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.
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.
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.
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.
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.
By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions In today’s digital age, enhancing the client experience is key for any organization. It’s especially important in public health.
Wyoming MMIS Implementation Case Study The Wyoming Department of Health faced the challenge of replacing its aging legacy Medicaid Management Information System (MMIS) to meet the evolving needs of its member population.
By Nilay Patel, Executive Vice President and General Manager, HealthTech Systems With more than 74.6 million enrollees, Medicaid is one of the largest healthcare programs in the U.S. Yet, outdated systems pose challenges to meeting the growing demands of Medicaid populations. Today, Medicaid accounts for one-sixth of all healthcare spending and half of long-term care spending, making it a large share of state budgets.¹ This significant financial commitment underscores the critical need for efficient, modernized systems.
By Susan Baker, Executive Vice President and General Manager, Integrated Health Solutions An Expert’s Guide for State Medicaid Agencies Stakeholder engagement isn’t just a buzzword: it’s the starting point for any Medicaid agency seeking to make better, more informed decisions. Gathering and applying stakeholder feedback can ensure that an agency’s programs are effective, inclusive, and well-received.
