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By Amara Lang Clayton, Marketing Conference & Event Planner
From October 21—23, 2026, Medicaid directors from across the nation and U.S. territories convened at the National Association of Medicaid Directors (NAMD) 2026 Conference. The conference featured programming on major policy and operational priorities, including 1115 waivers, children's behavioral health, duals integration, technology modernization efforts, and more. Against the backdrop of H.R. 1 implementation, directors were working through community engagement requirements, provider taxes, state-directed payments, and eligibility changes as January 1, 2027, approached.
Across these discussions, a common theme emerged: meaningful progress depends on trust, transparency, and collaboration among states, providers, community organizations, and federal partners.
Using Collaboration to Strengthen Medicaid
One of the strongest takeaways was that collaboration will play a defining role in the future of Medicaid.
Whether the focus is fraud prevention, children’s behavioral health, technology modernization, rural health care access, pharmacy costs, or managed care oversight, lasting progress depends on sustained, two-way engagement among states, federal partners, providers, community organizations, families, and Medicaid beneficiaries. This means listening to stakeholder perspectives, incorporating feedback into policy and implementation, and maintaining open communication and shared accountability throughout the process.
In the session, Building Children’s Behavioral Health by Design, speakers highlighted the importance of this collaborative approach. As more children experience mental, emotional, and behavioral health challenges, states are working to better align Medicaid, behavioral health, education, child welfare, and community-based support systems. Expanding home- and community-based services, strengthening early intervention, and improving crisis response can help support children and families before challenges escalate. These efforts also aim to reduce fragmentation and eliminate silos, so families are not left to navigate disconnected systems or endure repeated crises before receiving appropriate care.
Stronger partnerships can help build more coordinated systems of care and deliver better outcomes for the individuals, children, families, and communities who rely on Medicaid every day.
Using Technology to Strengthen Medicaid
Technology modernization was another central theme, with discussions emphasizing how artificial intelligence, shared infrastructure, improved provider directories, and streamlined administrative tools can strengthen Medicaid operations and improve beneficiary experiences.
Many states are also balancing several complex initiatives with limited capacity alongside H.R. 1 implementation. These include eligibility modernization, waiver renewals, and Rural Health Transformation Plans.
Procurement and downstream review processes can slow technology adoption, so states value feasible implementation plans, strong IT governance, and solutions that fit existing workflows.
Technology also has an important role to play in moving program integrity efforts from reactive to proactive. With the right infrastructure, tools, and data, states can assess their current capabilities, identify gaps, improve provider verification, revalidate high-risk providers, and detect potential fraud earlier.
More broadly, technology offers opportunities far beyond administrative efficiency. When implemented thoughtfully, it can drive measurable improvements in access, quality, accountability, and outcomes. In the session, The Future of Tech in Healthcare Medicaid, panelists encouraged states to be open to sharing and trying governance in a shared format.
By sharing resources, lessons learned, and effective governance models, states can accelerate progress and avoid the duplication that comes from developing solutions independently. Ultimately, technology should serve as a strategic tool for preventing fraud, improving oversight, expanding access, and delivering better experiences and outcomes for Medicaid beneficiaries and providers.
Using Community Partnerships to Strengthen Medicaid
Community partnerships are essential to building a more responsive and effective Medicaid program. By working with local leaders, community organizations, providers, families, Medicaid beneficiaries, and people who have directly navigated the health care and social service systems, states can better understand the needs and frustrations of diverse populations and help ensure that policy changes, work requirements, and new technologies are implemented equitably. States are using Rural Health Transformation Plans to explore workforce investments, community health workers, EMS and care coordination models, rural hospital stabilization, and payment approaches such as global budgets.
The conference also underscored the importance of tailoring Medicaid policies and services to the circumstances of the people and communities they are intended to serve. During the session, Rural Health Transformation Through the Lens of Medicaid, a community leader noted that while telehealth can expand access for rural residents it is not effective in every situation, particularly for adults with communication challenges. Insights like these are crucial to ensuring that new approaches improve access without creating additional barriers. Community partnerships also help connect Medicaid with behavioral health, education, child welfare, and other community-based services, reducing fragmentation and improving access to coordinated care.
Looking Ahead: Strengthening Medicaid Through Shared Action
Taken together, the conference discussions made clear that Medicaid’s future will depend not on any single policy, technology, or organization, but on how effectively states and their partners work together. Collaboration can build trust and shared accountability. Technology can provide the tools and data needed to improve oversight, efficiency, and access. Community partnerships can help ensure that policies and services reflect the real-world needs of the people and communities they intend to serve.
As states navigate H.R. 1 implementation and other complex changes, these principles will be essential. By listening to beneficiaries and other stakeholders, sharing resources and lessons learned, and developing practical solutions together, states and their partners can strengthen Medicaid and deliver more accessible, coordinated, and responsive services for the people who depend on it.
