The spotlight is on population health capabilities among health insurers. For proof, look no further than recent Requests for Proposals (RFPs) from state Medicaid programs that emphasize two key areas: health equity and social determinants of health. That’s according to reporting by RADAR on Medicare Advantage.

Six states, impacting approximately 11 million lives, have signaled a shift in managed care by adding new populations. Specifically, states are urging the integration of behavioral health, Managed Long-Term Services and Supports (MLTSS), and pharmacy services into acute care.  

For instance, Georgia is set to transition its older, blind, and differently abled Medicaid population to managed care, while Virginia aims to consolidate MLTSS and managed Medicaid plans. These changes underscore the imperative for insurers to adapt to evolving Medicaid needs.  

Analytics expertise in demand  

State Medicaid agencies are seeking improved capabilities among health insurers. The focus is on insurers equipped with tools to track outcomes and streamline processes, which recognizes data's crucial role in enhancing managed Medicaid efficiency. 

Centene Corp.'s CEO, Sarah London, highlighted this trend, telling RADAR on Medicare Advantage about the significance of Georgia's RFP, which includes the state's aged, blind, and differently abled population. The evolving managed Medicaid landscape presents challenges and opportunities for payer executives. Increased RFP activity and new population inclusions call for a strategic approach among health insurers. 

To thrive, payers must prioritize innovation, invest in advanced analytics, and align services with evolving Medicaid needs.  

Enter EmpowerHealth. Payers across the nation rely on our platform to keep members on track with their care plans and bridge crucial care gaps. Our promise? Elevate quality, drive improvements in Stars and HEDIS measures, and ensure members achieve health and well-being. 

Why EmpowerHealth? One major national payer client slashed a whopping $62 million in clinical and operational costs over just 18 months. 

We're revolutionizing engagement and simplifying navigation, and boosting member education—all while helping to reduce the cost of care.  

Let's talk today!