Guam Wins National Award for Innovative Collaboration to Modernize Medicaid IT Systems & Operations

The National Association of Medicaid Directors (NAMD) today announced that Guam’s Department of Public Health and Social Services has been awarded the 2025 Spotlight Award for their innovative tri-state and territorial collaboration to modernize its Medicaid IT system that is reshaping health care in the U.S. territory.

The award honors Guam’s strategic partnership with West Virginia and the U.S. Virgin Islands to modernize its Medicaid Enterprise System through innovative leverage and reuse strategies. The initiative has secured over $39 million in federal funding for fiscal years 2025-26 and successfully implemented critical pharmacy benefit management services that are already improving medication access for Guam’s 43,000 Medicaid beneficiaries.

“This collaboration demonstrates the extraordinary outcomes that result when states and territories work together to re-use information technology systems and build on existing consultancy support,” said Kate McEvoy, Executive Director of NAMD. “Guam’s leadership shows how strategic partnerships can accelerate modernization, reduce costs, and most importantly, improve the lives of Medicaid members.”

At the heart of the initiative is Guam’s implementation of a Pharmacy Benefit Manager (PBM) solution through reuse of the U.S. Virgin Islands’ existing contract, combined with project management partnership support from West Virginia. This approach enabled Guam to avoid lengthy procurement delays while providing access to critical medications, including specialty drugs that are difficult to source on-island.

“For years, we worked with a system that carried us through many seasons, but as health care needs grew more complex, we knew it was time to chart a new course.” said Theresa C. Arriola, Director of Guam’s Department of Public Health and Social Services and Guam Medicaid Director. “Our mission was to create a better way to serve our community, being there when every moment matters. The results speak for themselves.  Quicker access to medications, less time lost in paperwork, and a stronger sense of care. This is the change we promised, and it’s here.”

The collaboration was made possible by Guam’s enactment of the Leverage and Reuse Law in July 2024, which empowered the territory to adopt and leverage contracts and systems from other jurisdictions. The partnership spans multiple modernization domains including eligibility and enrollment, interoperability, and organizational readiness. Through this collaboration, Guam successfully launched its new pharmacy benefit management system on September 1, 2025, and secured over $39 million in federal funding for fiscal years 2025-26. The modernization effort has enabled the territory to navigate procurement timely and reduce administrative costs while implementing enhanced fraud detection and cost containment measures that streamline workflows and improve provider claim processing.

“This isn’t just about upgrading systems, it’s about shaping a future where our Medicaid program serves every person with dignity, speed, and reliability,” said Arriola. “A third of our population depends on Medicaid, and when I think about what this modernization means, especially during times of crisis like natural disasters or health emergencies, I feel immense pride in what our team has achieved.”

About NAMD’s Spotlight Award

The National Association of Medicaid Directors’ annual Spotlight Award recognizes exceptional leadership and innovation in Medicaid administration. The 2025 award specifically highlighted achievements that demonstrate excellence in driving value through improved member experience and efficient use of taxpayer resources. Learn more about the other 2025 winners here.