Technology Innovation in Medicaid: What to Expect in the Next Decade

Even though many people in the field worried that new technologies would never take hold because of significant barriers to adoption, a quiet yet remarkable transformation has been taking place over the last decade in the safety net, which serves the health care needs of Californians with low incomes or disabilities. Electronic health records (EHRs), electronic prescribing, and patient texting to modify behavior, which were once the domain of early adopters in the commercial sector, are now almost universally used in safety-net care. More recently, the coronavirus pandemic turbocharged the adoption of approaches like telehealth and remote monitoring among safety-net providers and their patients.

Myths have been shattered that people with low incomes or disabilities won’t use health care technologies, that providers would not invest in them, or that serving these patients with new tools could not be financially viable.

To learn what leaders in the field expect over the next decade, Manatt Health surveyed nearly 200 health care thought leaders across government, providers, plans, tech companies, community-based organizations, and investment firms. The survey was supplemented with more than 25 one-on-one interviews. The respondents foresaw a host of even more profound changes ahead:

• The astonishing growth of telehealth technologies — more than 100 times prepandemic levels — could continue if policymakers make permanent the emergency waivers that have so far allowed payments from Medicaid during the coronavirus pandemic.
• Care coordination technologies should extend their steady growth, enabling advances such as remote patient monitoring that ensure providers stay in touch with patients, care between different providers doesn’t fall through the cracks, and that the right care is given at the right time.
• Tools and services will increasingly target social risk factors, known as social determinants of health, which include housing, access to healthy food, transportation, and other issues that impact health outcomes and the cost of care.
• Services will shift from stand-alone offerings targeting specific needs like behavioral health and urgent care to integrated, platform-based models offering a wider array of care options.

Safety-net plans and providers — as well as the investors and entrepreneurs who serve them and the governments that shape markets — would be wise to take heed of the innovations rippling throughout the field. Those that get ahead of the changes will generate life-changing outcomes for their own patients and enrollees, and will be in a better position to foster regulatory and reimbursement reforms that unleash broader transformation across the health care system.