Changes to Medicaid eligibility and renewal requirements under the One Big Beautiful Bill Act (OBBBA) are creating uncertainty for healthcare organizations. More frequent redeterminations, evolving work requirements and shorter windows to secure coverage are expected to affect patient coverage, operational workflows and financial performance.
For many health systems, the challenge extends into patient relationships and administration. Patients who qualify for Medicaid can lose coverage because they miss a notice, fail to submit documentation on time or struggle to navigate a process that remains largely manual and paper-based.
To help address these challenges, R1 is partnering with Fortuna Health, a digital Medicaid enrollment and navigation platform focused on simplifying the enrollment experience and helping eligible patients maintain coverage.
A More Connected Approach to Enrollment
Medicaid enrollment has traditionally relied on extensive paperwork, phone calls and manual follow-up. As policy changes increase the volume and complexity of eligibility and renewal activities, these processes can become difficult to scale.
"The upcoming Medicaid changes create both operational challenges and opportunities for innovation," said Andi Zaro, Senior Vice President at R1. "By combining R1's operational expertise with Fortuna's technology, including Fortuna’s embedded AI capabilities, and Medicaid specialization, we can help patients maintain coverage, reduce financial risk for providers and modernize the way enrollment support is delivered."
By combining R1's operational expertise with Fortuna's technology, including Fortuna’s embedded AI capabilities, and Medicaid specialization, we can help patients maintain coverage, reduce financial risk for providers and modernize the way enrollment support is delivered.
Through the partnership, R1 is expanding its financial clearance capabilities by complementing the Phare operating system’s pre-bill functionality with Fortuna's digital Medicaid enrollment platform. With integration points across scheduling, registration and billing, the partnership helps ensure no patient gets left behind during the enrollment process. Patients can complete applications through a mobile-first experience, upload documents electronically, receive reminders about required actions and stay engaged throughout the enrollment and re-enrollment process.
The partnership combines Fortuna's digital enrollment technology and Medicaid expertise with R1's operational experience supporting hospital revenue cycle and financial counseling functions. With the Congressional Budget Office estimating that the number of uninsured people will increase by 7.8 million by 2034, those capabilities are key in helping healthcare organizations expand enrollment support, streamline administrative work and focus staff attention where it is needed most.
Fortuna currently supports Medicaid enrollment across more than 21 states, with plans to expand into additional states by the end of 2026 and throughout 2027.
Supporting Patients When Coverage Matters Most
Many uninsured patients are eligible for Medicaid but never complete the enrollment process. Others lose coverage during renewal periods despite remaining eligible. In both cases, administrative barriers can prevent patients from accessing the benefits available to them.
Fortuna's platform is designed to reduce those barriers through digital document collection, text and email communications in multiple languages, application reminders, state-integrated workflows, and ongoing renewal support. Patients also have access to Fortuna’s trained navigators who can help answer questions, resolve issues and provide guidance when additional support is needed.
The partnership is especially valuable for vulnerable patient populations who may face barriers to obtaining and maintaining Medicaid coverage. By simplifying enrollment, reducing administrative hurdles and providing personalized support, R1 and Fortuna can help more patients access the coverage they need while improving the overall patient experience and satisfaction.
“No one who qualifies for Medicaid should leave the hospital without a path to coverage,” said Nikita Singareddy, co-founder and CEO of Fortuna Health. “We build technology that ensures patient applications, whether started at or after a hospital stay, get to the finish line. With this R1 partnership and shared commitment, we’re helping patients finish what they started and get covered.”
We build technology that ensures patient applications, whether started at or after a hospital stay, get to the finish line. With this R1 partnership and shared commitment, we’re helping patients finish what they started and get covered.
The result is a more accessible enrollment process that helps patients maintain coverage and avoid disruptions caused by missed deadlines, incomplete documentation or changing program requirements.
Helping Hospitals Reduce Financial Risk
By streamlining enrollment and renewal activities, the R1-Fortuna partnership can help hospitals improve Medicaid conversion rates, reduce self-pay volume, accelerate application completion and create greater operational efficiency within financial counseling teams. Fortuna has reportedly achieved an application approval rate of more than 95%, with patients completing applications on an average of just six to seven minutes for a single-person household.
The partnership is particularly relevant as healthcare organizations prepare for policy changes that may increase enrollment complexity while reducing the time available to secure coverage after discharge. This digital front door to Medicaid enrollment can help hospitals identify eligible patients earlier, connect them with enrollment support and guide them through the process to help them obtain and maintain coverage.
Building for the Future
As administrative requirements become more complex, organizations need solutions that combine technology, automation and operational expertise to support both financial performance and patient access.
For R1 customers, the collaboration with Fortuna provides a new way to modernize Medicaid enrollment and financial counseling operations. By connecting digital engagement, proactive outreach, specialized Medicaid expertise and operational support, the partnership aims to create a more efficient experience for providers and a simpler path to coverage for the patients they serve.
