Dr. Rajaie Batniji, CEO and Co-Founder of Waymark, joins the podcast to discuss the opportunity to innovate in Medicaid managed care, how Medicaid is structured in the US and organized in each state, why Medicare Advantage startups pull in much more outside capital than Medicaid startups, and more!
Summary
Dr. Rajaie Batniji Discusses Innovations in Medicaid Managed Care
Dr. Rajaie Batniji, CEO and Co-Founder of Waymark, was recently interviewed by Jacob Emerson, where he discussed the potential to innovate Medicaid managed care. Here are some key takeaways from the podcast:
Medicaid in the US
Dr. Batniji explains that Medicaid is structured differently in each state, with some states having more managed care organizations while others have more fee-for-service arrangements. He also notes that Medicaid covers a wider range of services compared to Medicare, making it a more complex system.
Disparity in Venture Funding
Dr. Batniji notes that Medicaid startups do not receive as much venture funding compared to Medicare Advantage startups. He believes that this is due to the lack of market concentration and clinical need, making it a less attractive option for investors. However, he sees the potential to deliver solutions at a massive scale, which could make it a more appealing option in the future.
Community-Based Care Models
Waymark is working to build technology and a new healthcare workforce to create community-based care models for Medicaid patients. They partner with payers, providers, and local organizations to reach out to those who are rising in risk and have not been plugged into care yet. The technology identifies those individuals whom they can best serve and their team reaches out through phone calls, knocking on doors, and meeting them in the community. They also use a product called Lighthouse to help their healthcare workforce operate with the same experience as an experienced provider.
The Future of Medicaid Managed Care
Dr. Batniji believes that Medicaid managed care will continue to evolve and that there will be a greater push for value-based care. He also sees the potential for technology to play a larger role in healthcare, especially for Medicaid patients.
Overall, Dr. Batniji provides a thoughtful perspective on the state of Medicaid managed care and the opportunities for innovation. With companies like Waymark leading the way, it will be interesting to see how the industry develops in the coming years.
Note: This is an AI generated transcript, not edited by a staff writer and is solely intended for educational purposes. If you have any questions/concerns, reach out to podcasts@beckershealthcare.com
This episode aired on 04/11/2023 and can be listened here.
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