State Medicaid agencies play a critical role in supporting the health and well-being of millions of people nationwide. The effectiveness of these programs depends in large part on the leaders at every level responsible for their design and delivery. When Medicaid leaders have the skills, relationships, and support they need, they are better positioned to strengthen programs, navigate challenges, and improve outcomes for the people Medicaid serves.

Over the past five years, the Medicaid Pathways Program (MPP), through support from the Robert Wood Johnson Foundation, has invested in 100 rising Medicaid leaders from 37 agencies, helping them build new skills, strengthen the pipeline of future Medicaid leaders, and create a robust national peer network of senior Medicaid officials. To mark the program’s five-year milestone, the Center for Health Care Strategies spoke with four former MPP participants about their leadership journeys and how they have sustained and grown in their roles.

The alumni featured include Cristen Bates, Deputy Medicaid Director and Director, Office of Behavioral Health Initiatives & Coverage, Colorado Department of Health Care Policy and Financing; Sonali Duggal, Senior Director, Integrated Fiscal Strategy, MassHealth; Gene Hermanson, Deputy Medicaid Director, Montana Department of Public Health and Human Services; and Jill Stemple, Policy Director, Office of Mental Health and Substance Abuse Services, Pennsylvania Department of Human Services.

Four Leadership Lessons from MPP Alumni

The experiences shared by these alumni underscore the value of leadership development for individuals, teams, and Medicaid programs. Their reflections reveal four lessons about leading through change, empowering others, and growing as a leader over time.

1. Self-awareness drives leadership growth.

Increased self-awareness enables leaders to understand their strengths, limitations, and impact on others. As the reflections below illustrate, this insight can reshape how leaders approach decision-making, relationships, delegation, and day-to-day leadership practices.

C. Bates: I’m very extroverted, and I’ve learned a lot about working with introverts. I think about it often and create structures so introverts and extroverts feel comfortable, prepared, and can get what they need from meetings. For example, I prioritize written follow-up and better understand the value of an agenda. I view this as inclusivity, which I hadn’t thought of before.

G. Hermanson: I now prioritize self-reflection on a daily basis. There’s always a lot going on in Medicaid, but I regularly take time to self-reflect and ensure that I’m working at the right level.

2. Effective leaders empower teams.

Bringing leadership skills and tools back to teams strengthens collective performance by fostering clarity, trust, and shared accountability. When leaders model and apply these practices, they empower team members, strengthening team performance and organizational impact.

S. Duggal: I was clinging to the idea that accomplishing tasks made me valuable in my role. I didn’t embrace that it’s okay — and important — to delegate. I built confidence in MPP and embraced a shift in my role by focusing on relationships, vision, and support. I now coach others to carry out tasks and no longer feel my sense of worth is tied to doing everything myself.

J. Stemple: I’ve incorporated the staff development model we learned in MPP into my bureau’s processes. It informs our approach to succession planning and building a bench of emerging leaders who are ready to step up to the next level. We’ve also built it into our performance standards for staff. This tool helps our team think about where staff are growing and how we can best support them. This has become a shared practice and value across all supervisors in my bureau.

3. Investing in leaders strengthens Medicaid programs.

When leaders build skills to effectively manage the pace of change and shifting priorities, they approach policy efforts more strategically and collaboratively. This leads to stronger, more responsive policies that improve outcomes for members and stakeholders.

S. Duggal: When I finished MPP, MassHealth launched a major initiative to implement a mandatory primary care sub-capitation program for every single primary care practice — 1,100 practices at once. My team used a stakeholder analysis exercise I learned through MPP to work through it. It was helpful to step back, understand which stakeholders were affected, and plan our communications. The program is now fully implemented and running.

G. Hermanson: Delegation, done well, is impactful for big, complex initiatives. For example, we recently undertook a multi-pronged approach to a waiver application, which was ultimately approved by the Centers for Medicare & Medicaid Services. We also changed our state regulations for implementation and put out policy bulletins. It took strong delegation, clear ownership, and shared accountability across the team. Without those leadership skills, we wouldn’t have gotten these projects across the finish line.

4. Leadership development is a lifelong journey that grows through connection.

Leadership extends beyond any one individual. MPP provides a forum where participants can deepen their leadership approach, learn from peers, and continue applying those lessons long after the program ends. For example, building trusted national networks can advance collaboration and shared learning across states, while creating lasting professional relationships that leaders can draw on throughout their careers.

J. Stemple: I’m an introvert and don’t like big groups, but through my experience with MPP, I felt like I could engage and be comfortable in a big group, especially when it’s a group that has shared interests and we’re collectively working together on our leadership skills.

C. Bates: I left MPP with a solid cohort of Medicaid leaders I trust, who understand where I’m coming from and what I’m trying to accomplish. I’m now more adept at building cross-state collaboration and see the value of working with other Medicaid experts, especially subject matter experts. Having a national network to learn from helps me better support Colorado’s program. We can learn best practices as public servants from every single state, every single type of governor, administration, or secretary-level position. I think that is how you make national change in a program that is so state specific.

Now entering its sixth year, MPP continues to demonstrate that investing in people is an investment in stronger Medicaid programs. While policies and priorities evolve, the need for thoughtful, collaborative leaders remains constant. By deepening leadership skills, fostering lasting peer networks, and preparing the next generation of Medicaid leaders, MPP is helping build a more resilient Medicaid ecosystem that is better equipped to serve communities today and into the future.