Insights

Dec 12, 2025 – Case Study: Utah’s Medicaid Modernization Journey Utah has recently completed a groundbreaking initiative to modernize its Medicaid system. The state’s vision was to create a streamlined, efficient system that improved care delivery and health outcomes while optimizing administrative processes. Utah faced numerous challenges that are common across Medicaid programs, including outdated legacy systems, complex regulations, and the need for real-time data analytics to support decision-making. In June 2020, Utah Medicaid went live with its first updated release, the provider enrollment and management module. Then, in April 2023, Utah Medicaid went live with its last release which fully implemented a new system called Provider Reimbursement Information System for Medicaid (PRISM). Utah Medicaid now annually processes approximately six million provider claims plus managed care encounters, paying approximately $5 billion to more than 65,000 active Medicaid providers and managed care organizations.

Nov 26, 2025 – By Marnie Keogh, Senior Vice President, Marketing Reflections from the National Association of Medicaid Directors 2025 Conference: Challenges, Changes, and Opportunities Acentra Health returned from NAMD 2025 energized by the dedication of our nation’s Medicaid Directors and their teams. The conference, held November 18-21 at the Gaylord National Resort & Convention Center in Oxon Hill, Maryland, was the largest to date, giving us the opportunity to speak with many Directors. In a nutshell, here’s what we heard: the challenges brought on by market constraints will force them to change how they operate, giving them opportunities to do new things.

Aug 5, 2025 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Acentra Health applauds the steps taken by private health insurance leaders, the U.S. Department of Health and Human Services (HHS), and the Centers for Medicare and Medicaid Services (CMS) leadership to collaborate on accelerating care decisions and enhancing transparency around the prior authorization (PA) process. As this process with private insurers moves forward, we welcome the opportunity to contribute to this national discussion with our perspectives and highlight the work we are doing on behalf of our clients.

Jun 12, 2025 – By Todd Stottlemyer, Chief Executive Officer At Acentra Health, innovation isn’t just a buzzword — it’s a commitment to driving real change in how government healthcare programs serve the American public. Three of our executive leaders are being recognized by WashingtonExec for their pioneering work in government healthcare technology innovation.

May 29, 2025 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Incarcerated individuals often leave prison with complex health needs and little support waiting for them outside. Medicaid’s Section 1115 reentry waivers offer a chance to change that, but translating policy into impact takes more than paperwork. It requires strategic design, on-the-ground knowledge, and systems that don’t fall apart after the pilot phase.

May 8, 2025 – By Nilay Patel, Executive Vice President and General Manager, HealthTech Systems Across the country, Medicaid programs face growing demands for greater agility, stronger compliance, and better overall experience for the people they serve. In this environment, the state of Utah has emerged as a blueprint for what is possible when vision, technology, and strategic partnership align.

Dec 6, 2024 – By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions Youth transitioning out of residential facilities face numerous challenges, including inadequate healthcare and social support. Justice-involved youth (JIY) are at high risk for poor health outcomes, recidivism, and struggles with reintegration into society. In recognition of these needs, the Omnibus Reconciliation Act of 2022 mandated that states receiving Medicaid funding must provide health and social risk assessments to JIY 30 days before and post-release. With a compliance deadline looming at the start of 2025, state agencies must act quickly and proactively to establish systems that meet these requirements.

Nov 20, 2024 – By Verlon Johnson, Chief Government & Corporate Affairs Officer As always, Medicaid policy is shifting in ways that will profoundly impact state programs over the next few years. These mandates fall into four primary areas of focus: Justice-Involved Youth Services, Prior Authorization (PA) Modernization, Critical Incident Reporting, and Health Equity initiatives. Each mandate can significantly shape state Medicaid programs, and it is essential for Medicaid directors and state agencies to be vigilant and proactive in their preparations.

Oct 25, 2024 – Protecting At-Risk Populations from the Dangers of Climate-Related Events A barrage of climate-related emergencies has continuously put Oregon’s most vulnerable residents at risk. To tackle this challenge, the Oregon Health Authority (OHA) turned to Acentra Health. Together, they crafted a dynamic strategy that addressed immediate health-related social needs (HRSN) and fortified the state’s emergency response systems. This partnership has measurably improved health outcomes—while building resilience in communities most impacted by climate change.