AI-driven innovation in medicaid: enhancing access, cost efficiency, and population health management

Medicaid is a federal-state program that provides healthcare to over 80 million low-income Americans, including pregnant women, children, and individuals with disabilities. Up against a host of problems, including rising healthcare costs, disparity in access, and the management of chronic conditions among at-risk groups, Medicaid is one of the biggest healthcare payers in the U.S. Just as Medicare does, the use of Artificial Intelligence (AI) offers a major opportunity to change the delivery of care and operational efficiency in Medicaid [1] [16]. While there has been extensive conversation about AI in Medicare, the unique population and requirements of Medicaid require customized AI applications [1]. Chronic disease management, improving admin tasks, and a reduction in costs are amongst the ways AI tools can help, especially by focusing on social determinants of health (SDOH) that are important for Medicaid populations. The study will assess the ability of AI-enabled systems to reinforce Medicaid in handling its particular challenges while facilitating fair and quality care for its entire population of beneficiaries [8] [9].