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Medicaid Insights: How the Medicaid Workforce has Responded to the Pandemic

Fielded in September 2020, the Medicaid Insights Survey on Medicaid Agency Workforce measures the state of Medicaid agencies workforce during the first year of the COVID-19 pandemic.

Program Stream

The National Association of Medicaid Directors (NAMD) surveyed its 56 Medicaid Directors in September 2020 to understand how state Medicaid agencies – as major employers – have responded to the Public Health Emergency (PHE) in relation to their workforce. The survey also gave NAMD a glimpse into what the future may hold for the Medicaid workforce.

From NAMD’s survey, five common themes emerged across the states:

  1. Medicaid agencies, like the private sector, quickly embraced telework. Before the pandemic, less than five percent of the Medicaid workforce worked remotely. In September 2020, almost 80 percent of Medicaid staff were working from their homes. Employees are largely satisfied with remote work, including the improved work-life balance it offers. In addition, Medicaid programs have seen increased productivity in many agency functions. Because of this, many Medicaid Directors plan to continue some telework after the public health emergency lifts.
  2. Permanent telework is helping states recruit and retain talent. Recruitment and retention are longstanding challenges for Medicaid programs because the private sector offers higher compensation. Some Medicaid agencies are permanently allowing telework for specific positions to help recruit staff from a broader geographic region. Almost half of the 44 states and territories that responded intend to hire some employees to be fully remote positions on a permanent basis.
  3. Medicaid agencies are making sure the workforce has what it needs to succeed, including adequate technology. Because of the historically low rate of telework, one of the biggest challenges has been ensuring employees have the hardware and software they need to work virtually, including headsets, laptops, and cell phones. This was particularly difficult early in the pandemic when this hardware was in high demand. Medicaid agencies are continuing to build the technology infrastructure to support telework, including making sure employees are adequately trained on how to use it.
  4. Despite the upfront costs of telework, it may achieve long-term efficiencies. About a third of the 41 states and territories that responded are exploring whether they can achieve long-term savings by retaining some permanent telework. It may be possible to achieve these efficiencies through a reduction in the physical office footprint and through increased staff productivity.
  5. State teams value and miss in-person connection, which enables creative problem-solving. This connection is more difficult to replicate in a remote environment. It is an area where Medicaid programs, like other public and private sector leaders, will need to innovate as they look to retain a larger remote workforce after the pandemic.

Like many other major employers, COVID-19 is affording Medicaid agencies the opportunity to do business in a new way, and Medicaid Directors continue to rise to the challenge. As we look ahead, we expect Medicaid leaders to build on this success and continue to ensure their workforce can effectively and safely carry out the mission of Medicaid.

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