Medicaid continues to gain scale and importance nationally – as both the leading source of health coverage for Americans, and as a change agent within the healthcare marketplace.

With the number of Americans obtaining health coverage through Medicaid at an all-time high, and mounting evidence of the benefits of Medicaid expansion – to patients, providers, and states – 2016 will be a year of continued growth and change.

Interest in Medicaid expansion will remain high, enabled by the Centers for Medicare & Medicaid Services’ (CMS) willingness to consider alternative expansion designs. With the foundation of coverage laid and the push for payment and delivery system reform occurring in all parts of the healthcare system, expect states to ramp up their efforts to extract more value for their dollar. New payment vehicles that incentivize providers to adopt more effective and efficient models of care will continue to gain steam, along with renewed focus on the highest-cost and highest-need patients, including the frail elderly, the disabled, justice-involved populations, and those with serious mental health and substance abuse problems.

Finally, with a Presidential election on the horizon, there will be enormous pressure on federal regulators to secure the legacy of the past eight years. Expect a flurry of activity from CMS in these next months – finalizing regulations, upgrading systems, setting parameters on waivers, and generally tying up loose ends – efforts that will be hampered, but not halted, by accelerating staff turnover in anticipation of a new Administration, and continued scrutiny in the politically charged lead-up to election day.