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HR1 isn’t just changing Medicaid policy. It’s stress testing Medicaid performance.

by: Scott Schnell, MedZed CEO


In my latest piece for MedCity News, I argue that one of the defining operational challenges facing plans right now isn’t measurement — it’s engagement.


Most performance frameworks assume members can be reached, guided, and retained in care through conventional channels. But for a meaningful share of high-acuity populations, that assumption simply doesn’t hold. When engagement breaks down, quality scores fall, utilization rises, and financial pressure compounds.


From the outside, this looks like underperformance.

From the inside, it looks like a system measuring outcomes without accounting for whether engagement ever occurred.


HR1 has intensified the stakes. Tighter margins and more frequent redeterminations mean there is far less room for disengagement.


Engagement isn’t a “nice to have.” It’s infrastructure.


Appreciate the opportunity to contribute to the MedCity Influencers series. Would welcome others’ perspectives on how plans are stabilizing performance in this environment.


Contact us to see how our team can help your members Community Partners



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Guest
May 08

I read the post about how HR1 is really putting Medicaid’s performance systems under pressure and showing how hard it is to reach people who need care, not just meet numbers. It made me think of when I had to balance homework with real life and once used finance assignment help because I was confused by the basics and needed time to focus on understanding things better. It shows how tools can support real engagement in tough situations.

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