As state Medicaid agencies establish Beneficiary Advisory Councils (BACs) under the Centers for Medicare & Medicaid Services (CMS) Ensuring Access to Medicaid Services Rule, CMS encourages them to develop a recruitment process that reflects the “diversity of States’ Medicaid community and beneficiaries.” This approach helps ensure that a broad range of experiences and perspectives inform Medicaid policy and program decisions.

States have used a range of strategies to recruit BAC members. This tool highlights states’ recruitment approaches, including examples from states participating in the Center for Health Care Strategies’ (CHCS) Building State Capacity for Community-Informed Policymaking Learning and Action Series. It is designed to support states in strengthening future recruitment efforts by showcasing effective practices.

Recruitment Strategies

Understand Your State’s Medicaid Population

To ensure broad representation on BACs, states need a clear picture of their Medicaid populations. Using agency, plan, provider, and community data, states can better understand the distribution of individuals across the program — for example, those living in rural communities, individuals with intellectual and development disabilities, and members enrolled in various Medicaid programs. States can then develop BAC composition goals that reflect the populations being served by Medicaid and tailor outreach efforts based on those goals. While states may not be able to achieve perfect representation across all population groups served by Medicaid, having clear goals will support the broadest representation possible.

North Dakota developed a matrix of key member characteristics for its BAC — such as geographic location, Tribal affiliation, and gender — and used it to match BAC applications with targeted member categories. The state then prioritized outreach to specific counties and Tribal communities to broaden representation on the BAC to reflect its Medicaid population.

Partner with Community-Based Organizations

Community-based organizations (CBOs) can play a helpful role in identifying potential BAC members and providing ongoing support to members. With their trusted relationships and deep community ties, CBOs can help connect states to specific populations — such as families with children with special health care needs — and help promote BAC opportunities. In Virginia, for example, the state identified two gaps in BAC representation: Spanish-speaking individuals and residents of rural communities. To address these gaps, Virginia partnered with two CBOs to recruit members of these specific groups onto their BAC and strengthen relationships with those communities.

Use a Multi-Pronged Approach

States can promote BAC recruitment through a variety of channels, including social media, community events and forums, printed materials and emails, and partnerships with providers, clinics, and CBOs. Gathering member feedback on communications preferences can help refine outreach strategies. In Alaska, the Department of Health partnered with the Alaska Children’s Trust (ACT) — a statewide CBO focused on ending child abuse and neglect — to support BAC recruitment. ACT promoted the BAC opportunity through its social media channels and CBO network. ACT also hosted a series of listening sessions to increase awareness of the BAC among Medicaid members and connect interested individuals with application information.

Make Informational Materials Accessible

Developing easy-to-read recruitment procedures and materials helps to raise awareness of the BAC’s purpose and clarify expectations for both potential BAC members and state Medicaid agencies. Idaho, for example, developed a Selection and Recruitment Process document outlining the BAC’s purpose, member responsibilities, term lengths, time commitment, and how member input would be used. Similarly, states have created FAQ documents to address common inquiries related to BAC recruitment. Michigan created an FAQ that describes the purpose of the BAC, eligibility requirements, compensation, potential meeting topics, and its relation to the state’s Medicaid Advisory Committee (MAC).

States can consider including the following information on BAC recruitment materials:

• BAC eligibility: Current and former Medicaid members, family members, caregivers;
• Benefits to participation: Opportunity to meaningfully participate in shaping Medicaid policy and programming, engagement with leadership/BAC members, compensation; letters of recommendation for external employment.
• Expectations: Time commitment, meeting frequency, in-person versus virtual;
• State obligations: Compensation/reimbursement, accommodations, educational components;
• State point of contact: Individual who can be contacted for more information; and
• Application information: Clear how-tos for members interested in applying.

Create Culturally and Linguistically Appropriate Outreach Materials

Recruitment- and BAC-related materials with clear language and culturally appropriate messaging will ensure that members can easily understand and engage with BACs. Many states have created outreach materials — flyers, FAQs — in multiple languages. Massachusetts’ has posted BAC materials on its MassHealth Member Advisory Committee in Chinese, Haitian Creole, Brazilian Portuguese, Spanish, and Vietnamese. States can also engage current BAC members and CBO partners to review and provide input on new BAC outreach and promotional materials to ensure they resonate with intended audiences.

Simplify the Application Process

Creating a simple and straightforward application process can facilitate effective BAC recruitment. Materials should be available in multiple languages and offer flexible options for application submission (e.g., both online forms and through standard mail). Concise and straightforward applications will remove barriers to completion and enable members to easily complete required questions. Sample application questions include: (1) connection to Medicaid (e.g., former/past member, caregiver, family member); (2) interest in participating in the BAC; (3) availability; (4) preferred language; and (5) demographic data.

Ensuring transparency throughout the application and selection process is important. This includes clearly communicating interview timelines, notification dates, and next steps. States can develop a standardized approach for reviewing applications to ensure a fair and transparent selection process. Some states recruit new members during certain timeframes, while others accept BAC applications on a rolling basis. Several states — such as Arizona, Massachusetts and Virginia — publicly post their BAC applications on BAC websites to increase visibility and accessibility.

Maintain connections with BAC applicants

In July 2025, states launched their newly established BACs. For many states, the response rate to recruitment efforts far exceeded available BAC spots. States may want to consider maintaining relationships through listservs and newsletters with members who were not selected to create a pipeline of future BAC participants, as well as people who may be interested in engaging in other forms of Medicaid community engagement. Developing a standardized acknowledgment letter that includes information about other member engagement opportunities can sustain interest. States can also partner with existing BAC members to refine recruitment processes and identify new outreach strategies to broaden the applicant pool.

What’s Next

BACs present an important opportunity to bring lived experience into the design and refinement of Medicaid programs and policies, including upcoming federal work requirements. States can use a range of recruitment strategies to ensure the broadest representation of Medicaid members as possible on their BACs and ensure meaningful and diverse member engagement.