National Association of Medicaid Directors

What it reported doing in 2024

Conferences and Medicaid and Public Health Collaboration: NAMD hosted its Annual Membership Meeting in Chicago in June 2025 and its signature Fall Conference in Washington, D.C. in November 2024. NAMD conducted planning, agenda development, and follow-up activities related to these convenings. The Annual Membership Meeting is a gathering of NAMD members, senior agency staff from states and territories, and federal partners, with attendance of nearly 200 in 2025. The Fall Conference convenes over 1,500 national, state, and industry leaders, with 1,510 attendees in 2024 representing all 56 states and territories. Both conferences included board meetings and discussions related to organizational business. NAMD advanced efforts to operationalize Medicaid and public health partnerships by increasing literacy among Medicaid Directors and other health care payment officials on federal and state/territory public health priorities. NAMD fostered cross-sector connections and identified opportunities to align strategies and optimize Health Resources and Services Administration (HRSA), public health, and Medicaid funding for sustainable impact. Engaging all 56 states and territories through convenings, technical sessions, and interest groups, NAMD promoted workforce solutions with a focus on integrating non-traditional providers, or workforce extenders, as billable providers while addressing behavioral health and maternal health needs. In collaboration with HRSA and other national associations representing state and territory officials, NAMD co-led webinars, policy forums, and the National Committee for Sustainable Medicaid and Public Health Partnerships to coordinate approaches and amplify impact. NAMD also produced publications highlighting HRSA initiatives and state and territory innovations. These resources, including blogs, newsletters, thought pieces, and webinars, promoted best practices and reinforced cross-agency learning.

Financial Efficiency

• Mission deployment rate: 63.1%; rating input score 63
• Program expense ratio: 73.6%; rating input score 74
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: 1 of 6 controls in place; rating input score 17
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 63rd percentile among comparable filings
• Governance controls: 8 of 9 controls in place; rating input score 89
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 10.2%; rating input score 63; 63rd percentile among comparable filings
• Total-asset coverage ratio: 1.55; rating input score 53; 53rd percentile among comparable filings
• Liabilities to assets ratio: 0.36; rating input score 30; 30th percentile among comparable filings
• Officer compensation ratio: 27.1%; rating input score 7; 7th percentile among comparable filings

Growth

• Program expense growth: 10.4% per year; rating input score 100; 65th percentile among comparable filings
• Revenue growth: 9% per year; rating input score 100; 64th percentile among comparable filings
• Asset growth: 13.7% per year; rating input score 100; 71st percentile among comparable filings