Improving Lives Through Medicaid Data Innovation

Each state’s Medicaid program faces unique issues throughout the policy process. Mathematica’s digital solutions team helps states through that process, producing insights on the effectiveness of their policies.

Explore our Data Analytics Process and Projects

Problem definition and unique needs
What we need to know to address challenges and improve programs.
Problem Definition
Data Management
Analytic Models
Business Intelligence

Defining the Problem, Identifying the Solution

The right data analytics solution should drive program improvement, but to achieve this goal, it also has to be a tool that teams will use in their day-to-day work. This is why we begin by sitting down with clients to crystallize the issues and clearly articulate policy problems and requirements. We meet state Medicaid agencies where they are, bringing systems and solutions architects together with policymakers to find the right path forward.

Together we identify and transform the data needed to quantify the problems, and help find policy options to solve them. We then use outcomes-focused analytics solutions to monitor and evaluate programs, with a focus on quality improvement and system transformation.

We identify and apply data management, analytic, and visualization techniques to data curated for the problem space, generating information you can use to gauge policy efficacy, make decisions, report progress, and seize opportunities.

Exploring Solutions with Human-Centered Design
In our technology-driven world, it’s important to stay human-centered. We combine our expertise in policy and analytics with human-centered design to get to the heart of the problem and iterate toward the best solution.

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Building Secure Data Management Solutions to Optimize Output

Secure data storage that allows for governance and control

Mathematica’s commitment to data protection is demonstrated by the stringent safeguards we deploy to protect the information entrusted to us. These safeguards follow a defense-in-depth strategy, where layers of security, privacy and data protection controls block unauthorized access to, and use of, data. Our data storage solutions—data lakes, data warehouses, and data marts— are built to the FedRAMP and NIST 800-53 Moderate security control baselines, which are the gold standard control frameworks across federal and state government health organizations.

Our data storage architecture accounts for your needs related to the volume of data processed and stored, the types of analytics to be performed, the frequency of reporting, and the format of the output. Our solution suite includes the ability to store structured or unstructured data at scale, provides interoperability using many formats such as FHIR or Hl7, and uses commercial off-the-shelf (COTS) tools to facilitate data ingestion.

Data quality: the first step on the journey to insight

Bad data make it impossible to ask insightful questions and receive accurate answers. Mathematica has a robust data quality and quality assurance framework that verifies data are complete and accurate at all stages of the data and analytics life cycle. Defining data quality requires an understanding of the context for that data. Our deep subject-matter expertise in Medicaid policy and data enables us to design data quality frameworks that support policy and operational decisions. These frameworks systematically evaluate large-scale data sets for completeness and integrity through automated data validation. They also include program-specific business validation rules that ensure the data are clear and understandable in the real world.


Working with the State of Maryland to Improve Data Quality

Learn how we're using our data quality tool, Imersis, to help Maryland improve their Medicaid data and, as a result, see better health outcomes through customer service and program integrity.

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Improving Programs and Preparing for Future Challenges with Analytic Models

We apply our expertise at the intersection of data, methods, policy, and practice, combining increasing computational power and technology with abundant and diverse information, to gain evidence-based insight for our clients. Analytic models are mathematical techniques for quantifying relationships between data elements, identifying patterns within data sets, or predicting events or outcomes using available data. Such models can help policymakers and program administrators improve their current programs and prepare for the future.

Business Intelligence : Transform, Share, and Explore Data

Business intelligence (BI) is a set of methodologies, processes, architectures, and technologies that transform raw data into meaningful information for strategic, tactical, and operational decision-making. BI allows Medicaid agencies to visualize and tell a story with data pulled from a variety of sources. The filtered data can be easily exported for presentations and further analysis.

These interactive visualizations can be shared publicly or securely to privileged users with the capability to control access and functionality. We also build self-service BI functionality so that privileged users can access data elements to build and share their own reports, dashboards, and visualizations.

Mathematica is not beholden to certain BI tools – we configure to the agency solution using a multitude of tools and methods that fit the specific challenge.

Building a Data Analytics Platform for North Carolina

The Olmstead vs. L.C. Supreme Court decision requires public entities to provide community-based services to people with disabilities if such services are appropriate, are desired by the individual, and can be reasonably accommodated. North Carolina’s Department of Health and Human Services hired Mathematica to develop a platform that gathers data from Medicaid, housing, employment, and other community-based service providers and transforms the data into useful information. Through an interactive dashboard, decision makers at the Department of Health can monitor the effectiveness of Transitions to Community Living services to help eligible adults with serious mental illnesses live independently in the community of their choice.

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Related Staff

To connect with one of our experts on this project or to get more information about these tools, please send an email to

Paul Messino

Paul Messino

Principal Researcher

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Kent Davis

Kent Davis

Principal Solution Architect

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Jessica Ross

Jessica Ross

Senior Researcher

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