Lorie Martin and Hilary Kennedy, National Association of Medicaid DirectorsMay 23, 2019
Medicaid directors in states across the country navigate an increasingly complex world, one in which they balance the needs of internal staff, external stakeholders, a dynamic federal partner, and — of course — the beneficiaries that their program serves. Yet, while Medicaid directors essentially serve as the CEOs of the largest health plans in their states, they often move up the ranks within state government with little of the kinds of executive leadership training ubiquitous in the corporate world.
To help Medicaid directors and their senior management teams steer the course, the Center for Health Care Strategies (CHCS) is partnering with the National Association of Medicaid Directors (NAMD) to launch a new podcast series, Medicaid Leadership Exchange. The podcast series, made possible with support from the Robert Wood Johnson Foundation, features discussions with Medicaid directors on priority topics related to leading their state agencies. The conversations offer candid insights into leadership strategies that have worked — and those that have not worked — straight from Medicaid directors themselves.
Following are brief descriptions of the first three episodes in the series. We hope that you will listen to these 20-30 minute conversations when you have space in your day — making breakfast, walking the dog, or on the commute to the office — and that they serve as a resource to support your leadership development efforts.
This conversation — led by Ed O’Neil, a leadership development expert focused on change and renewal in the health care system — features insights on Medicaid leadership from Gretchen Hammer, former Colorado Medicaid director and senior strategic advisor for NAMD, and Mark Larson, former Vermont Medicaid director and vice president of policy at CHCS. Gretchen and Mark joined Ed to discuss their approaches to leadership, and how it is both an art and a science. Key takeaways include:
- Medicaid is an ever-evolving landscape, which requires leaders to adapt, while simultaneously maintaining predictability and stability for staff. One way to walk that tightrope is to have authentic interactions across different types of relationships, building trust both internally and externally.
- Leadership is a balance of getting things done while still keeping one’s sights on the end goal. It is important to develop mechanisms that allow for time and focus on the broader strategic work of the agency, despite the constant pull of day-to-day tasks.
- Medicaid directors, like many leaders in the public sector, are often in that role for a short period of time. Forming effective habits and mindsets can help one take advantage of a short tenure, and engage in relationships and activities that support oneself and teams.
It has been a long time since Medicaid agencies were charged with simply paying claims for services delivered. Today, in many states, Medicaid is a key driver of broader delivery system and payment reforms, and often works in partnership with other agencies on innovative ways to address social determinants of health and gaps in health equity. In this episode, Allison Taylor, Indiana Medicaid director, and Cindy Beane, West Virginia Medicaid director, join NAMD’s Gretchen Hammer and CHCS’ Mark Larson to share how their agencies have nurtured cross-agency relationships. Key takeaways include the need to:
- Establish a mutual vision and expectations at the agency leadership level and communicate that vision to staff across agencies.
- Ensure that the shared vision and expectations are communicated using language that works across agencies, building a sense of shared purpose across partner agencies.
- Invest time to establish and maintain trust, including face-to-face time to build relationships across staff that will span leadership tenures and other changes in each agency.
A highly functioning executive team can be an invaluable asset to a Medicaid director. However, highly functioning teams do not just happen effortlessly, as if by magic. It takes a conscious commitment to identify the right mix of skills, expertise, responsibilities, and personalities to develop an executive team that appears to have happened by magic. In this podcast, Stephanie Muth, Texas Medicaid director, joins NAMD’s Gretchen Hammer and CHCS’ Mark Larson as they share insights about what can help make an executive team work. Key takeaways include:
- When thinking about whom to include on an executive team, do not just focus on Medicaid expertise. The interpersonal dynamics of a team, and other complementary skills each member can bring, are also important factor to consider.
- It is human nature to focus on tasks, or short-term issues, because of the sense of accomplishment derived from “checking something off the list.” However, as an executive team, it is important to protect time for strategic, longer-term thinking about vision and direction.
- Once a Medicaid director has assembled a highly functioning executive team, let that team do its work. Trust those team members, and empower them to make decisions that align with the strategic vision of the director.
NAMD and CHCS will continue to work together to identify topics and facilitate conversations as part of the Medicaid Leadership Exchange podcast series. Look for the podcasts on iTunes, Google Podcasts, or wherever you listen to your podcasts.