^{Pictured: Alexis Kalman, Tina Hawkins, Alisha Ray, Stephanie Christofferson, Claudia Soto, Dorinda Murray, Russell Thompson and Gabe Schoenlein.}

Prime Therapeutics (Prime)’s State Public Sector team recently attended the 2025 Medicaid Enterprise Systems Conference (MESC) in Milwaukee. Participants experienced a forward-thinking, collaborative environment focused on modernizing Medicaid systems — with a notable emphasis on pharmacy-related innovations. The conference featured over 100 sessions, including several that addressed the intersection of pharmacy, data and Medicaid policy. 

Pharmacy stakeholders explored how real-time analytics and artificial intelligence (AI) are transforming medication management, formulary oversight and pharmacy benefit administration. Sessions highlighted the use of predictive analytics to identify medication adherence risks and optimize pharmacy spend, as well as the integration of pharmacy data into broader Medicaid enterprise systems to support whole-person care. 

“Attending MESC 2025 gave us an opportunity to connect with clients, prospective clients and industry colleagues to strengthen existing relationships, form new relationships and gain insight into the Medicaid Rx market,” said Gabe Schoenlein, principal business analyst for Prime. 

One standout takeaway was the growing role of AI in pharmacy-related Medicaid operations. The Safe AI in Medicaid Alliance (SAMA) introduced frameworks for responsibly deploying AI in areas like prior authorization, fraud detection and pharmacy claims processing. Additionally, sessions emphasized the importance of modular system design to support pharmacy benefit managers (PBMs) and state agencies in adapting to evolving Centers for Medicare & Medicaid Services (CMS) regulations. 

“Our active participation at the MESC 2025 conference gives us the opportunity to influence decisions and policies at a national scale, said Russell Thompson, senior principal, IT architect for Prime. “We — along with peer service providers, state programs and regulatory agencies — form a community that can address how to incorporate regulatory updates from CMS, security mandates as well as technology advances in AI and data science to improve member access to care in a responsible manner.” 

Stakeholders from state Medicaid agencies, PBMs, health IT vendors and federal partners connected through panels and peer exchanges, fostering new collaborations aimed at improving pharmacy outcomes and reducing administrative burden. 

“Attending MESC 2025 conference was an inspiring experience, said Claudia Soto, assistant vice president, account management for Prime. “The sessions on One Big Beautiful Bill Act (OBBBA) legislation and AI advancements stood out. Our state partners are not just talking about the future — they’re actively building it. Seeing their engagement and readiness to implement real solutions made it clear: the future of Medicaid technology isn’t coming; it’s already here. I’m proud to be part of this transformative moment.” 

Alexis Kalman, director, analytics for Prime added, “Participating in MESC2025 allowed us to hear directly from CMS the strategic direction for all Medicaid clients. Clearly understanding the federal guidance and directives that states must follow positions us to make informed recommendations for modernization and program advancement, while staying focused on access to care and improving health outcomes.” 

Prime aims to build healthier communities by delivering affordable, reliable services that help improve health outcomes and coordinate care, while helping members the resources they need to live healthier lives.