The 1s and 0s that live inside the country’s digital health systems represent data that can unlock federal funding and provide information about a community’s overall health.
What’s more, those data points reflect millions of people's lived experiences: doctors’ visits, whether their parents can afford their medications, and whether their kids receive affordable healthcare through federally funded programs.
States are responsible for reporting this kind of health data to the Centers for Medicare & Medicaid Services (CMS), which, in turn, helps the agency administer funds and services to states through programs such as Medicaid and the Children’s Health Insurance Program (CHIP).
Why Health Data Reporting Between States and CMS Is So Important
Fiscal Accountability
Over 78 million people were enrolled in Medicaid and CHIP in 2024. These programs represent massive investments, accounting for over $950 billion annually in taxpayer funds. Data reporting is how CMS verifies that every dollar is spent correctly. According to MACPAC.gov:
“Data on Medicaid and CHIP play a key role in answering policy questions that affect program enrollees, states, the federal government, providers, and others, and in ensuring accountability for taxpayer dollars. … The timeliness, quality, and availability of federal administrative data is of particular concern.”
Funding Accuracy
Federal funding for programs like Medicaid and the Children’s Health Insurance Program (CHIP) is directly tied to state data reporting. States are legally required to submit precise enrollment, expenditure, and quality measure data to draw down and maintain their federal matching funds.
When reporting systems are slow or unwieldy to use, these calculations can get distorted—potentially leaving states underfunded and unable to sustain care for their communities.
Outcome Tracking
High-quality reporting translates millions of individual medical claims into a clear national picture of public health and can even help improve individual health outcomes. It enables policymakers to track real health outcomes across state lines, such as postpartum care quality, childhood vaccination rates, and follow-up care after mental health hospitalizations.
Building Tech to Enable Compliant Reporting and Make Administrators’ Jobs Easier
When CMS set out to improve Medicaid and CHIP data-reporting applications that support healthcare services for more than 90 million people, it needed tools that could scale across 50 states and territories while making life easier for users and state administrators.
Coforma, along with our subcontracting partners, transformed this need into the Medicaid Data Collection Tools (MDCT)—a suite of six new or modernized applications that form the digital crux of state-to-federal public health data reporting.
Alleviating Administrative Burden
Both state and federal data teams work under intense pressure, often balancing shifting policy mandates with limited organizational resources. We wanted to equip these administrators with tools to make their jobs easier. As Anna Hawk, Senior Product Manager on MDCT, shares:
“With all of the states and different constituents that the government serves, they are stretched thin. Budgets have been reduced. And so our job is to make the reporting process as pain-free as possible for them.”
Introducing Features to Facilitate Easier Data Reporting
Our user research unearthed a very manual reporting journey. Before interacting with digital platforms, local data analysts gathered information from internal systems, compiled it into Excel sheets, and then entered it into federal databases.
We introduced features to streamline the final part of that workflow within the MDCT suite, making it easier for these administrators to input reported data. Among these was a “copy-over” feature for semi-annual and annual reporting requirements, which mimics state tracking files but handles the heavy lifting automatically. According to Anna:
“The copy-over is a huge win that wasn’t known when we took on the MDCT contract. When we got in there, we realized, ‘Oh, they can't go through and do this every year.’ And so it copies the data so they’re just going through and editing. It saves massive amounts of time.”
Modular Architecture Creates More Time for UX Improvements
We also created a reusable, modular architecture for MDCT applications. When engineers can copy validated code structures that are already aligned with the CMS Design System, they can quickly stand up new features, giving developers more time to work alongside design teams on product refinements. As Anna puts it:
“We’re not reinventing the wheel every single time. … The modular approach means we can focus on things like accessibility features we need in the system, nice-to-have designs, and UX improvements. That’s where you get to delight your customer more.”
Getting Quality Data from the Start
Data accuracy is an important safeguard for financial and operational safety within CMS. Data errors discovered after a contract reporting period ends can lead to labor-intensive corrections.
To shorten this feedback loop, we are developing new validation rules for major state reports. This helps protect data integrity right at the point of entry. Anna shares:
“We are working on a new validation feature set that we’ll embed into the systems to continue homing in on getting good quality data from the start. Then, they don’t have to go back in, which is no small task for these big reports.”
Designing for Data Reporting Variance
Data reporting across and even within states is highly variable. Every municipality operates in distinct physical and digital environments, making it challenging for both federal analysts and state administrators to aggregate information into a unified national pipeline.
Designing technology and processes that accommodate this variance has far-reaching benefits beyond any single program. That’s why our teams conducted 40 research sessions across 18 states to build MDCT. When digital systems are built to meet local administrators where they are, data quality and reporting improve for everyone.
Making a Positive Difference in People's Lives
Improving data reporting can help federal analysts evaluate clinical models and deliver better health services to communities across the country. According to Anna:
“These health data reports track things like how long it takes for people to get to their appointments. How far apart people are from their primary care physicians or pediatricians, how long the wait times are once they are in those facilities, things like that.”
Building the digital infrastructure to facilitate the transfer of this very human information means healthcare networks operate effectively, public funding lands exactly where it is needed most, and vulnerable families receive the care they deserve.
Coforma has partnered with CMS on three phases of the MDCT contract since 2022. We’ve collaborated with our excellent subcontracting partners—Aquia, BlueLabs Analytics, Blue Tiger, For People, and Stratiform Digital—at various phases of the project.
About the Authors
Anna Hawk is a Senior Product Manager currently leading the Medicaid and CHIP Data Collect Tool efforts at the Centers for Medicare & Medicaid Services (CMS). With over a decade of experience in product management, Anna is deeply committed to the civic tech space, leveraging user-centered product management practices to build intuitive digital tools that drive positive, real-world impact for public programs.
Alicia Eberl-Lefko, MHS, CHES, PMP, directs growth and proposal efforts across the Department of Health and Human Services (HHS), including CMS, as Coforma’s Healthcare Growth Leader. With over 25 years of project delivery and business development experience in the federal health arena, she has focused her career on facilitating positive public health outcomes through communications and technology.