By Nilay Patel, Executive Vice President and General Manager
Despite a dip when COVID-era provisions ended, Medicaid enrollment continues to go up.
In 2024, Medicaid enrollment increased by about 30% since February 2020. And in March 2026, the Kaiser Family Foundation shared that the Medicaid/CHIP enrollment reported by the Centers for Medicare & Medicaid Services (CMS) enrollment has increased by just over 4 million people since 2020, despite large swings during the pandemic period.
Many states struggle to attract and retain providers in their Medicaid networks. In the face of a growing Medicaid population, to provide the care members need, it is crucial that State Medicaid Agencies (SMAs) do whatever they can to enroll providers of the right types, in the right places, to care for their clients.
One way to do this is to make the enrollment process as frictionless as possible by selecting the right enrollment platform.
Efficient, easy provider enrollment is the first step to ongoing provider engagement
It’s crucial to have healthcare providers available to care for Medicaid clients wherever and whenever they need it. SMAs can take steps to meet providers where they are by making enrollment as simple and straightforward as possible. This sets the stage for a strong, ongoing relationship with providers.
Here are 4 steps SMAs can take when choosing an enrollment platform to promote a robust network and provider engagement:
1. Make enrollment as streamlined as possible
As the number of patients outpaces the number of providers, they are having to take on larger and larger patient loads. Plus, providers have growing administrative burdens, and they are already tasked with enrolling with multiple different payers. Providers are stressed and busy, so it is essential that Medicaid enrollment processes are understandable, require minimal effort, and are processed and approved quickly.
The SMA’s first impression with a provider is during the enrollment process, which sets the foundation for a cooperative relationship serving the community. Ease of enrollment can set the stage for providers’ willingness to participate in the program and remain enrolled.
2. Support a range of provider types with flexible configurations
As SMAs diversify and expand the ways they are supporting clients, they are incorporating more types of providers to deliver care. Different kinds of providers require different content and information. Enrollment platforms need to be flexible and configurable to onboard a range of providers.
When state or federal policies change, SMAs need a platform that supports rapid and cost-efficient updates. It’s crucial to have a platform that supports modifications using configurations and minimizes code updates, so testing and deployment can be done quickly without significant effort or software releases.
3. Offer easy maintenance and omni-channel provider support
Enrollment platforms should have simple update processes that allow providers to quickly and easily maintain their data, which improves the quality of information for members, as well as the SMA.
Once enrolled, providers should have access to ongoing, easily accessible support through multiple channels, such as provider portal, secure messaging, IVR, chatbots, and live agents via phone or chat. This support infrastructure can address inquiries quickly and according to providers' communication preferences and resolve issues on the first contact. Today’s technology-savvy providers appreciate self-service options for assistance, communication, and updates.
4. Consider implementation and a strong roadmap
Selecting an enrollment platform requires additional considerations beyond its features and architecture. SMAs must consider the implementation effort of each solution, ensuring that the provider system can be effectively stood up and integrated with other state systems and processes.
The Medicaid Enterprise Systems (MES) ecosystem is complex and requires collaboration and a deep knowledge of industry practices. Choosing an experienced vendor with a proven system and a history of successful, timely implementations delivers on the promises of modularity and achieving a state’s goals.
The platform vendor should also have a well-defined product roadmap for the solution. A shared product platform that is continually improved allows states to adapt to whatever the future may bring.
By prioritizing technology solutions that make enrollment easy, can be easily maintained, and are built to adapt to the future, SMAs can be assured that they’re doing what they can to help providers enroll in their system and be ready to care for their clients.
Learn more about Acentra Health’s Provider Enrollment solutions here.
