The healthcare industry is facing several challenges, particularly in the aftermath of the pandemic. Vulnerable and low-income populations are at a greater risk during this period and have higher health needs. Medicaid is a jointly funded health insurance program provided by the federal and state governments, serving as the primary payer for low-income individuals, senior citizens, people with disabilities, children, and pregnant women.

Enrollment in Medicaid has increased significantly due to various factors such as the Affordable Care Act (ACA) expansion, rise in eligible beneficiaries resulting from pandemic-related unemployment, and the continuous coverage mandate from the Centers for Medicare and Medicaid Services (CMS) under the Public Health Emergency (PHE). Consequently, stakeholders such as health plans, government authorities, investors, and providers, are reshaping the program to improve health outcomes for the target population. As a result, there is a greater focus on improving the efficiency of Medicaid delivery through managed care organizations, use of technologies such as automation and predictive analytics, and leveraging data-driven insights to positively impact health equity in the country.

In this report, we examine some of the major trends in the US Medicaid market and the sourcing implications for providers operating in this segment.

Scope

• Industry: healthcare
• Geography: North America

Contents

In this report, we

• Examine the US health expenditure on Medicaid
• Analyze key themes in the Medicaid market
• Study the Medicaid Business Process Services (BPS) market size

Membership(s)

Healthcare Payer and Provider Business Process

Sourcing and Vendor Management