Escaping the Year-End Dash: Why Medicaid Plans Must Shift to Year-Round Engagement

For years, Medicaid plans have relied on a familiar ritual: the year-end sprint to close care gaps, re-engage hard-to-reach members, retrieve charts, and salvage HEDIS performance before the deadline hits. But in 2025, that sprint has become more unsustainable than ever— and in many cases, unwinnable.

The members who most influence quality scores are often the least connected to the healthcare system. They’re navigating unstable housing, food insecurity, unpredictable work schedules, caregiving burdens, and chronic condition fatigue. These are not issues that can be solved with a burst of automated calls in Q4.

That’s why a growing number of plans — and the partners who support them — are pivoting to year-round engagement models that reflect the realities of Medicaid populations.

Why the Year-End Dash Is Failing 

There are several structural reasons why the traditional Q4 sprint no longer works—and why plans are increasingly unable to rely on it.

1. Trust can’t be built in November: Disengaged members don’t reappear because a plan calls once a year. Trust is built through consistent touchpoints over months — not days — and through relationships strong enough to support navigation, shared decision-making, and follow-through.

2. Care gaps rarely exist in isolation: Behind every missed screening or follow-up is a real-life barrier: no transportation, unstable housing, food insecurity, lack of caregiver support, or unfamiliarity with the healthcare system. Addressing these issues requires a whole-person approach and the steady presence of care teams, not a last-minute rush. This longitudinal whole-person approach also enables a virtuous circle of improvement to members’ overall well-being and extends the benefits beyond immediate HEDIS compliance to other important areas such as utilization reductions without significant additional effort. 

3. Digital HEDIS and redetermination churn demand continuous accuracy: Digital reporting leaves little room for retroactive fixes. If documentation isn’t complete all year, it won’t be fixable in Q4. Likewise, fluctuating Medicaid eligibility requires ongoing member tracking — not episodic outreach.

4. Providers can’t absorb seasonal spike: Primary care practices are already strained. When hundreds of chart requests and gap-closure reminders arrive at once, provider abrasion increases, and cooperation drops. Predictable, year-round collaboration is more sustainable for everyone.

Why Year-Round Engagement Wins

A continuous engagement model distributes the work across 12 months — smoothing operational load, improving documentation accuracy, and stabilizing performance. Plans that engage members consistently see higher follow-through on visits and referrals, stronger relationships with providers, and fewer avoidable escalations.

This is the philosophy behind MedZed’s hybrid field-and-tech model: support disengaged members every month of the year, not just at the end of it. Field teams build trust in homes and communities, help members understand how to navigate the system, introduce them to their primary care providers, coordinate follow-ups, and address whole-person needs such as food, transportation, and housing support.

When these barriers are addressed steadily over time, the clinical gaps close naturally — and stay closed.

The Path Forward: Quality Must Be a Year-Round Operation

The year-end dash belongs to a different era of HEDIS. Complex populations, digital reporting, and regulatory shifts have made it clear that quality must be a year-round operation.

If more of the system adopted this mindset — and the infrastructure to support it — the Q4 scramble would fade, replaced by a steady cadence of member engagement and provider collaboration.

This isn’t just a more humane approach for members. It’s a more realistic approach for plans.

And in today’s Medicaid landscape, it’s the only approach that truly works.