Explore how states are safeguarding vulnerable Medicaid populations through innovative strategies in HCBS waitlist management, critical incident reporting, and justice-involved reentry care. This session highlights practical, data-driven approaches to improve access, enhance safety, and ensure continuity of care for high-risk populations across Medicaid programs.
What you'll learn:
- How to modernize Medicaid waitlist management and improve access
Learn how states are using prioritization, triage models, and data-driven scoring to reduce wait times, improve equity, and connect individuals to services faster. - How incident management systems enhance safety and compliance
Understand how critical incident reporting systems support real-time tracking, regulatory compliance, and proactive interventions to protect individuals receiving HCBS services. - How Medicaid reentry programs improve outcomes for justice-involved populations
Explore how 1115 waivers, care coordination, and community partnerships support successful transitions from incarceration to community-based care. - How data, coordination, and partnerships drive better Medicaid outcomes
Discover how integrated platforms and collaboration across states, providers, and community organizations improve care continuity, transparency, and long-term outcomes.
Participants
- Dawn Fitzgerald, MBA, Vice President of Business Expansion, Acentra Health
- Rob Noble, MBA, Vice President of Operations, Acentra Health
- Emily Proctor, MA, LPC, AADC, CEAP, Clinical Director for West Virginia, Acentra Health
Read the transcript
Note: This is a polished transcript of the full session and is not intended to be a verbatim record.
Opening and session overview
[Approx. 00:30–02:00] The session introduces key strategies for safeguarding vulnerable Medicaid populations, focusing on waitlist management, critical incident reporting, and reentry care for justice-involved individuals.
Waitlist management challenges and policy drivers
[Approx. 04:30–08:00] The discussion highlights the scale of the issue, with nearly 700,000 individuals on HCBS waitlists nationwide, often waiting months or years for services. CMS requirements now emphasize transparency, equity, and measurable progress in reducing wait times.
[Approx. 08:30–10:00] Traditional “first-in, first-out” approaches are challenged, with the need to prioritize based on urgency, risk, and individual circumstances rather than time alone.
Data-driven prioritization and care coordination
[Approx. 10:00–14:00] The panel explores how triage models, scoring systems, and analytics can help states prioritize individuals more effectively, balancing fairness, risk, and long-term outcomes.
[Approx. 14:00–17:30] A practical model is presented showing how individuals move from application to service delivery, including intake, prioritization, provider matching, referral, and ongoing monitoring to ensure timely access and improved outcomes.
Critical incident reporting and system modernization
[Approx. 18:00–22:00] The session shifts to critical incident reporting, defining incidents such as abuse, neglect, safety risks, and emergency events that require immediate attention to protect vulnerable populations.
[Approx. 22:00–25:00] West Virginia’s implementation of an incident management system is highlighted, demonstrating rapid deployment, high case volume handling, and strong compliance with federal requirements.
[Approx. 25:00–27:30] Key lessons include the importance of electronic systems, data integration, stakeholder collaboration, and robust reporting to track trends and improve care quality.
Regulatory alignment and system impact
[Approx. 27:30–28:30] CMS requirements for incident management systems—including electronic tracking, reporting standards, and compliance thresholds—are driving states to modernize processes and improve oversight.
Reentry care for justice-involved populations
[Approx. 28:30–33:00] The discussion transitions to Medicaid reentry programs, highlighting the high prevalence of behavioral health conditions and chronic illness among incarcerated individuals and the need for coordinated care during transition to the community.
[Approx. 33:00–36:00] Policy drivers include 1115 waivers and federal mandates that allow Medicaid-funded services pre- and post-release, improving access to care and reducing recidivism.
Implementation challenges and best practices
[Approx. 36:00–42:00] Key challenges include:
- Building community provider networks
- Addressing facility readiness and resource gaps
- Integrating IT systems and data sharing
- Defining success metrics and tracking outcomes
- Coordinating non-clinical supports (housing, employment, transportation)
Solutions include collaborative planning, centralized care coordination, and data-driven program design.
Real-world implementation example
[Approx. 42:30–45:30] A case example illustrates how a coordinated reentry program supports an individual from pre-release assessment to post-release care, including care planning, provider coordination, and outcome tracking.
Closing takeaways and integrated strategy
[Approx. 46:30–48:00] The session concludes by connecting all three strategies—waitlist management, incident reporting, and reentry care—through a common theme: data-driven coordination and system modernization are essential to improving outcomes for vulnerable populations.
Q&A and practical insights
[Approx. 48:00–56:00] Final discussion highlights practical approaches, including:
- Using data transparency and partnerships to reduce wait times
- Addressing variability in health record systems across facilities
- Leveraging centralized platforms to track care delivery, outcomes, and ROI
- Exploring risk scoring and prioritization models to improve decision-making