HR1 isn’t just changing Medicaid policy. It’s stress testing Medicaid performance.
- James V
- 2 days ago
- 1 min read
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.
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