An Overview of Partnership History

Collaborations between public universities and state government are not new; historically, investments by states in their university systems have yielded public benefits in diverse areas such as training and workforce development, support to public education and information technology.  In the recent past, relationships have also emerged around university system support to state public health care initiatives, primarily involving the Medicaid program.  On the heels of key changes to federal Medicaid law in the mid and late 1980s, Medicaid programs have grown to dominate state budgets and expenditures for Medicaid services and administration now represent the largest budgetary item in virtually every state.  The number of program beneficiaries and program expenditures will continue to grow as the Affordable Care Act has greatly expanded the reach and influence of the Medicaid program, making it the key driver in the effort to increase health insurance coverage under health care reform.  By virtually any measure, Medicaid program administration now represents the most challenging undertaking of state government.

However, state Medicaid agencies may not be uniformly and consistently resourced and equipped to meet that challenge in a manner that best serves program beneficiaries or a state’s fiscal climate.  Over this 30-year Medicaid growth curve, over a dozen collaborative relationships have developed between public university systems and state health and human services agencies, typically around a particular need of Medicaid for topical research, program evaluation or policy guidance or other discrete areas where a state agency may lack adequate resources.  Representative partnerships would include:

  • The Cutler Institute for Health and Social Policy at the University of Southern Maine’s Muskie School of Public Service partners with state agencies in Maine — including the executive branch and the Maine Department of Health and Human Services — to provide research and policy analysis, training and technical assistance, and program development and implementation.
  • The Florida Center for Medicaid and the Uninsured, housed within the College of Public Health and Health Professions at the University of Florida, engages in a contractual arrangement with the Florida Agency for Health Care Administration to provide research and data analysis leading to the development of policy options for the Florida Medicaid agency.
  • The Hilltop Institute at the University of Maryland, Baltimore County, maintains a data warehouse repository for the state’s Medicaid agency (Maryland Medical Assistance Programs), and affords the state with key policy development support.
  • The California Medicaid Research Institute (CaMRI) at the University of California San Francisco’s Philip R. Lee Institute for Health Policy Studies has a master agreement with the California Department of Health Care Services — which oversees the California Medicaid program (Medi-Cal) — to provide research and analysis that guide health policy decisions.

Although these and other university-state relationships in the healthcare arena have been and continue to be of great value, there remains significant additional benefit that could be derived under the umbrella of these partnership engagements.  Some of the factors inhibiting greater engagement are:  

  • Federal financial incentives that encourage the development of these public partnerships are not universally appreciated.
  • Federal reimbursements available to offset some university-based costs of providing administrative support are sometimes not recognized. 
  • Opportunities for private grant makers to maximize the value of their grant dollars by investing their dollars through these partnerships are not fully exploited.

In part due to these factors, the full range of opportunity for these partnerships — ranging from technical assistance, operations, consultation, data collection and management, program evaluation, evidence-based policy making, among other activities — remains largely untapped.

It is a primary goal of this website resource to share information about these financial incentives and programmatic opportunities, both to lay the foundation for the sustainability of public university-state partnerships and to encourage the development of new and expansion of current partnerships. Material benefits flow to both parties in such relationships, including financial and programmatic ones. An enhanced resource base available to state government allows it to better fulfill its public charge and also to keep the conduct of essential state public tasks within the public sphere.