MediKey

MediKey is an AI-powered platform that helps healthcare organizations identify eligible patients, automate Medicaid enrollment and recertification, and prevent coverage loss while reducing uncompensated care.

Active

Providence, RI

Open source: No

MediKey is an AI-powered Medicaid eligibility and retention platform developed by ITO Health to address one of the most persistent challenges in U.S. healthcare: eligible individuals losing or failing to obtain coverage due to administrative complexity. The project began in 2024 in response to growing demand from healthcare organizations navigating Medicaid redetermination and, more recently, work requirement policies. MediKey is designed for hospitals, federally qualified health centers (FQHCs), behavioral health providers, and Medicaid managed care organizations that serve large Medicaid populations and are financially and clinically impacted by coverage churn. It is used by frontline staff such as community health workers, financial counselors, and care managers to identify uninsured or at-risk patients, determine eligibility using rules-based logic, and guide them through enrollment and recertification workflows. To date, MediKey has been deployed across multiple healthcare and community-based settings, helping organizations identify significant missed Medicaid revenue, reduce uninsured rates, and streamline enrollment workflows. Early implementations have demonstrated the ability to uncover tens of thousands of dollars in previously unbilled encounters within months, while also improving patient access to care and continuity of coverage. We are actively seeking partners across state agencies, healthcare systems, and community organizations to expand this work. Opportunities to support the project include piloting MediKey in new jurisdictions, collaborating on Rules-as-Code standardization efforts, contributing to policy-to-code translation, and partnering on research and evaluation to further validate impact.