The California Health Care Foundation aims to ensure that all Californians have access to the care they need, when they need it, at a price they can afford. In our status quo, however, many patients delay vital care or forego it altogether, whether because they cannot find it or they cannot afford it.
Payers and providers know what they need in order to deliver better, more affordable care — and patients know what they need in order to more easily access that care. For the most part, however, the products and services that could address those needs are not available. Some exist, but only in the commercial market, and many others have not yet been developed.
For those investors and entrepreneurs able to develop solutions that meet the real needs of the safety net, an unparalleled opportunity to achieve impact and scale awaits.
The Medicaid Market Opportunity
As the nation’s largest health insurer, Medicaid offers investors and entrepreneurs an especially promising opportunity to deliver value and improve health care at scale. Facing pressure to improve access, efficiency, and quality, the Medicaid market is primed for innovation.
Fast Facts about the Medicaid Market:
- Medicaid covers one in five Americans. California’s state Medicaid program, Medi-Cal, is the largest in the nation and covers one in three Californians.
- Nationally, annual Medicaid spending exceeds $550 billion. In California, Medi-Cal spending will approach $100 billion this year, including federal matching funds.
- California currently has numerous active pilot programs and more than $10 billion of new funding to incentivize approaches to delivering care that improve quality and lower costs.
- Just 5% of patients account for more than 50% of Medicaid spending, leaving significant room for innovations that improve outcomes and reduce costs for complex patients.
Click on the resources below to learn more about this untapped market.