At this critical time, states are searching for ways to curb Medicaid spending growth without compromising vital health care services for the country’s most vulnerable populations. This policy brief outlines five of the most promising opportunities to improve the health of high-risk Medicaid beneficiaries. States adopting these strategies can lead the health care system in providing cost-effective and high-quality care within Medicaid and beyond. CHCS published this brief through funding from the Robert Wood Johnson Foundation and with the assistance of the Government Innovators Network at the Harvard University Kennedy School of Government.