Medicaid MCOs

🤝 Specialized Medicaid Management

Comprehensive solutions for Medicaid Managed Care Organizations. Improve member outcomes, manage complex populations, and ensure regulatory compliance with integrated care coordination, social determinants screening, and automated quality reporting.

34%
Reduction in Emergency Department Visits
89%
HEDIS Measure Compliance
67%
Improvement in Care Coordination
Medicaid MCO Management Dashboard

Address Unique Medicaid MCO Challenges

From complex population management to regulatory compliance, our platform is designed specifically for Medicaid managed care challenges.

Complex Population Management

Manage diverse member populations with multiple chronic conditions, social barriers, and complex care needs.

Social determinants screening
Multi-condition care plans
Cultural competency tools

Care Coordination at Scale

Coordinate care across multiple providers, specialists, and community resources for better outcomes.

Multi-provider coordination
Community resource mapping
Care plan synchronization

Quality Measure Reporting

Meet CMS and state-specific quality requirements while improving member health outcomes.

Automated HEDIS reporting
State-specific measures
Real-time quality tracking

Comprehensive Medicaid MCO Platform

Purpose-built capabilities for Medicaid managed care organizations and their unique member populations.

Social Determinants Integration

Identify and address social barriers to health with comprehensive screening and community resource connections.

Behavioral Health Coordination

Integrate behavioral health services with primary care for holistic member management.

Maternal & Child Health

Specialized programs for pregnancy care, pediatric health, and family planning services.

Long-Term Services & Supports

Coordinate LTSS benefits with medical care for dual-eligible and high-need members.

Member Outreach Automation

Automated member engagement for appointment reminders, health education, and care gaps.

Predictive Risk Modeling

Identify high-risk members early with predictive analytics and intervention triggers.

Measurable Health Outcomes

Real improvements in member health outcomes and MCO performance metrics.

28%
Increase in Preventive Care
Members receiving recommended screenings
45%
Reduction in Readmissions
30-day hospital readmission rates
52%
Improvement in Medication Adherence
For chronic condition management
73%
Member Satisfaction
With care coordination services

Why Medicaid MCOs Trust Simpl

Member-Centered Care

Holistic approach addressing medical, behavioral, and social needs.

Regulatory Compliance

Meet all CMS and state-specific reporting requirements automatically.

Cost Effectiveness

Reduce avoidable utilization while improving member satisfaction.

Specialized Medicaid Programs

Targeted programs for specific Medicaid populations with measurable outcomes.

Maternal Health Programs

Comprehensive prenatal and postpartum care coordination with community support services.

Key Outcomes:

35% reduction in preterm births
89% prenatal care completion
67% postpartum visit compliance

Behavioral Health Integration

Integrated behavioral health services with primary care and substance abuse treatment.

Key Outcomes:

42% increase in BH engagement
31% reduction in crisis interventions
58% improvement in PHQ-9 scores

Chronic Care Management

Multi-condition care plans with medication management and lifestyle intervention support.

Key Outcomes:

28% reduction in A1C levels
34% fewer complications
46% improvement in self-care

Community Resource Integration

Connect members with community resources and social services to address social determinants of health and improve overall outcomes.

Social Services Directory

Comprehensive database of local social services, food banks, and community organizations.

Transportation Coordination

Integrate with transportation services for medical appointments and pharmacy visits.

Housing & Food Security

Address basic needs that impact health outcomes and care adherence.

Community Resource Integration Map
2,500+
Community Partners
84%
Resource Utilization

Transform Your Medicaid MCO Operations

Join Medicaid MCOs nationwide that have improved member outcomes, enhanced care coordination, and achieved better regulatory compliance with Simpl Healthcare.