Checklist

Medicaid Readiness Checklist

Four Capabilities for a Smaller, Higher-Acuity Population

Medicaid work requirements and six-month redeterminations take effect in 2027. Plans will manage a smaller, higher-acuity population with faster renewal cycles and tight seven- and 30-day follow-up windows. Delayed data, manual work, and unclear priorities can keep care teams from finding members and acting in time.

This checklist helps health plans score their care management model across four capabilities: visibility, prioritization, clinical intelligence, and workflow automation. Care teams can see whether they spot member events in real time, rank outreach by urgency, and start each call with the latest clinical context. It also shows how much manual work still sits between knowing and acting.

The result: a clear score that shows where your plan is well positioned, partially ready, or structurally exposed, and which gaps to close first.