Engaging Consumers in Medicaid Program Design: Strategies from the States

Jane M. Zhu
Ruth Rowland
Rose Gunn
Sarah Gollust
David T. Grande
Peer-Reviewed Article
March 2021
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Study explores how select state Medicaid agencies design consumer engagement approaches, and identifies lessons on the impact of these approaches.


Research has shown benefits for public engagement in health policy development. However, at the time of this study’s publication in 2021, there was little existing guidance or research on how state Medicaid agencies engage consumers in program design. This qualitative study of 50 Medicaid program leaders in 14 states examined the structure and focus of consumer engagement approaches, and identified both challenges and facilitators of success.


This study reported on high-level consumer engagement strategies employed by state Medicaid agencies. While federal law requires that states have a medical care advisory committee to advise Medicaid agencies, these committees are implemented in different ways and states have a range of other approaches to engage consumers in program design. About two-thirds of states interviewed used additional engagement mechanisms beyond these committees — some noted that having a range of approaches allowed for inclusion of a more diverse mix of perspectives. Facilitators for effective engagement efforts include supportive state agency leadership, strong relationships with community partners, and a range of strategies to recruit and support consumers. Longer-term committees and advisory groups that focus on consumer education, discussion, and recommendations may be a valuable strategy to inform decision-making.


This study illuminates the spectrum of consumer engagement efforts at select state Medicaid agencies, including short-term and largely symbolic engagement to deliberative bodies exploring program features and policies. State Medicaid agencies and other stakeholders can apply lessons from this study when designing consumer engagement approaches.  

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