Becker’s Healthcare Podcast: “Simplifying Payer Operations and Strengthening Provider Relationships”
Guest: Sharon Williams, CEO, University of Michigan Health Plan
Host: Scott King
Date: February 2, 2026

Episode Overview

This episode of Becker’s Healthcare Podcast features a deep dive into the evolving dynamics between healthcare payers and providers amid industry-wide cost pressures and workforce shortages. Sharon Williams, CEO of University of Michigan Health Plan and experienced consultant, shares her insights on current operational challenges, opportunities for innovation (especially regarding AI), and bold recommendations for regulatory and industry change to improve healthcare affordability and access.

Key Discussion Points & Insights

1. Sharon Williams’ Background and Approach

• Experience: 30 years in healthcare, spanning roles with “the Blues,” consulting for both payers and providers, and advising state/federal agencies and digital health companies (01:01).
• Perspective: “I feel like I've touched almost every facet of the healthcare industry in the U.S.” – Sharon Williams (01:21).

2. Provider Relationships amid Cost Pressures and Workforce Shortages

• Proactive Communication:
  • University of Michigan Health Plan emphasizes over-communicating with providers, preferring direct phone conversations with office managers over mass emails (01:42-02:20).
  • Sharon notes, “Some of these conversations can get a little contentious, and we're working specifically to keep it civil, keep it respectful...” (02:26).
• Shared Challenges:
  • Both payers and providers struggle with financial pressures and difficulty recruiting quality staff.
• Creativity Out of Necessity:
  • Health organizations are developing new training programs and career pipelines, such as internships and fellowships, to address workforce gaps.
  • Sharon observes, "It's pushing a level of creativity that I think is unparalleled." (03:20)

3. Gaps Between Payer Strategy and Operational Execution

• Manual Processes:
  • “My God, do we love a spreadsheet and a fax machine!” – Sharon Williams (03:55).
  • Healthcare lags behind other industries in automation and tech adoption.
• Need for AI:
  • AI is essential but underutilized due to outdated processes and siloed solutions.
  • “We are an industry in need of AI... but we don’t have the right tools to really be able to execute.” (04:16-04:28).
• Overcomplicated Contracting:
  • Contracts are “overly complicated and it doesn't need to be that complicated.” Simplicity would enable more value-based contracts.

4. Investments and Initiatives to Reshape Health Plans

• Integrating AI: Process Before Technology
  • AI will not work unless payer operations are simplified first:
    • “AI will not be effective unless we improve our processes. And we need to simplify.” (05:56)
    • Current tools often serve only single points, not full workflows.
  • Emphasis on end-to-end process optimization with AI enhancing transparency and accountability for all stakeholders, especially providers and members (06:20).
  • On removing “sludge”: Both payers and providers must question, “Are we being a little pedantic here or can we get rid of some of the sludge that's in the system that we really don't need?” (07:05)

5. True Consumer-Focused Simplification

• Challenge of Consumer Experience:
  • Sharon cautions against paying lip service to consumer-centricity: “If we really cared about our patients and our members, would our deductibles be that high?” (07:41).
  • Tools like Chargemasters and confusing insurance terminology alienate consumers.
  • “Consumers don’t understand this stuff... if you’ve got to have a PhD in economics to understand, then we’re really not being consumer-friendly.” (07:49-08:05)

6. Preferred Regulatory and Industry Changes

• Universal Healthcare Coverage:
  • Sharon’s top regulatory wish: universal, cradle-to-grave coverage (not necessarily single payer).
    • “We need cradle to grave... people coming on and off insurance... trying to figure out, can I pay rent, can I pay for food, or can I pay for health insurance?” (08:23-09:08)
• Eliminate Prior Authorizations:
  • Calls prior auth “sludge” that creates animosity among all parties.
  • Proposes less punitive post-hoc quality reviews instead.
  • “What prior authorizations have come to represent is the sludge in the system in a form of cash flow management.” (10:27)
• Reduce Consumer Cost Barriers:
  • Suggests removing high deductibles and coinsurance, which function as a tax on providers and confuse patients.

7. Barriers to Change and Cost Pressures

• Why Change Is Hard:
  • Tradition and politics, plus an ingrained belief that processes like prior authorization add value, even when denials yield only marginal direct savings:
    • “We are the land of steady habits... the net of actual denied care is somewhere between 2 to 5%.” (11:24-11:47)
    • Need for brave leadership and true change agents.
• Top Margin Pressures:
  • Rising utilization trends—across all products, not just expensive new drugs (like GLP-1s) (12:41).
  • Soaring drug costs, aggravated by the U.S. subsidizing drug pricing for the world.
  • Sharon advocates “global pricing” tools, referencing consultants comparing international prices for each drug (13:22-13:50).

Notable Quotes & Memorable Moments

• On Overcoming Healthcare’s Tech Aversion:
  • “My God, do we love a spreadsheet and a fax machine!... We are lagging behind many other industries and there's extraordinary opportunity.” – Sharon Williams (03:54-04:12)
• On False Consumer-Centricity:
  • “If we really cared about our patients and our members, would our deductibles be that high?... We’re really not being consumer-friendly.” – Sharon Williams (07:41-08:05)
• On Prior Authorization:
  • “What prior authorizations have come to represent is the sludge in the system in a form of cash flow management.” – Sharon Williams (10:27)
• On Drug Pricing:
  • "[The] United States is subsidizing drug and pharmacy costs for the world and we need to adopt global pricing." (13:16)

Timestamps for Core Segments

• Guest Background: [01:01]
• Provider Relationships & Workforce Shortages: [01:42-03:30]
• Gaps in Payer Operations: [03:51-05:28]
• AI & Process Simplification: [05:42-07:22]
• Consumer Experience Critique: [07:33-08:12]
• Regulatory/Industry Changes: [08:12-11:05]
• Barriers to Change: [11:05-12:26]
• Margin Pressures & Drug Pricing: [12:41-13:59]

Tone

The conversation is candid, pragmatic, and focused on actionable solutions. Sharon Williams brings seasoned expertise and outspoken advocacy for transformative change, counterbalanced by Scott King's attentive facilitation and emphasis on practical steps forward.