Despite the current and changing rules for Medicaid policy, financing, and reimbursement (see Building A Vision & Strategy For Navigating Uncertain Times: The Health & Human Service Leader’s Challenge), Medicaid remains a major payer in the U.S. health care system. It is currently 18% of the total U.S. health care spending (see National Health Expenditures Fact Sheet). That explains the interest of executives in the Medicaid RFPs that were released last year—among the most read RFPs in the OPEN MINDS Government RFP & Contract Database.

But the enrollees in state Medicaid plans are changing. The share of Medicaid-enrolled seniors and people with disabilities in health plans rose from 57% in 2019 to…