Bridging Medicaid and Public Health: Turning Shared Goals into Shared Systems
As states face mounting budget pressures, workforce shortages, and rising rates of preventable disease, one truth has become clear: Medicaid and public health can no longer afford to work in silos. The National Association of Medicaid Directors’ new resource, A Medicaid Leader’s Playbook: Action Steps to Building Public Health Partnerships, offers a practical roadmap for how agencies can work together to improve outcomes and maximize impact.
At Coral, we see this moment as more than an opportunity for collaboration. It is a turning point for how states design sustainable, value-driven health systems.
Why This Playbook Matters Now
The Playbook arrives at a time when federal and state priorities are converging around whole-person care, prevention, and efficient use of public resources. With COVID-era public health funding having ended, workforce challenges deepening, and new budgetary pressures from the OBBA, states need to rethink how their systems coordinate across agencies.
By aligning Medicaid’s individual-level data, financing power, and accountability frameworks with public health’s population-level reach and prevention expertise, states can build a shared infrastructure that improves outcomes and reduces duplication.
The Playbook outlines concrete steps including understanding public health value, initiating partnerships, navigating relationship scenarios, and institutionalizing collaboration. These steps provide state leaders with a clear starting point for sustainable systems change.
From Concept to Implementation
In our work with state agencies, Coral Health Advisors helps translate policy alignment into operational frameworks that create lasting sustainability. That includes:
Designing governance structures that connect Medicaid and public health strategies.
Building cross-agency funding approaches that support community health workers, doulas, and prevention infrastructure
Developing shared performance metrics that bridge clinical care and population health
Facilitating stakeholder engagement and capacity building to ensure partnerships lead to results.
Designing value-based payment (VBP) models within Medicaid that incentivize providers to work with public health to improve outcomes.
These steps move beyond coordination and make collaboration a permanent part of how states manage health transformation.
Making Collaboration a Strategic Advantage
For states advancing VBP models, Medicaid and public health partnerships are essential. In our experience implementing VBP models in Medicaid, public health’s upstream prevention strategies help reduce costly downstream utilization, while Medicaid’s financial levers create sustainability. Together, they can address maternal health, behavioral health, and chronic disease in ways that improve population outcomes and strengthen fiscal performance.
Depending on the state, public health and Medicaid may be collocated within the same state agency or separate entities. We have found that fostering these relationships takes thoughtful time and effort with the need to develop a shared understanding of each other’s work and to speak a common language.
As the Playbook notes, recognizing and addressing timing and cultural differences is key to building effective collaborations. Coral’s work helping states design and implement these partnerships turns that insight into action by aligning governance, building a shared language, and unlocking Medicaid funding to deliver results.
The Bottom Line
The Medicaid Leader’s Playbook is more than a guide. It is an invitation for Medicaid and public health leaders to move beyond ad hoc coordination and toward systems built on shared accountability and lasting impact.
At Coral Health Advisors, we help states take that next step by designing frameworks that make collaboration operational, measurable, and sustainable.
Learn more about the Playbook from the National Association of Medicaid Directors and explore how Coral can help your state translate these principles into practice.