Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode: Strengthening Payer Provider Collaboration and Advancing Site Neutral Care with Saria Saccocio, MD, MHA
Date: February 28, 2026
Host: Scott King (Becker's Healthcare)
Guest: Dr. Saria Saccocio, Chief Medical Officer, ESSENCE Healthcare

This episode features Dr. Saria Saccocio, who shares insights on how payer-provider relationships are evolving amid regulatory, cost, and workforce pressures. The discussion centers on the deepening collaboration between health plans and providers, the importance of data sharing, the need for site-neutral care, and how industry practices can shift toward greater affordability and access.

Key Discussion Points & Insights

Dr. Saccocio’s Background (01:02–01:42)

• Career Path: Family physician with experience in solo practice, teaching, health system leadership, and payer roles.
• Guiding Philosophy: Focuses on ensuring members get the right care, at the right place and time, with the right experience.

“I so enjoy the work that we do serving our members and ensuring everybody gets the right care, right place, right time, and has the right experience on their journey for health.” — Dr. Saria Saccocio (01:21)

Evolving Payer-Provider Relationships (02:00–03:52)

• Collaboration: There’s a pronounced shift toward deep, collaborative partnerships.
• Data as Foundation: Accurate, real-time, and actionable data at the member level is essential to drive strategy and deliver results.
• Transparency & Joint Problem-Solving: Both parties are expected to be transparent about strategies, work together on challenges like prior authorizations, pharmacy spend, and product expansion.
• Listening & Alignment: The most important aspect is listening to providers and aligning efficiency efforts across multiple contracts and workflows.

“This is the most critical part of the work that we do. And at the end of the day, we're in this together. We are here to provide exceptional care to patients and those who deserve that access to care.” — Dr. Saria Saccocio (02:03)

“Everybody needs this accurate data. This is what I hear asked for the most and the appreciation that we have been able to deliver down to the member level, the data that impacts the care that our health systems and providers deliver...” (02:23)

“We've got to be a part of the solution in developing efficiency and reliability so that care is delivered consistently regardless of who the health payer is.” (03:41)

Gaps Between Strategy and Execution (04:36–06:47)

• Member Access: Biggest gaps are ensuring timely access to ambulatory care and resources when needed.
• Site of Care Shift: Ambulatory services are being reduced as payers and providers shore up margins, pushing care to higher-cost hospital settings.
• Pharmacy Cost Pressures: High medication costs burden members and plans alike.

“When services that can be delivered in an ambulatory space…are shifted back to a hospital with a significant price tag...we've got to get to a point where regardless of the site of care, that the service delivered that's the same, costs the same.” (05:38)

Investments That Will Reshape Health Plans (06:58–08:44)

• Population Health Focus: Cardiometabolic health (e.g., heart disease, obesity) is the most critical investment area.
• Lifestyle & Social Determinants: Need to address safe environments, workplace activity, and behavioral health.
• Medication Barriers: The rise of costly medications like GLP-1 agonists for weight loss/diabetes requires payers to balance access with cost.

“Cardiometabolic investment is critical to the future and the quality of life for all Americans.” (07:18)
“A driver of cardiometabolic impact is obesity. It often starts there…it's starting in the pediatric space…” (07:26)

Improving Affordability & Access: Regulatory and Industry Practices (08:44–10:08)

• Site Neutrality: The top regulatory change would be to ensure the same care costs the same regardless of the provider’s address.
• Pharmacy Costs: Accelerate access to biosimilars and generics to counteract the unsustainable costs of specialty drugs.
• Future Uninsured Risk: High costs threaten broader access; more people could become uninsured if costs aren’t addressed.

“Site neutrality is what's frankly best for our patients...Receiving the same care at the same price, regardless of the address, really matters...” (08:55)
“We have some therapies now that cost $1 million a year…fewer and fewer people will have access to health care and more people will be uninsured in 2026 and onward...” (09:25)

Margin Pressures and Forward-Looking Strategies (10:08–12:21)

• Quality Emphasis: Star performance and improvement are major pressures; outcomes, gaps in care, operations, and experience all matter.
• Social Conditions: Social determinants—like food security and the ability to pay for medications—are increasingly central.
• Patient-Centered Mindset: Keeping the patient’s experience at the forefront, as exemplified by “What would Mimi do?”, is vital to guide strategy and service.

“It always ends with quality, quality of care. So I think of star performance, there's a tremendous amount of pressure to maintain where we are. We're a four and a half star HMO plan…” (10:27)

“We should not be practicing medicine the way we did five years, ten years ago. We should get better year after year after year.” (10:59)

“That's what we should all be doing, is holding the hands of our patients and ensuring they have an exceptional experience and know that they're taken care of and can receive the highest level of care again, regardless of location.” (11:55)

Notable Quotes

• “We are here to provide exceptional care to patients and those who deserve that access to care.” — Dr. Saria Saccocio (02:05)
• “Everybody needs this accurate data...delivered down to the member level...in a way that is actionable so that we can impact that health and transparency of strategy.” — Dr. Saria Saccocio (02:22)
• “Cardiometabolic investment is critical to the future and the quality of life for all Americans.” — Dr. Saria Saccocio (07:18)
• “Site neutrality is what's frankly best for our patients and for overall Americans.” — Dr. Saria Saccocio (08:54)
• “We should not be practicing medicine the way we did five years, ten years ago. We should get better year after year after year.” — Dr. Saria Saccocio (10:59)
• “That’s what we should all be doing, is holding the hands of our patients and ensuring they have an exceptional experience and know that they’re taken care of...” — Dr. Saria Saccocio (11:54)

Key Timestamps

• [01:11] — Dr. Saccocio’s background journey
• [02:03] — The critical importance of payer-provider collaboration
• [04:36] — Biggest current gaps: access and pharmacy costs
• [06:58] — Population health and future investments
• [08:53] — Regulatory wish list: site neutrality & pharmacy affordability
• [10:27] — Margin pressures and quality as a core focus
• [11:54] — The patient experience as a guiding principle

Episode Tone

The episode is optimistic, solutions-oriented, and patient-focused, blending the strategic perspective of a health plan executive with the empathy of a practicing physician. Dr. Saccocio stresses the importance of partnership, actionable data, innovative investments, and never losing sight of the patient's experience amidst industry change.