Medicaid Transformation Project

The Medicaid Transformation Project is a national effort to transform healthcare and related social needs for the most vulnerable. Throughout this 2-year mission, health systems will implement innovative solutions that address challenges like behavioral health and substance use disorder to improve health for underserved individuals and families across the country.

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“Healthcare today must be consumer-centric, and engage patients with personalized experiences. Together, we must bring down healthcare costs in order to provide access for the most vulnerable communities. It is my hope that our collaboration will unleash new avenues that bring down barriers to care and improve the overall health of our communities.”
Lloyd Dean, President and CEO, Dignity Health
“We’ve seen exciting and positive momentum with digitally-enabled solutions that engage our physicians, caregivers, patients, and consumers. Through the Medicaid Transformation Project, we know we can share what we’ve learned with other systems and amplify our ability to help patients through what we learn from these impressive partners”
Dr. Rod Hochman, President and CEO, Providence St. Joseph Health
“The gap between the needs of vulnerable populations and the healthcare they receive is too great. We are no longer interested in discussing the problems our patients are facing or just piloting solutions – we’re interested in solving them as quickly as possible.”
Dr. David Feinberg, CEO, Geisinger
“As the largest not-for-profit healthcare system in Texas – a state which did not expand Medicaid – we remain committed to meeting the needs of the communities we serve, including providing access to care for those who cannot afford it. We are energized to be part of leading this national initiative and advancing sustainable solutions to meet the growing needs of our most vulnerable populations.”
Jim Hinton, CEO, Baylor Scott & White Health
“As part of our purpose to help people live well, we are committed to expanding access to critical healthcare services. The Medicaid Transformation Project aligns with our community-focused approach to meeting the needs of those we are so privileged to serve.”
Jim Skogsbergh, President and CEO of Advocate Aurora Health
“We believe tomorrow’s solutions for today’s health disparities will be rooted in digital solutions and technologies that are easy to implement and scale. This unique partnership brings together like-minded systems who are committed to delivering greater value to those who deliver, receive, and pay for healthcare.”
Nick Turkal, MD, President and CEO of Advocate Aurora Health
"We are passionate and purposeful about building better health for the diverse communities we serve. We joined the Medicaid Transformation Project because we believe in collaboration, not duplication. Working with AVIA and other leading health systems will help us get to better health and care faster for vulnerable populations."
Dr. Penny Wheeler, Allina Health President and CEO

Mission statement

In partnership with healthcare leaders and Andy Slavitt, our mission is to change the health and care of the Medicaid population by leveraging digital solutions and innovative care models to more effectively and efficiently meet the needs of ~75 million Americans and other vulnerable populations.

The impact and opportunity:

  • One in five Americans are covered by Medicaid
  • 50 percent of U.S. births are financed
    by Medicaid
  • Medicaid is the country’s number one payer for behavioral health services
  • 33 cents of every dollar for a physician's services are paid by Medicare or Medicaid
  • $15B in incentives available for innovative care models
  • $650B estimated Medicaid & Duals market size

A shared vision

Dignity Health
Providence St. Joseph Health
Geisinger
Baylor Scott And White
Advocate Aurora
Allina Health
Christiana Care Health System
Froedtert & the Medical College of Wisconsin
Memorial Hermann
Navigant Health
OSF HealthCare
Presbyterian Healthcare Services
Rush University Medical Center
University of Virginia Health System
Henry Ford Health Systems
Spectrum Health
Priority Health
Ballad Health
Jefferson

Challenge areas

Behavioral health
Approximately 9M adults on Medicaid are diagnosed with mental illness and Medicaid spending for these patients is 4x higher than normal.

How can digital solutions integrate behavioral health screenings into low acuity sites of care and improve appropriate access to mental health care?
Substance use disorder
Over 30,000 people die every year from heroin and painkiller overdoses and in 2009, the US spent $24B on substance use disorder treatment; 69% came from public sources.

How can innovations improve the infrastructure and organization of substance use treatment and recovery?
Women and infant care
Medicaid pays for over half of all US births and covers ~25M adult women; this population struggles with appropriate access to prenatal care, which is a top factor in reducing low birthweight infants.

How can digital solutions improve maternal visit attendance and coordination between visits to improve infant outcomes?
Avoidable emergency
department visits
On average, health systems are paid 36 cents on every dollar spent for ED visits by Medicaid patients and ~ 1/3 of Medicaid patients visiting the ED show up at least four times in a calendar year.

How can innovations improve access to appropriate and timely lower cost and acuity care settings?

Partners in action

The Medicaid Transformation Project is led by AVIA and former CMS Acting Administrator Andy Slavitt. Since leaving government, Andy has founded Town Hall Ventures, a venture capital firm devoted to investing in and supporting entrepreneurs who are improving the health of underserved populations.

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