Medicaid leaders play a critical role in guiding their programs to meet the needs of the people they serve. State agencies, however, often face challenges finding and retaining employees, particularly senior leaders. Most senior Medicaid leaders are promoted from within, making the development of a robust pipeline of rising leaders essential for agency health and resilience. Medicaid agencies also increasingly recognize the need to better support the advancement of staff with backgrounds and identities that reflect the communities that agencies serve, including staff with personal experience with Medicaid or another publicly financed program.

This report, developed by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation, explores the perspectives of Medicaid staff on the availability and importance of leadership development strategies for cultivating a diverse pipeline of Medicaid leaders. The report, based on interviews and a national survey of Medicaid staff, shares key findings stratified by aspects of identity, agency roles, and lived experience. The findings can help inform Medicaid agencies seeking to build a diverse and strong pipeline of future leaders. It also includes a survey results chartbook, which provides deidentified, aggregated survey results.