Mr. Balaji Shesharao Ingole

AI-Driven Innovation in Medicaid: Enhancing Access, Cost Efficiency, and Population Health Management

The U.S. Medicaid program, which provides health coverage to low-income individuals and families, faces numerous challenges related to rising healthcare costs, care accessibility, and managing diverse population health needs. This paper explores how Artificial Intelligence (AI) can transform Medicaid by optimizing operations, improving patient outcomes, and reducing costs. We focus on AI’s role in predictive analytics, care coordination, fraud detection, and personalized medicine. Drawing insights from existing data models and Medicaid-specific challenges, we propose AI-driven solutions that align with Medicaid's focus on equitable care delivery and public health outcomes. Additionally, we analyze how localized AI models can address privacy and regulatory issues, ensuring compliance while enhancing efficiency.