Medicaid Delivery Innovation Initiative (MDII)
Medicaid Delivery Innovation Initiative
No-cost rapid service delivery improvement and lasting technology capacity for state Medicaid programs
The moment
New federal requirements take effect January 1, 2027. States must implement work verification systems, switch to semiannual eligibility redeterminations, and absorb new cost-sharing rules. Most state Medicaid agencies do not yet have the technical capacity to meet these requirements.
The problem made visible
Many state Medicaid agencies know they need to modernize. What they are looking for is the technical expertise to diagnose what is broken, the support to build tech capacity, and a proven methodology that delivers results.
A peer-reviewed study published in Health Affairs in November 2025 evaluated what happens when a small technical team works directly alongside state Medicaid staff for seven weeks. Four states. No new legislation. No new funding. The results: an average 21.6 percentage point increase in automated renewal rates and an 8.3 percentage point decrease in procedural terminations.
The intervention worked. What it could not do was leave the tech capacity behind. MDII was built to address that problem.
What we provide
Tech Talent Project’s MDII engagement has three components:
Discovery sprint
A dedicated team of MDII Fellows works alongside state staff for seven weeks: two weeks of preparation and research, one week on-site, and four weeks of implementation support. The team includes specialists in product management, user-centered design, software engineering, and talent strategy. Together with state staff, they use data, user research, and stakeholder interviews to identify the specific barriers blocking service delivery and produce co-designed, prioritized recommendations.
Recruitment Support.
States gain access to Tech Talent's network of 11,000+ mid-to-senior technologists. MDII Fellows identify hiring pathways and connect agencies with qualified candidates ready to step into the roles the sprint identifies. States also receive training in best practices for recruiting and interviewing technical talent.
Ongoing coaching
Placed tech leaders can receive government and Medicaid-specific support. MDII Fellows continue meeting with state staff to unblock longer-term transformation efforts. The goal is that a state builds an internal team to sustain what the sprint started.
Track record
Tech Talent Project is currently working with eight states in 2026. Each engagement is customized to the state’s specific needs and existing technical capacity, with a focus on ex parte renewals, reduced procedural denials, and reduced worker burden.
Tech Talent’s MDII team partners with the National Association of Medicaid Directors (NAMD) to surface promising practices and real-world examples from states and territories so Medicaid programs nationwide can advance locally tailored solutions and technical capacity advancements that deliver value for the people they serve and taxpayers alike.
The MDII methodology builds directly on the federal USDS Medicaid program evaluated in the Health Affairs study. Members of that team co-created MDII to extend the same model’s impact through lasting in-house talent, addressing one thing the federal program could not do: leave the capacity behind when the engagement ended.
Interested in learning more?
State Medicaid leaders
Ready to explore what MDII can do for your state? We start with a 30-minute conversation to understand your specific challenges and priorities. No commitment required.
Funders and partners
Work with us to build state technical capacity. If you are investing in Medicaid delivery, health, or government capacity, we would welcome a conversation.