In conversation with Mitch Vidovich of Independence Blue Cross

From Upward Growth Podcast · 32:15

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Health plans are working through policy change on several fronts at once. Litigation is clouding the future of Medicare Advantage Star Ratings, states are taking their own approaches to implementing H.R. 1 in Medicaid, the ACA marketplace is absorbing the expiration of enhanced tax credits, and employers face PBM reform on top of continued double-digit cost increases. Mitch Vidovich describes the stretch from 2025 through 2029 as the most disruptive period in health policy since the ACA, with each year adding changes that build on the last.In this episode of the Upward Growth Podcast, Ryan Peterson sits down with Mitch Vidovich, Vice President of Government Affairs at Independence Blue Cross, where he leads federal and local policy and advocacy for the Philadelphia-area Blue plan. They talk through how a government affairs team turns a long CMS rule into a clear read for leadership, what plans are seeing in ACA enrollment and morbidity, how plans make product and quality investment decisions while the Star Ratings program is still being decided in court, and where AI is easing friction in prior authorization and where it may be adding to medical trend.Mitch also brings his earlier experience as a Capitol Hill staffer to the politics of the moment, including congressional interest in how a subset of providers are using the No Surprises Act arbitration process, what tends to move administratively when Congress is divided, and how policymakers are responding to public frustration aimed across the healthcare system. The conversation was recorded ahead of the November 2026 midterm elections.What you’ll hear:How Mitch’s team turns a several-hundred-page CMS rule into the few items leadership needs to know, and decides what to bring back to CMS and the congressional committees of jurisdictionThe 2025 through 2029 timeline Mitch walks through, from the Inflation Reduction Act’s Part D changes to H.R. 1, PBM reform, and the next presidential administration, and why Medicaid implementation of H.R. 1 may be the hardest for plans to build strategy aroundThe shift in Medicare Advantage away from adding benefits for growth and toward benefits tied directly to total cost of care and beneficiary satisfactionWhat the loss of enhanced ACA tax credits has meant for enrollment and morbidity in Pennsylvania, and whether New Mexico’s state-funded assistance offers a path for other statesHow Independence approaches prior authorization, including the share of claims that require it today and agreed-upon imaging criteria with Penn Medicine that remove prior auth for clinicians who meet themHow plans file 2027 bids and decide where quality dollars go without knowing what the Star Ratings program will look likeWhat separates Blue plans handling this moment well from those that are struggling, and why trust in the Blue brand matters as plans look at diversificationWhere AI shows up in plan operations and federal policy, including CMMI’s WISeR model, conversational AI for Medicare Plan Finder, ambient scribes and medical trend, and the risk of a “battle of the bots” between providers and payersMitch’s closing advice on what earns a yes from a health planAbout Upward Growth: Upward Growth is a health plan market advisory firm. We work with health tech vendors, investors, provider organizations, and management consultancies on how health plans actually buy, operate, and make decisions. Subscribe to the newsletter: https://upwardgrowth.substack.com/Connect with Ryan on LinkedIn: https://www.linkedin.com/in/ryan-peterson-1a20866/Learn more about Upward Growth: https://www.upwardgrowth.com

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