The Medicaid Enterprise Systems Conference (MESC) has always been a gathering place for leaders shaping Medicaid’s future. In 2025, the focus of conversation centered on adapting, building trust, and keeping pace with the new pressures brought by HR 1 and rapid AI adoption.

For Briljent, the week in Milwaukee was about listening to the challenges states face, learning from peers, and returning with insights on how to help agencies prepare people beyond systems for what comes next. The themes were clear: compliance is tightening, technology is advancing, and readiness is everything.

HR 1: The Defining Policy Force

“The real challenge isn’t understanding the rules. It’s executing them without overwhelming staff, losing coverage accuracy, or eroding public trust.”

At MESC, HR 1 (The One Big Beautiful Bill Act) was a clear undercurrent. Work requirements, tighter eligibility verification, and new compliance expectations are converging quickly—and the operational lift will be significant.

👉 What the One Big Beautiful Bill Means for State Agencies, Vendors, and Implementation Teams

The real challenge isn’t only understanding the rules. It’s executing them without overwhelming staff, losing coverage accuracy, or eroding public trust. Legislative scrutiny and media attention will only heighten the stakes. For technology partners, these pressures mean modernization projects can’t succeed without workforce alignment and clear adoption strategies.

That’s why Organizational Change Management and training stood out as priorities. Preparing staff to adapt, communicate, and collaborate across silos is the difference between controlled implementation and cascading disruption.

AI Adoption: Beyond the Hype

“Every posture—from cautious to bold—can be productive if supported with the right training, communication, and change management.”

Another emerging theme at MESC was the promise (and uncertainty!) of AI. While AI tools are advancing quickly, adoption still depends on people’s confidence and readiness. Staff resistance, job security concerns, and uneven training were named as barriers across multiple sessions. Governance and monitoring were also flagged as areas often overshadowed by the excitement of new pilots.

👉 AI OCM and Training

At our booth, we brought this challenge into focus through an interactive AI Persona Quiz. The goal was to spark conversation about how different attitudes toward AI can shape adoption. The real insight was that every posture—from cautious to bold—can be productive if supported with the right training, communication, and change management to adopt AI with clarity and trust.

Throughlines from the Field

“Success in Medicaid modernization isn’t just about technology—it’s about people, preparation, and partnerships.”

Success in Medicaid modernization isn’t just about technology; it’s about people, preparation, and partnerships. In our conversations at MESC, four themes stood out:

1. OCM and Training Are Essential. Again and again, sessions reinforced that organizational change management and training are the linchpins of adoption—whether implementing HR 1 requirements, rolling out AI pilots, or modernizing eligibility systems. Projects falter when staff aren’t supported to adapt to new systems and processes.
2. Data Without Action Falls Flat. As one session put it, “Reporting isn’t analytics—it’s just reporting.” Agencies are generating massive amounts of data, but the value lies in translating it into decisions. The demand is not just for dashboards, but for alignment between technical skill and strategic execution.
3. Technology Outpaces Readiness. Investment in infrastructure is growing, but human adoption lags behind. Without a clear path to readiness, new systems risk becoming shelfware instead of solutions. This is where training and OCM can bridge the gap between innovation and implementation.
4. Connection Matters Most. As one Briljent colleague reflected, “Technology is the tool, but solving problems relies on connecting with people in a way that makes them heard and understood.” That spirit was echoed across MESC: partnerships and trust are what turn plans into outcomes.

👉 From Confusion to Cohesion: How OCM Enhances System Modernization

Looking Ahead: Preparing People for What’s Next

MESC 2025 underscored a reality that leaders already know: Medicaid’s future depends less on new systems and more on how people are prepared to use them. HR 1, AI pilots, and eligibility modernization are all converging, and the margin for error is shrinking.

Briljent’s role is to ensure that agencies don’t face those pressures alone. We combine organizational change management, training, and strategy to turn complex mandates into manageable actions and help teams adapt confidently.

States and partners alike are looking for more than compliance—they’re looking for outcomes that last. That starts with people who are ready for change, supported by partners who understand what’s at stake. That’s where Briljent shows up.

As the landscape continues to evolve, our commitment remains constant: centering people, building trust, and fostering partnerships that make lasting change possible. With empathy, clarity, and collaboration, we’re ready to help shape the next chapter of Medicaid innovation—together.