Preparation is key to support a smooth transition from one state government administration to the next. During the 2018 midterm elections, 20 states elected new governors, eight of which represented a change in political party. We asked former state agency staff and our Guidehouse Medicaid experts to share some best practices and lessons learned on what state Medicaid agencies can do to prepare for a transition.

Steps for State Medicaid Agencies to Consider

It’s likely that state Medicaid leadership has already started the planning process and met with the incoming administration’s transition teams. State Medicaid agencies can take these steps to help the incoming administration get up to speed:

• Summarize key initiatives and decisions: Develop an executive briefing that provides a description of each Medicaid initiative.
• Develop options analyses regarding key initiatives: To support decision-making, the agency should provide options analyses regarding key initiatives.
• Identify key risk areas: In addition to continuing key initiatives, new administrations will need to be made aware of areas that could pose a risk to the continued success of the Medicaid program.
• Prepare a key stakeholder list: The agency should identify key stakeholders to help the new administration determine who needs to be at the table for key decisions or for insights regarding proposed Medicaid program changes.
• Update budget projections: To support the governor’s budget proposal, which is developed shortly after taking office, the agency should proactively refine its financial projections, budget development timelines, processes, and deliverables.
• Develop educational materials: The agency should be prepared to educate the new administration, and tailor materials to the new administration’s experience with Medicaid.