How State Public Health and Medicaid Agencies Can Build Partnerships to Improve Outcomes
State officials share strategies for expanding and sustaining collaborative efforts
Throughout the country, states are working to improve health outcomes with the efficient use of resources. In particular, they are building partnerships between public health and Medicaid agencies to better align programs, funding, and expertise around shared goals.
To help states develop effective cross-agency partnerships, the nonprofit Center for Health Care Strategies, in a project with The Pew Charitable Trusts, interviewed public health and Medicaid officials from 14 states to explore how collaboration can support individual agency goals and to discuss strategies for establishing and maintaining successful relationships. Below are key findings from these interviews.
Partnerships can help states turn shared priorities into action
In many states, public health and Medicaid agencies have formed partnerships around shared priorities set by state administrators, legislative mandates, and grant funding requirements. These efforts are often focused on individual health issues or programs, but their scope can expand and evolve as health needs shift. Many states formalize partnerships through joint strategic planning and written agreements. For example, New Hampshire created a statewide roadmap that outlines shared priorities, goals, and efforts to improve population health. Such written agreements help increase interagency collaboration by highlighting common goals.
Successful partnerships are built around data sharing
Public health and Medicaid agencies each collect data that can provide valuable insight. While Medicaid agencies can share demographic data and information on healthcare providers and healthcare utilization and claims, public health agencies can share data on disease prevalence, population health measures, and immunizations. In interviews, state officials reported that they use cross-agency data sharing to better understand their population health needs, identify service gaps, evaluate statewide health initiatives, and more efficiently use resources.
While some states rely on ad hoc data-sharing practices, others have formalized agreements that establish sustained data sharing between the two agencies. In Massachusetts, the public health and Medicaid agencies share aggregated administrative data, such as the number of doulas enrolled as Medicaid providers and doula certification rates to support statewide doula workforce planning and increase access to doula services among Medicaid enrollees.
Officials in other states described the value of data-sharing agreements that define what data may be shared and how it may be exchanged and used. Once an agreement is in place, staff in both agencies can work together more efficiently. In North Carolina, the public health and Medicaid agencies have created data-sharing agreements for specific initiatives. For example, to help identify pregnant Medicaid beneficiaries who qualify for WIC—the federal supplemental nutrition program for women, infants, and children—the public health agency provides birth registry data, while Medicaid provides enrollment and claims data.
States also use shared data to create public-facing dashboards and reports to inform community health work. For example, Alaska’s state health information exchange uses both Medicaid and public health data to inform healthcare providers on treatment decisions and efforts to improve quality of care.
Strong relationships and leadership buy-in can promote partnerships
Staff expertise, strong cross-agency relationships, and leadership support all help fortify data sharing and other collaboration between public health and Medicaid agencies. State leaders have found that establishing and maintaining ongoing relationships across all levels of staff can help build leadership support and strengthen partnerships. For example, the New Jersey public health agency holds multilevel interagency meetings that cover state health priorities, collective goals, and long-term vision.
State officials cautioned that partnerships can be difficult to sustain when leadership changes, staff capacity is limited, data systems are incompatible, or agencies lack clear processes and permissions for data sharing. Even when permissions are in place, some states report that barriers such as incomplete demographic data or privacy concerns can prevent them from using the information effectively. For example, state officials in Tennessee noted that strict interpretation of state legislation on data privacy has limited the type of information that can be shared in public health-Medicaid agency partnerships. Officials emphasized the importance of formal structures such as data use agreements, regular data sharing, and shared databases to support exchanges over time.
Further efforts can help expand existing partnerships
This research demonstrates the opportunity for public health and Medicaid officials to grow existing state partnerships and adapt strategies to their specific needs. States can begin by:
- Identifying resources that could support partnerships, as well as existing points of connection between public health and Medicaid agencies.
- Documenting data assets housed by state public health and Medicaid agencies.
- Reviewing current data use agreements and identifying ways to expand their application.
- Reviewing current state priorities and identifying an initial health issue that could be better addressed through coordinated action by public health and Medicaid agencies.
As partnerships mature, states can formalize arrangements through routine communication channels, data-sharing processes, and other structures that support long-term collaboration. With those relationships in place, states can better understand population health needs, improve care coordination, increase program efficiency, and advance health outcomes.
Amanda Carrillo-Perez is a senior associate, Rachel Zetts is a senior officer, and David Hyun is a director with The Pew Charitable Trusts’ state health solutions project.
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