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Agency for Healthcare Research Quality

Medicaid Medical Directors Learning Network

The Medicaid Medical Directors Learning Network provides a forum for clinical leaders of the State Medicaid programs to discuss their most pressing needs as policymakers. This fact sheet describes the mission and activities of the Medicaid Medical Directors Learning Network.


Supported by the Agency for Healthcare Research and Quality since 2005, the Medicaid Medical Directors Learning Network, as an integrated national resource, seeks to advance the health of Medicaid patients in the States and across the Nation while best stewarding available resources. The network is focused on the development and use of evidence-based medicine, measurement and improvement of health care quality, and the redesign of health care delivery systems.

The members will accomplish this mission by:

  • Creating and sustaining a vibrant learning community for State Medicaid medical directors and other senior clinical leaders to promote and share best practices for the medical direction of State Medicaid programs.
  • Offering the expertise and experience of State Medicaid medical directors to Federal agencies and national organizations involved in creating policy or implementing programs.
  • Implementing nationally significant multistate measurement and quality improvement projects.


"Improving the lives of Medicaid patients through excellent health stewardship."


Learning network participation is open to Medicaid medical directors and those in similar clinical leadership positions who advise the Medicaid director for one or more components of a Medicaid program administered by a State, territory, or the District of Columbia.


The Medicaid medical directors oversee the learning network and facilitate its activities. A steering committee oversees activity development. Network activities, including Web conferences, online discussions, and face-to-face meetings, allow medical directors to discuss and prioritize issues and exchange knowledge about State policies and practices among peers. Annually, medical directors participate in:

  • Three in-person meetings to review latest evidence on pressing clinical issues, discuss health care research implications for policy evaluation and construction, and meet with experts in relevant systems of heath care research and delivery.
  • Web forum communications to share information and solicit feedback on, among others, coverage determinations, eligibility criteria, and Federal regulations. Since the network's inception, there have been more than 1,500 posts on a variety of Medicaid-applicable topics.
  • Web conferences and open mic calls to convene a subset of medical directors interested in discussing specific issues raised on the Web Forum, to dissect the findings of a recent journal article or evidence report, or to introduce members to new resources. Regular topics include State Current Procedural Terminology (CPTs) and Healthcare Common Procedure Coding System (HCPCS) code decisions, hospital readmissions, and emergency room utilization management.
  • Multistate collaboratives to critically analyze specific clinical topics and review possible policy solutions to perceived problems. For example, the network is currently working on a project to benchmark State readmission rates for comparison as well as share policies and practices intended to decrease preventable readmission rates.

Current as of October 2011

Internet Citation:

Medicaid Medical Directors Learning Network. October 2011. Agency for Healthcare Research and Quality, Rockville, MD.


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