The Art and Science of Medicaid Budget Forecasting

From the National Association of Medicaid Directors: “The Art and Science of Medicaid Budget Forecasting.”

Medicaid accounts for 30.7% of total state expenditures, the single largest category in state budgets. That means even a small deviation in forecasting can send ripple effects well beyond the Medicaid program itself.

NAMD's newest brief explores how states navigate one of their most consequential and most complex fiscal responsibilities. Drawing on interviews with state Medicaid agency financial leaders, The Art and Science of Medicaid Budget Forecasting examines how states build and refine expenditure forecasts, the complexities introduced by new policy, public health events, and data gaps, and innovations states are using to improve accuracy and manage uncertainty.

While uncertainty is inherent to budget forecasting, particularly in a period of significant change, Medicaid agencies bring together fiscal, policy, and program experts with deep knowledge of the program. That expertise enables states to navigate risk, protect program integrity, and ensure Medicaid continues to help millions of people live their healthiest lives while making effective use of taxpayer dollars.