Under the Same Sky featuring Karen Shields
Karen Shields, KMS Health Consulting, discussed lessons learned from her more than 30+ years of expertise in serving vulnerable populations.
Preparing for Medicaid Work Requirements: Karen Shields on Collaboration, Compassion, and Getting It Right
In the latest episode of Under the Same Sky, Abner Mason welcomed guest speaker Karen Shields, CEO of KMS Health Consulting and former Deputy Director at CMS’s Center for Medicaid and CHIP Services. With over three decades of experience in public and private sectors, Karen brings a rare blend of operational insight and heartfelt commitment to serving vulnerable populations.
Shields shared her perspective on the implementation of H.R.1, the landmark legislation introducing national Medicaid work requirements. She emphasized that success hinges not just on policy or technology but on guiding people through change with empathy and clarity.
“Human-centered design requires us to be humble enough to realize that the design is not the goal. The human is the goal,” said Shields.
Drawing from her experience with ACA rollout and Medicaid redetermination, Shields outlined key lessons:
- Collaborate early and often: Don’t wait until plans are polished. And get in a larger room with everyone involved to understand the big picture and make sure all stakeholders are aligned.
- Design with users in mind: Get feedback from the people who will have to go through the redetermination process. Make sure what you design works for them.
- Build layered support systems: From standard call centers to help reeducate members on what they need to do, to providing case workers to individually navigate people with more complex situations through the process.
- Create feedback loops: Enable systems to improve continuously by developing a continuous feedback and development lifecycle to address things you didn’t plan for as well as things that break.
Shields also cautioned against relying solely on technology, noting that AI can help, but it must be paired with human support to truly meet people where they are.
Shields concluded with emphasizing that states should build inclusive governance, listen deeply, and stay humble. As states and health plans prepare for full implementation in just five quarters, her advice is both timely and essential.
“This is doable. But it has to start big and then get small, not the other way around.”
Join us for the next conversation in the series on Thursday, November 6, at 1:30pm (ET) with special guest John Morales, an Analytics expert.
