Medicaid leaders are responsible for operating health coverage programs that serve more than 80 million individuals across the nation and administering upwards of $600 billion in state and federal funds. There are few opportunities at the state and territory level, however, for ensuring a robust pipeline of well-prepared and diverse individuals to oversee these vital programs.

To understand the current pathways to Medicaid leadership positions and uncover opportunities to strengthen this pipeline, the Center for Health Care Strategies (CHCS), with support from the Robert Wood Johnson Foundation, conducted a national analysis. Through surveys and interviews, CHCS sought to identify common pathways to Medicaid leadership positions, challenges, and opportunities for developing a stronger and more diverse pool of future Medicaid executives, and the skills necessary to succeed in these roles. This report highlights key findings from the survey, interviews, and a literature scan. It also includes a survey results chartbook, which provides deidentified, aggregated survey results.