State Medicaid and public health agencies could improve community health outcomes by sharing data, coordinating resources, and forming formal partnerships that survive leadership and policy changes, according to a new Pew Charitable Trusts report.

 

What happened

Pew Charitable Trusts published a report on Oct. 28 examining how states use collaboration between Medicaid and public health agencies to address maternal and child health, chronic disease, behavioral health, and healthcare workforce shortages. The research found that these partnerships already produce positive results. However, many remain limited to individual programs or short-term initiatives instead of becoming part of agencies’ long-term operations.

Medicaid agencies maintain enrollment, provider, and claims information. Public health departments collect data on disease prevalence, immunizations, births, and deaths. The report found that combining those records helps states identify gaps in healthcare access, target interventions, and evaluate whether programs work.

 

Going deeper

The report highlights examples of states putting data sharing into practice, along with the obstacles they face.

  • Idaho: The state combined Medicaid diabetes screening data with public health estimates of diabetes prevalence to find where disease rates were high, but screening rates were low.
  • North Carolina: The state lets designated public health employees access Medicaid data through formal agreements. Its Healthy Opportunities pilots use Medicaid funding to address food insecurity, transportation, and interpersonal violence. The report found the state partially reduced program costs through fewer emergency department visits.
  • Minnesota: The state is developing data-sharing agreements with other state departments to support automated Medicaid eligibility determinations.
  • California: The state is looking to maximize data sharing to reduce paperwork and caseworker intervention as it implements H.R. 1.
  • Challenges: States face incompatible data systems that limit interoperability, and they lack enough funding for technology upgrades. States need IT systems that securely connect Medicaid claims, enrollment records, immunization databases, vital records, and other health information across agencies.

Learn more: Information sharing best practices

 

What was said

David Hyun, a project director with Pew’s State Health Solutions team, explained why the two agency types fit together. “They have a lot of the same health goals at the state level, they just come at it from different angles, and they bring in different interventions and strengths, so to speak, in addressing those problems,” Hyun said in an interview.

Hyun also described how the agencies measure success differently. “On the Medicaid side, any health outcomes that can be translated into cost is very important, but typically, public health doesn’t do that,” he said. He added that public health agencies aggregate data at the community level, while Medicaid agencies focus on how individual members’ health outcomes affect overall cost savings.

Hyun said Pew aims to help states move beyond isolated collaborations by working directly with them to put the report’s recommendations into practice. “It’s really about creating a sustainable framework that is less likely to be impacted or swayed by the changing leadership and funding environments,” he said.

 

Why it matters

This report comes as states aim to update Medicaid systems and administrative processes ahead of new federal requirements under H.R. 1. States are preparing for more frequent eligibility reviews and work-reporting requirements, and those changes may force agencies to coordinate data across systems to manage the added demands. Minnesota’s and California’s data-sharing efforts show states already moving in that direction.

The findings also matter for the limited resources states have to work with. Hyun emphasized that the research did not specifically examine H.R. 1 or its fiscal impact on state agencies. Still, he said partnerships can help agencies use limited resources more efficiently by combining expertise and funding around shared priorities.

 

The bottom line

Medicaid and public health agencies should invest in formal agreements, compatible data systems, and shared metrics now, so their collaboration continues when leaders, staff, and funding shift.

Read also: How does email ensure interoperability?

 

FAQs

What is Medicaid?

Medicaid is a joint federal and state program that provides health coverage to low-income individuals and families.

 

What does a state public health agency do?

A state public health agency monitors and works to improve the health of the whole population through things like disease tracking, immunization programs, and health education.

 

How does HIPAA affect data sharing between agencies?

HIPAA allows certain disclosures of health information for public health and health care operations, but agencies must still follow its privacy and security requirements.

 

Who is Pew Charitable Trusts?

Pew Charitable Trusts is a nonprofit research and policy organization that studies public issues, including state health policy.