Strategies to Help State Medicaid Agencies Maximize Their Impact and Advance Population Health

Abstract

State Medicaid agencies (SMAs) face an ever-evolving landscape characterized by increasing demands. To fulfill their traditional role as a source of health coverage and their newer role as a driver of population health, SMAs must manage two important sets of competing needs: 1) balancing collaboration, regulation, and purchasing; and 2) balancing daily operations with care delivery reforms. To help SMAs balance these needs, this report offers a strategic approach that includes:

• developing and managing key agency functions like benefits administration, compliance, and provider engagement,
• leveraging these functions to improve population health, and
• supporting their leadership teams.

To realize these goals, SMAs will need support from governors’ offices, umbrella health and human services agencies, and state legislators to properly fund their efforts. This backing would enable Medicaid agencies to consider ways to coordinate across agencies and identify other state agency investments that would have long-term benefits in Medicaid.

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