This is the first article in our LinkedIn series called “AI Can’t Wait.”  I mentioned in a post last week that I will be exploring how health plans can prepare for the real-world impact of the Big Beautiful Bill.

Our goal is to offer practical insights on how AI-led engagement can help organizations navigate these changes with greater precision, speed, and scale. First up – a focus on Medicaid. The rules are shifting fast, and here is how plans can act now to stay ahead.

The $50 billion Big Beautiful Bill (BBB) is setting in motion some of the most sweeping changes to Medicaid we've seen in years. The operational shift for health plans and states will establish new requirements, new member behaviors, and potentially a dramatically higher bar for outreach and compliance.

Most plans already know this. But acknowledging the challenge and being ready to act are two different things.

At RadiantGraph, we want to help organizations prepare for what’s next. So let’s dive in.

What’s Changing

Under new guidelines, Medicaid programs are required to verify member eligibility and work-related activity on an ongoing basis. That includes confirming 80 hours of work, volunteering, or qualifying activity each month, unless exempt. The complexity of the process, the variability across populations, and the pace of rollout mean millions of members risk losing coverage not because they’re ineligible, but because they don’t respond in time or don’t understand the steps.

Plans and state-level Medicaid administrators will need to deliver personalized outreach, ensure compliance, and report outcomes. And, as I have mentioned previously and consistently, this isn’t about politics or opinion. It’s about operational processes, data, and capacity.

While all of us are still unpacking the full implications, there are important dynamics at play between states and plans. Reporting requirements ultimately sit with the states, but it is the plans that are responsible for driving adoption. Striking the right balance, and clearly communicating where responsibilities lie, will be critical.

Is Member Experience Now a Compliance Issue?

For many Medicaid enrollees, communication gaps are real. They may not open mailers, miss phone calls, or not see text messages. Yet today, those very messages determine whether they keep their coverage. Medicaid is plagued by the “unable to reach” (UTR) population, often estimated at 20–30%, making it incredibly difficult for states and plans to confirm eligibility or provide critical updates.

To meet this moment, plans need to go beyond mass messaging and think strategically about who is at risk, what their barriers are, and how to reach them effectively.

This is where AI-led engagement becomes necessary. At RadiantGraph, we combine predictive modeling, behavioral signals, and real-time data to create Smart Cohorts, which are groups of members with shared risk factors, communication preferences, and response patterns.

Then we pair those cohorts with automated content generation and voice AI, enabling plans to deploy targeted, ongoing outreach that feels human.

But, healthcare, like every other industry, needs time to test engagement models, refine messaging, integrate data sources, and ensure outreach is aligned with compliance workflows and that window is closing quickly.

There’s also a resource angle to all of this too. The staffing and infrastructure required to do this manually are significant. But AI and automation can help offset that burden. It’s not about replacing people, but about equipping teams with tools that learn, adapt, and support operations.

This Is an Opportunity to Lead

Health plans that move quickly can build an engagement model that not only meets the new Medicaid requirements, but also improves member trust, satisfaction, and retention. With key provisions set to take effect starting December 2026, including increased eligibility redeterminations and work requirements for able-bodied adults beginning January 1, 2027, there is little time to waste.

By acting now, health plans can avoid last-minute scrambles and position themselves for long-term success. In the long run, that means fewer disruptions, better health outcomes, and more sustainable operations.If you’re a plan executive, I’d encourage you to ask:

• Do we know which members are most likely to fall through the cracks?

• Can we personalize outreach at scale based on real-time behavior?

• Are we closing the loop between outreach, compliance, and operations?

If the answer is “not yet,” now is the time to act.

In the coming weeks, we’ll cover other issues being impacted by this Bill and I look forward to sharing ideas and hearing how you’re thinking about this evolving landscape.

Want to know more? Reach out to the our team to learn how we can help engage members to recent Medicaid requirements: https://radiantgraph.com/Contact-Us

Visit www.RadiantGraph.com to learn more about how AI can boost your member engagement efforts.