HJNO Jul/Aug 2026

HEALTHCARE JOURNAL OF NEW ORLEANS  I  JUL / AUG 2026 51 Joe Sullivan CEO Louisiana Healthcare Connections Network Management as a Lever for Improvement As expectations rise, so too does the responsibility of health plans to actively manage their provider networks. Network participation is not simply a matter of cre- dentialing or geographic coverage; it is in- creasingly tied to performance. Health plans are accountable to states for quality outcomes, and as a result, they must ensure that their networks are com- posed of providers who can meet those expectations. This includes evaluating performance on quality measures, respon- siveness to care coordination efforts, and willingness to engage in data sharing and improvement initiatives. Providers who consistently demon- strate strong performance and partnership will be positioned for continued success. Those who do not, whether due to poor quality outcomes, limited collaboration, or lack of data transparency, may find their role within health plan networks at risk. This is not punitive; it is a natural evo- lution of a system focused on outcomes. When resources are increasing and expec- tations are rising, maintaining the status quo is no longer a viable option. The Need — and Challenge — of Change Change is difficult. Healthcare, in particular, has long been shaped by established practices and entrenched workflows. But the current moment demands a different approach. The status quo has not delivered the level of health outcomes that Medicaidmembers deserve. Continuing along that path will not produce different results. For providers, the question is no longer whether change is coming, it is whether organizations are prepared to adapt. A Choice for the Future Medicaid’s future will be defined by those willing to evolve. Providers that em- brace quality accountability, invest in data capabilities, and engage as true partners with health plans will not only succeed, they will help transform the health of the communities they serve. Those that are unable or unwilling to make that transition risk falling behind in a system that is rap- idly moving forward. The opportunity is significant. With in- creased investment, clearer expectations, and stronger alignment between states, plans, and providers, Medicaid is posi- tioned to drive meaningful improvement in health outcomes. Realizing that poten- tial will require shared accountability and a willingness to change. For the families who rely on Medicaid, as well as the tax- payers funding it, change is not just neces- sary; it is overdue. n REFERENCES "Medicaid Managed Care Tracker,” KFF, n.d., accessed June 15, 2026, https://www.kff.org/ data-collections/medicaid-managed-care- tracker/. “Medicaid Enrollment Declines,” PAR Louisiana, July 28, 2025, accessed June 15, 2026, https:// parlouisiana.org/publications/medicaid- enrollment-declines/. “Overall in Louisiana,” America’s Health Rankings, 2025, accessed June 15, 2026, https://www. americashealthrankings.org/explore/measures/ Overall/LA. Louisiana Department of Health, “Louisiana Medicaid Increased Physician Reimbursement Rates Beginning July 1, 2025,” press release, July 29, 2025, https://ldh.la.gov/news/7537. Louisiana Department of Health, “Louisiana Medicaid Implementing New Payment Model for Hospitals,” press release, August 25, 2022, https://ldh.la.gov/news/6732. Joe Sullivan is the CEO of Louisiana Healthcare Connections. Previously, he served as the health plan’s chief operating officer and vice president of operations.Before joining Louisiana Healthcare Con- nections, he was the regional director of financial operations and area vice president of operations at Amedisys Home Health &Hospice Care.He received his MBA in finance fromWake Forest University and his bachelor’s degree inmarine transportation from the U.S. Merchant Marine Academy in Kings Point, NewYork. Providers are expected to not only de- liver care, but to demonstrate results. That includes: • Consistently meeting or exceeding quality benchmarks; • Actively sharing timely, accurate clin- ical and operational data; and • Engaging in coordinated care man- agement efforts with health plans. In this environment, passive participa- tion is no longer sufficient. High-perform- ing provider organizations are those that embrace data-driven care, engage with health plan quality strategies, and view collaboration as integral to their practice, not as an administrative burden. Data and Collaboration as Essential Infrastructure At the core of this shift is the role of data and coordinated care. Health plans aggregate and analyze population-level information that individual providers often cannot see in isolation: identifying rising-risk members, gaps in preventive care, and patterns of avoidable utilization. When that data is shared effectively, it becomes a powerful tool for providers, enabling earlier intervention, more informed clinical decision-making, and stronger alignment with quality goals. Similarly, collaboration around care management, especially for high-risk or complex populations, has been shown to improve outcomes and reduce avoid- able costs. Whether through care transi- tion support, embedded care managers, or coordinated outreach strategies, these partnerships are essential to delivering whole-person care. In short, data sharing and collaboration are no longer enhancements to care delivery. They are foundational capabilities required of Medicaid providers and health plans.