Governing Magazine Takes on the Question of Medicaid Leadership

“Medicaid Has Great Responsibility Without Great Power,” reads the headline in Governing magazine in an article about the Fund’s new Medicaid leadership report. “There’s no denying that the government health-care program has expanded in the past 50 years,” the article begins. “But for all its growth, Medicaid hasn’t really improved its governance or increased its power.”

The article, which includes an interview with former Medicaid director and report author Andy Allison (pictured left), brings to light the questions raised in the report about how state Medicaid programs are organized and governed today.

The article notes that the growth of Medicaid—and the diminished resources for its leaders—could be behind the high turnover rate of Medicaid leaders. Since January 2014, at least 23 are known to have left their positions. As Andy Allison told Governing about his tenure as a Medicaid director, he “knew the value of the experience, but I felt like I continually faced an underfinanced, undermanaged system.”

Like the report, the article focuses on how Medicaid is run (in many states, it’s not a separate agency); the fragmentation of Medicaid leaders’ responsibility (many don’t have control of services like mental health or long-term care; and compensation (higher salaries might be needed to recruit the kind of leaders that states need).