Federal Analysis
States Modernize Medicaid Eligibility Systems
March 16, 2026
States are undertaking urgent modernization of Medicaid eligibility and managed care oversight systems to address unprecedented enrollment growth and rising program expenditures. This modernization emphasizes automation, data integration, and predictive analytics to improve operational efficiency, program integrity, and member experience. Ernst & Young LLP has provided an evidence-based roadmap to guide states in implementing sustainable, data-driven Medicaid program reforms.
- Why this matters: Medicaid programs face increasing demand and fiscal pressures, making modernization critical for maintaining program sustainability and compliance.
- Procurement professionals should anticipate increased opportunities for IT modernization, data analytics, and consulting services supporting Medicaid eligibility and managed care systems.
- States like Washington are key early adopters, indicating regional procurement activity and potential pilot projects.
- Vendors offering automation, data integration, and predictive analytics solutions aligned with CMS and MACPAC guidance may find growing demand in Medicaid modernization initiatives.
Modernization is no longer a technical choice; it is an operational and fiscal imperative.
— Chris Deelsnyder, Health & Human Services leader at Ernst & Young LLP
Agencies
Centers for Medicare & Medicaid Services, Medicaid and CHIP Payment and Access Commission, Washington State Medicaid Program
Vendors
Ernst & Young LLP