]

Thanks so much for the background info. You know, you just, you just mentioned those, those gaps and you know, where do you see the biggest gaps today between population health strategy and then real world outcomes?

[B]

Yeah, I'd start by saying that our industry has made meaningful progress in a number of areas today. Our health plans are much better at identifying members who may need support. And we also have built a wide range of program and capabilities that simply did not exist at scale, say 10 or 15 years ago. Having said that, I'd say the biggest gap we still see is around behavior change. Ultimately, population health works only if members are able and willing to take actions that improve their health. Whether that's taking medications, consistently seeing their PCP, or making lifestyle changes. And the nuance there is that those behaviors happen in the context of people's everyday lives. So remember, maybe dealing with transportation barriers or work constraints or caregiving responsibilities. So even when the system identifies the right intervention, turning that into real world action is much harder. And that's the biggest challenge. I would say that's where the intentional engagement becomes really important. How we are outreaching, the message, the channel, the trust relationship, all of that starts mattering. And in this area, I would say with newer tools Such as AI enabled communication and personalization. We could close this gap even further if we use these levers thoughtfully just

[A]

to follow that up. How much does data play a role in closing that gap? Because it sounds like the way Humana and you like to close it is by kind of knowing a member's daily routine and what their life is like. So how much can data, data help?

[B]

That data plays a huge role, I would say, not only in understanding who needs our help, but also when they need our help. At the end of the day, like I mentioned earlier, population health is all about getting to the right member at the right time with the right intervention. And all of those insights come from the data.

[A]

Absolutely. And the next topic I want to ask you about, Poncuri, is what operational challenges still make it difficult for health plans to translate population health strategy into measurable impact?

[B]

Yeah, a couple of things come to mind here, and the first one that we just touched upon is data, like getting the right data at the right time. In many cases, even today, the signals we rely on come with some delay. So. So for example, claims data, it often arrives with a lag, and then even the predictive models that are using that information give out data takeaways. And this matters, like I said, because population health is very sensitive to timing. If the need for identification for the intervention is identified weeks or months after an event, the opportunity to influence behavior or care decisions get smaller. So I would say that is the key operational challenge. And then the other one is coordination across different players. Population health programs typically involve a variety of players, like health plans and providers, care management teams, and often vendors. And even sometimes even within one organization, different teams may hold different pieces of the data or the operational responsibility. And then if those pieces are not well coordinated, outreach can be delayed or misaligned or even missed altogether. So those are the key operational challenges that come to mind.

[A]

Thanks so much. And I also wanted to ask what changes will be most important for health plans to improve outcomes through population health management and value based care?

[B]

Yeah, one way I think about this is where does population health take place? The way I segment it, it happens in two places. First is the clinical setting, and then the second one is members everyday life in the clinical setting. Deeper operational alignment with providers will continue to be important. As we know, members tend to trust their providers the most. And many population health interventions ultimately depend on what happens or after those clinical encounters. So the most effective programs are the ones or would be the ones that are designed with the providers or care teams and fit naturally into their workflows rather than sitting outside the care delivery process. And I flag here that value based care models have helped move the industry in that direction. But we would need to continue on the operational alignment with our providers because it is just as important as the financial alignment. And then the second place where population health happens is members everyday life their day to day lives. This is where they decide whether to adhere to the medication. And decisions regarding diet and physical activity and preventative care happen when they're just leading their lives. The effective lever here would be to engage members thoughtfully. Like I mentioned earlier, we are doing this, we can always make this happen better. And technology could play a role here if it is applied in a way that supports how members actually make these decisions in their daily lives.

[A]

You know, there's obviously a lot of moving parts with health plans and health care, especially in regards to, you know, recent government regulations. But what do you think health plans should prioritize over the next few years to make population health programs more effective?

[B]

Yeah, like you said, there are so many moving parts. There can be different priorities based on where an organization is at and what they're trying to achieve. But a few things that come to mind based on what we have discussed. First, we should continue to improve on how we translate insights into timely intervention. It's important so that we can act at the moment when it actually influences outcomes and, and not later. Secondly, I'd say strengthening coordination across the ecosystem so efforts across these different players, like plans, providers and other partners, they are aligned and not fragmented. And the third one that comes to mind is we should continue to evolve how we engage members themselves. There's been a meaningful progress here, but we need to keep thinking how we give members tools and pathways and ultimately more agency in their own health journey. Members need to be in the driver's seat here and we all should be very effective enablers for them to get to their most optimized health. And I feel that is where population health ultimately succeeds.

[A]

I think it's a great way to put it that members should feel like they're in the driver's seat. I think that'll lead to a lot of happy members that, that mindset. And the last thing I want to ask you, Poncuri, is, you know what, what do you think it takes to be an effective leader in the, in the health plan space right now?

[B]

Gosh, there's so many things, but I would say being a collaborative partner with different stakeholders that are in the field. And like I said, it involves providers and it involves vendors. There is so much innovation that is happening, but all of that is happening in the background of the legacy systems. So how do we integrate things so that they are seamless? They actually help the achieving the health outcomes that we all want to achieve. I would say that makes for an effective leader in the healthcare space right now.

[A]

Thanks so much for joining the podcast and for a great conversation as always, and really looking forward to having you speak at the Spring Fire Issues Roundtable.

[B]

Yeah, I'm looking forward to it and thanks for chatting with me, Scott. It was great.