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Medicaid is unique in both its mission and its risk. Plans must serve populations with the greatest medical, behavioral, and social needs while operating within tight margins.
On top of that, states increasingly tie reimbursement to quality through performance withholds, raising the stakes for every metric. Falling short threatens both financial viability and member trust.
At MedWatchers, we believe solving Medicaid’s toughest problems means tackling both care gaps and the social drivers behind them. Our solutions integrate medical, behavioral, and social data to identify gaps and guide interventions that move the needle where it matters most.
We help Medicaid plans improve performance on HEDIS, CAHPS, and the Adult and Child Core Sets, while aligning with complex, state-specific requirements.
Our CareIQ solution delivers up to 6:1 returns for the highest-risk members, reducing avoidable utilization while reinforcing financial sustainability.
We address the full spectrum of member needs - including medical, behavioral, and social determinants - for populations with the greatest risk and complexity.
We connect members to plan benefits and community resources that improve access, address barriers, and promote whole-person care.
Using predictive analytics and real-time insights, we identify risk earlier, target interventions more effectively, and help plans improve performance on key quality metrics.
Language access is a CMS priority in advancing health equity. We deliver care in 30 languages, bridging communication gaps and building trust with every member.
We help plans meet state-specific requirements and performance metrics to safeguard reimbursements and optimize performance.
With MedWatchers, Medicaid plans and partners gain the tools and support to transform quality, enhance compliance, and better serve their communities.
Contact us today to learn how we can help raise quality scores, improve outcomes, and strengthen member trust.
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