How States Can Improve Medicaid Encounter Data Kevin McAvey Laura Nolan Shelli Silver Jonah Frohlich April 10, 2026

https://www.healthaffairs.org/content/forefront/states-can-improve-medicaid-encounter-data Federal expectations for operational efficiency within state Medicaid programs are very high, and the pressure continues to mount at the same time as states face dramatic reductions in federal funding. H.R. 1 sets new expectations for how administrative data must be used to support program functions, from eligibility and enrollment to payment oversight and accountability. States have a narrow window in which to invest in building a modern Medicaid data ecosystem—the core infrastructure, processes, and people needed to meet new federal expectations for data-driven policy and program decision making. This means engaging state staff, health plans, providers, and technology developers to align on goals, identify gaps, and quickly implement enhancements to drive improvements.