State Medicaid agencies play a central role in translating policy changes into action. Policymakers and state Medicaid directors recognize the need to invest in human capital and support agency staff in navigating the changing health policy landscape. However, once initial investments in staff capacity building are made, how best to apply newly developed leadership skills and foster continued professional growth can be difficult to determine.

Since 2016, New Jersey has invested in building the leadership skills of more than 50 mid-level managers and nine county directors through the New Jersey Medicaid Academy (NJMA). Developed by the Center for Health Care Strategies (CHCS) and funded through The Nicholson Foundation, the NJMA is targeted to state and county staff who administer Medicaid. It is designed to: (a) build staff knowledge about Medicaid fundamentals; (b) expose participants to national trends in publicly financed health care; (c) foster cross-agency relationship building; and (d) build leadership skills. CHCS has similar programs focused on leadership development and capacity building in three additional states: California, New Hampshire, and Vermont.

Leadership “In Action”

To help graduates apply NJMA lessons to current policy issues facing New Jersey Medicaid, The Nicholson Foundation is supporting an additional collaborative project focused on putting the Academy “into action.” Competitively selected, cross-agency teams receive technical assistance, and support from CHCS to develop a project in a key policy area of importance to NJ FamilyCare. This provides an opportunity for graduates to immediately apply knowledge from the Academy and nurture newfound cross-agency relationships.

From May through September 2016, the first cohort of project teams with support from CHCS were responsible for engaging with stakeholders, conducting research, and preparing final recommendations to the agency’s leadership. Their projects focused on:

  • Behavioral health homes for individuals recently released from the criminal justice system;
  • Developing a blueprint for value-based purchasing; and
  • Promoting uptake in health information exchange through contracts with Medicaid managed care plans.

Since October 2016, New Jersey’s Medicaid leadership has further explored many of the teams’ policy recommendations. For example, progress has been made to implement enhanced care coordination through New Jersey’s Behavioral Health Home pilot for individuals recently released from prison.

The participants valued the opportunity to apply the Academy curriculum and further their professional development. One participant stated: “Personally, I have not had this level of individualized professional development, constructive feedback, and support for quite some time as my career progressed in state government. I cannot emphasize enough the value and appreciation for this type of professional development as a manager.”

A second cohort of project teams kicked off in February 2017 with topics reflecting the growing need to address rising costs for complex populations and identify new value-based purchasing strategies. Specifically, the two selected project teams are focusing on: (1) cost analysis of enhanced case management for individuals with substance use disorder who are experiencing homelessness or have unstable housing; and (2) strategies to improve the accuracy of managed care organization provider directories and other reporting requirements to align with future value-based purchasing initiatives. The projects are currently underway and the teams are slated to share recommendations with Medicaid leadership this fall.

The Value of Leadership in a Changing Medicaid Landscape

Given the constantly evolving federal and state policy environment and pressure to control costs, Medicaid programs have been challenged to find innovative ways to deliver care and efficiently administer programs across multiple siloes. New Jersey’s investment in building staff capacity by putting the NJMA curriculum into action is especially compelling. The breadth of issues the projects explore demonstrates the state’s commitment to identifying innovative strategies to improve care delivery, access, and outcomes for the 1.7 million NJ FamilyCare beneficiaries. Building a staff that is equipped to be adaptive and collaborative may only become more important as states address potential federal Medicaid policy changes.

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