State Medicaid programs must balance member and provider needs, federal compliance requirements, operational performance and modernization priorities.
EY teams work alongside Medicaid agencies to connect policy, operations and technology in ways that strengthen program delivery and improve the experience for members, providers and the workforce.
Frank Berry
Tony Franklin
Core Medicaid workflows can be standardized, streamlined and automated to reduce manual effort, improve visibility and support more consistent, auditable operations.
Modernized eligibility operations can improve accuracy, timeliness and coordination through standardized processes and more connected data.
Stronger data visibility, case management and tracking can improve how agencies identify, manage and resolve fraud, waste and abuse concerns.
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Enterprise integration capabilities can support interoperability, standardized data exchange and phased modernization through scalable architecture.
Practical roadmaps align policy, operations and technology investments so agencies can sequence modernization efforts and make informed delivery decisions.
Program management capabilities provide governance, prioritization and execution oversight aligned to strategic goals and regulatory requirements.
Centralized governance improves visibility, aligns initiatives and coordinates delivery across complex transformation efforts.
Human services programs play a critical role in supporting children, families and vulnerable populations.
Stronger operations, better data, coordinated service delivery and sustainable implementation can help agencies improve access, manage demand and deliver more consistent outcomes.
Greg McKay
Amanda Tate
Coordinated eligibility operations improve access, streamline processes and support more consistent service delivery across programs.
Operating model redesign, workforce support and data-driven performance management can strengthen safety, permanency and wellbeing outcomes.
Improved access, coordination, crisis response and provider accountability can strengthen complex behavioral health systems.
Modernized operations and targeted process improvements can improve timeliness, accuracy and customer experience.
Stronger provider networks can expand access, reduce waitlists and improve visibility into provider performance and accountability.
Improved oversight and risk management can reduce fraud, waste and abuse while maintaining continuity of service delivery.
Aligned strategy, systems, implementation and change adoption can help agencies realize greater value from technology investments.
A coordinated approach to strategy, operations, governance and technology can help transformation efforts translate into lasting organizational change.
Improved claiming accuracy, compliance support and financial stewardship can help agencies maximize eligible federal funding.
Rural health programs require coordination across providers, public health agencies, community organizations, employers, health plans and state leaders.
Through Rural Health Transformation Programs and related initiatives, states can align priorities, build realistic roadmaps and manage grant compliance risk while expanding access to care.
Michael Botos
Tim Van de Water
Stand up a centralized strategic command center leadership team and tools for coordination of integrated, milestone-based planning and execution, policy, governance and performance management.
Design and implement digital customer experiences, including telehealth, consumer-facing mobile apps, remote monitoring technologies and AI-based agents for efficiency, empowerment and navigation.
Develop cross-agency and cross-organizational data architecture, standards-based data models and collaborative governance models for interoperability and bidirectional data sharing for care coordination.
Design initiative-specific strategies and action plans for launch readiness, operational execution, community collaborator and stakeholder engagement, and “hands-on” support for delivery execution.
Design community-based collaboration strategies and governance models to align public and private sector stakeholders on common priorities, collective action and shared accountability for rural health outcomes.
Development and implementation of financial sustainability strategies beyond initial funding, including reimbursement strategies, alternative payment models and public-private partnerships.
Design and implement grants management and fiscal compliance processes and support across the application, issuance, management and reporting lifecycle to meet federal and state requirements.
Design and implement initiative launch strategies, stakeholder engagement and communication, including rural health transformation program branding and messaging, digital community hubs, portals and mobile apps.
Behavioral health systems are increasingly central to broader health and human services transformation.
Integrated strategy, operations, data and technology can help agencies improve access, strengthen coordination and build more sustainable systems of care.
Dr. Terri Timberlake-Briscoe
Data-informed planning and capacity assessments help align resources, define future state priorities and address system gaps.
A comprehensive view of the behavioral health continuum can identify service gaps, strengthen coordination and improve access and outcomes.
End-to-end transformation can improve operations, strengthen service delivery models and support sustainable modernization.
Streamlined licensing and regulatory processes can improve compliance, oversight and operational efficiency.
Integrated approaches to homelessness can align behavioral health services, housing resources and community partnerships to strengthen systems of care.
Enterprise system integration and stronger data management can improve interoperability, visibility and data-driven decision-making.
Redesigned and automated business processes can reduce manual effort, improve consistency and increase operational efficiency.
Supporting states in stabilizing operations while advancing toward integrated, data-informed crisis response models.
Public health agencies need the capacity, infrastructure and tools to respond to evolving community needs while managing compliance, funding and program performance.
Stronger data, modernized operations and efficient grant administration can help agencies deliver more effective public health programs.
Data, automation and AI-enabled tools can help agencies track, manage and report on complex requirements.
Data-enabled and digitally delivered approaches can strengthen program, financial and enterprise performance management.
Efficient grant lifecycle management supports planning, administration, reporting and compliance.
Improving end-to-end visibility and coordination across provider networks, vendors and critical services to reduce disruption and maintain continuity of care.
Enhancing alignment across federal agencies, states and partners through clear governance, shared data and consistent communication frameworks.