Protecting Medicaid’s Most Vulnerable: A Call for Smarter Solutions

With Medicaid funding under scrutiny, the healthcare landscape for the nation’s most vulnerable populations hangs in the balance. Scott Schnell, CEO of  MedZed has dedicated over a decade to reaching and supporting Medicaid and dual-eligible members who are often disengaged from primary healthcare. 

His message is clear: slashing Medicaid programs without careful consideration will not only harm those who need care the most but also drive up healthcare costs in the long run.

For the past 11 years, MedZed has provided community-based healthcare services across 11 states, partnering with 22 health plans, hundreds of providers, and community organizations. Schnell and his team specialize in finding and engaging high-risk, hard-to-reach patients—those who account for a staggering 30-50% of total healthcare spending.

According to recent rankings from one of California’s major Medicaid managed care plans, MedZed ranks among the top Enhanced Care Management providers in Los Angeles (#2 out of 30) and San Diego (#4 out of 20). Another Medicaid managed care plan gave MedZed high marks for achieving quality improvements for members with high blood pressure and diabetes, noting the company outperformed the company’s targets by 12 times for both groups. 

These rankings underscore the importance of preserving and expanding community-based healthcare solutions rather than cutting programs that have a demonstrated impact on cost savings and patient outcomes.

Avoiding Short-Sighted Cuts

Schnell warns that the proposed $880 billion in Medicaid cuts cannot be offset by merely reducing fraud, abuse, or administrative waste. 

“There’s not that much there,” he states. “We need to protect essential programs that provide preventive care, social support, and care coordination. Without these, we’re simply shifting costs elsewhere—to emergency rooms, hospitals, and crisis interventions that are significantly more expensive.”

Studies have consistently shown that addressing social determinants of health—such as stable housing, access to healthy food, and reliable transportation—reduces unnecessary ER visits and hospitalizations. Without funding for these programs, healthcare costs won’t disappear; they will simply be passed on to providers and the healthcare system overall. 

As policymakers debate Medicaid reforms, Schnell urges them to consider three key factors:

1. Are we truly saving money, or just shifting costs to other areas of the healthcare system?
2. Will these cuts reduce expenses, or will they drive up costs long-term as patients avoid care due to financial barriers?
3. How can we invest in smarter Medicaid solutions that prevent costly crises before they happen?

The Power of Community Health Navigators

A cornerstone of MedZed’s success is its team of Community Health Navigators (CHNs)—dedicated professionals who work directly within the communities they serve. Unlike traditional healthcare providers, CHNs meet patients where they are, conducting home visits and building relationships based on trust and shared experiences.

“Our CHNs live in the same neighborhoods, speak the same languages, and often attend the same places of worship as the people they serve,” Schnell explains. “This authentic deep connection makes all the difference in engagement and care outcomes.”

The impact speaks for itself. Through its CHN-centered model, MedZed has achieved remarkable results:

• 40% engagement rate from total referrals
• 38% reduction in emergency room visits
• 54% decrease in inpatient admissions and total medical costs

Schnell attributes the success of CHNs to four key factors:

• Trust-building: CHNs form personal connections with patients, creating a sense of familiarity and reliability.
• Passion: Many CHNs have personal experiences with healthcare disparities, fueling their dedication to making a difference.
• Coordination: CHNs work closely with local providers, community organizations, and health plans to ensure holistic support.
• Strong leadership and support: MedZed’s leadership fosters a culture that empowers CHNs and provides the necessary tools to succeed.

To further validate MedZed’s CHN-centered strategy, Schnell points to the results of a recent Center for Medicare and Medicaid Innovation (CMMI) evaluation of the Accountable Health Communities (AHC) model. He says the study proves what he and his team have long known: Community Health Navigators (CHNs) are the primary driving force behind better outcomes. Their ability to build trust and guide members through the healthcare system helped to reduce total costs for Medicaid members by 3% and by 4% for Medicaid members. Importantly, the study found that even when social needs, like food insecurity and transportation, weren’t fully addressed, CHNs still improved health outcomes by helping members navigate the system, keeping them engaged in care, and offering advocacy so acutely needed.

Leveraging Technology for Better Care

To amplify its strength in human connection, MedZed continually cultivates an infrastructure of tech-driven solutions to enhance efficiency and improve patient care. The company invests millions annually in technology to streamline scheduling, automate care plans, and integrate with health IT systems.

Some of MedZed’s most impactful innovations include:

• Customized care plans and state-specific assessments to navigate Medicaid’s complex, state-by-state regulations
• Real-time alerts for critical patient issues, ensuring timely intervention
• A goal to incorporate AI-powered scheduling and note-taking to reduce administrative burdens on healthcare workers

As MedZed continues to evolve, the company is investing in Salesforce Health Cloud and automation tools to further enhance its ability to track and engage patients.

A Scalable Model for the Future

With over 50,000 patients served and more than a million hours of care delivered, MedZed has developed a scalable model that can be expanded to new markets. Schnell envisions a future where community-based healthcare becomes the standard for Medicaid populations nationwide.

“In the richest country in the world, over 80 million Medicaid members still face hunger, homelessness, and healthcare barriers,” Schnell says. “We believe our model can reach and support a million people through strategic partnerships with health plans, provider groups, and hospitals.”

Despite growing challenges, Schnell remains optimistic about the future. His final message is clear: cutting Medicaid programs without considering their broader impact will lead to higher costs and poorer health outcomes. Instead, investment in proactive, community-driven healthcare solutions—like MedZed’s CHN model—can reduce costs while improving lives.

With Medicaid’s future hanging in the balance, one thing is certain: the need for smart, sustainable solutions has never been greater.

Scott H. Schnell is co-founder and chief executive officer of MedZed, a for-profit provider of community-based services to address the Health-Related Social Needs of high-risk, high-need Medicaid and dual-eligible Medicare members who are hard to reach and disengaged from primary healthcare. Since starting the company in 2014 with the mission to inspire and enable better health, Schnell has developed MedZed’s business model, technology platform and member acquisition plan to partner with managed health plans to improve member health outcomes, lower utilization rates and reduce costs. An entrepreneur for several decades, Schnell has started, grown, led and sold several companies.