Improving Medicaid Policy Through State/University Research Partnerships

Andrew Coburn
Paul Saucier
Vernon Smith


This is archived content; for historical reference only.

The Medicaid program is one of the country’s most significant drivers of health policy, services experimentation, and health care financing. States face constant pressure to justify Medicaid policies, assess the potential impact of proposed program changes, measure program performance, and evaluate reforms designed to maximize the program’s cost-effectiveness. Access to information and evidence of what works has become vital to managing an extraordinarily complex program.

Over the past decade, dozens of states have developed formal partnerships with health policy research centers. In 2005, the California HealthCare Foundation funded a team of analysts and former Medicaid directors to examine the feasibility of establishing a joint policy research center at a university in California. The team surveyed six selected state/university health policy research partnerships to learn how they are organized and operate, how well they are working, what issues they have faced in developing and sustaining their collaborations, and how they have addressed those issues.

This research yielded these key findings:

  • To enhance the sustainability of the partnership, a number of states have developed formal partnership agreements and structures.
  • Medicaid directors value the specialized technical expertise provided by the research centers in data analysis, program evaluation, and policy analysis.
  • All six of the centers and the state partners surveyed engage in a formal agenda-setting process to determine an annual scope of work.
  • The experiences of these partnerships highlight the benefits of having staff on both sides of the relationship who can bridge the worlds of policy and research.
  • Some partnerships have operated informally with regard to publication rights, but most have developed explicit publication agreements and dissemination procedures to reduce the potential for conflict. Agreements that balance the interests of centers and state partners allow both the center to publish within time frames that preserve confidentiality for a certain period of time, and to ensure appropriate joint review of findings and documents.
  • Research centers and Medicaid agencies are concerned about the real or perceived conflicts of interest created by centers working for other parties, such as the state legislature, provider organizations, or other state agencies. Ground rules for communication about such engagements are an important tool to prevent and manage potential conflicts.

The complete report is available under Document Downloads.