{"id":14249,"date":"2025-04-25T10:06:37","date_gmt":"2025-04-25T10:06:37","guid":{"rendered":"https:\/\/distilinfo.com\/healthplan\/?p=14249"},"modified":"2025-04-25T10:06:37","modified_gmt":"2025-04-25T10:06:37","slug":"medicaid-transformation-moving-beyond","status":"publish","type":"post","link":"https:\/\/distilinfo.com\/healthplan\/medicaid-transformation-moving-beyond\/","title":{"rendered":"Medicaid Transformation: Moving Beyond Healthcare in 2025"},"content":{"rendered":"
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In 2025, states across America are pioneering an unprecedented transformation of Medicaid programs, fundamentally reshaping how we address people’s health, economic stability, and mental well-being through innovative, person-centered approaches. As value-based care models expand and requirements continue to evolve, technology’s role in shaping this shift is more critical than ever. Leading this charge is Taylor Justice, co-founder and president of Unite Us\u2014a software platform dedicated to advancing whole-person care. In a recent interview with Fierce Healthpayer, Justice shared his perspective on what Medicaid transformation looks like in 2025 and how it will continue to redefine the future of health and community care delivery.<\/p>\n

The Growing Scrutiny of Medicaid Programs<\/strong><\/h2>\n

Federal and state leaders are actively exploring ways to manage Medicaid program costs more effectively through innovative models of care delivery. “More than ever, we’re seeing Medicaid agencies and Medicaid programs specifically being looked at under a microscope,” said Justice.<\/p>\n

This heightened scrutiny comes at a time when Medicaid enrollment has experienced significant fluctuations following the COVID-19 pandemic and subsequent unwinding of continuous enrollment provisions. As states work to balance budgets and address growing healthcare costs, innovative approaches to Medicaid delivery are becoming increasingly important.<\/p>\n

Innovation at the Core of Transformation<\/strong><\/h2>\n

Justice emphasized that the long-term success of these efforts will require sustainable infrastructure and true interoperability between traditional healthcare systems and the community-based organizations (CBOs) that provide critical non-medical services.<\/p>\n

“Innovation is critical, and it’s also at the heart of Medicaid transformation, and we’re seeing many states adopt different approaches that are tailored to their unique needs,” Justice explained.<\/p>\n

These innovations include everything from expanded telehealth services to community-based care coordination models that address social determinants of health. States are increasingly recognizing that medical care alone cannot address the complex factors that influence health outcomes, particularly for vulnerable populations.<\/p>\n

Building Sustainable Infrastructure for Long-term Success<\/strong><\/h2>\n

One of the most significant challenges in Medicaid transformation is creating infrastructure that can support these innovative approaches over the long term.<\/p>\n

“And these programs have the potential to deliver significant cost savings both in the community, for government, and for healthcare,” said Justice. “But success really depends entirely on building sustainable infrastructure. Historically, we haven’t seen a lot of investment in public health. You see it a lot on the healthcare side, but how does that extend to the community? How do we improve billing for non-medical claims? We don’t want to replicate what we see in healthcare from revenue cycle management and just bring that over to the community side of the house.”<\/p>\n

This sustainable infrastructure must include robust data systems that can integrate information across healthcare and community settings, as well as payment models that appropriately value and incentivize community-based services.<\/p>\n

Bridging Healthcare and Community Services<\/strong><\/h2>\n

A critical component of Medicaid transformation is breaking down the traditional silos between healthcare providers and community-based organizations. This integration is essential for addressing the full spectrum of factors that influence health outcomes.<\/p>\n

Unite Us has positioned itself as a key player in this space, providing technology solutions that connect healthcare providers with community-based organizations. By facilitating these connections, Unite Us helps ensure that individuals receive comprehensive care that addresses both medical and non-medical needs.<\/p>\n

The Future of Medicaid Transformation<\/strong><\/h2>\n

Looking ahead, Justice and the team at Unite Us are focused on continuing to drive innovation and support ongoing efforts to transform Medicaid. This includes working closely with state Medicaid programs and other stakeholders to develop new models of care that drive greater efficiencies and aim to put people on a path to self-sufficiency by comprehensively addressing barriers to economic, health, and mental well-being.<\/p>\n

“We believe the future is going to continue to be shaped by some of the innovations that we make,” said Justice. “We’re 12 years old. We were beating the war drum on closed-loop networks since the very beginning. When the market just wanted a robust list of resources, we were the first organization to reimburse a non-medical need as a Medicaid benefit in North Carolina.”<\/p>\n

Data-Driven Decision Making<\/strong><\/h2>\n

As Medicaid transformation continues to evolve, data will play an increasingly important role in shaping policy decisions and program design. By leveraging data analytics, states and healthcare organizations can identify trends, assess program effectiveness, and make evidence-based decisions about resource allocation.<\/p>\n

Unite Us is well-positioned to contribute to this data-driven approach through its software platform, which captures valuable information about service delivery and outcomes across both healthcare and community settings.<\/p>\n

Conclusion: A Holistic Approach to Health and Wellbeing<\/strong><\/h2>\n

The transformation of Medicaid programs represents a fundamental shift in how we think about health and wellbeing. By moving beyond traditional healthcare models to embrace a more holistic approach that addresses social determinants of health, states are working to improve outcomes while also managing costs.<\/p>\n

As Justice and Unite Us have demonstrated, technology will play a crucial role in facilitating this transformation. Through innovative software solutions and a commitment to building sustainable infrastructure, organizations like Unite Us are helping to bridge the gap between healthcare and community services, ultimately creating a more integrated and effective system of care for vulnerable populations.<\/p>\n

The journey toward fully transformed Medicaid programs is ongoing, but the innovations being implemented today are laying the groundwork for a future where healthcare and community services work together seamlessly to support whole-person care.<\/p>\n<\/div>\n<\/div>\n

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In 2025, states across America are pioneering an unprecedented transformation of Medicaid programs, fundamentally reshaping how we address people’s health,… Continue Reading <\/i><\/a><\/p>\n","protected":false},"author":1,"featured_media":14250,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[1],"tags":[1547,1233,1215,579,1543,1548,1539,1545,1546,109,1544,1541,1542,106,1540],"class_list":{"0":"post-14249","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-distilinfo-originals","8":"tag-closed-loop-networks","9":"tag-community-based-organizations","10":"tag-data-integration","11":"tag-healthcare-innovation","12":"tag-interoperability","13":"tag-medicaid-cost-savings","14":"tag-medicaid-transformation","15":"tag-non-medical-services","16":"tag-public-health-investment","17":"tag-social-determinants-of-health","18":"tag-sustainable-infrastructure","19":"tag-taylor-justice","20":"tag-unite-us","21":"tag-value-based-care","22":"tag-whole-person-care","23":"entry"},"_links":{"self":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/14249"}],"collection":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/comments?post=14249"}],"version-history":[{"count":2,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/14249\/revisions"}],"predecessor-version":[{"id":14252,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/posts\/14249\/revisions\/14252"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media\/14250"}],"wp:attachment":[{"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/media?parent=14249"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/categories?post=14249"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/distilinfo.com\/healthplan\/wp-json\/wp\/v2\/tags?post=14249"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}