Module 1	Introduction	Unit 1 IIS Sustainability Toolkit Introduction
Module 2	Getting Started	Unit 1 How to Use this Toolkit
Module 3	Defining IIS Sustainability	Unit 1 What is IIS Sustainability and Why Does it Matter?
Module 4	Strategy 1: Diversifying Funding	Unit 1 Diversifying Funding Introduction	Unit 2 Approach A. Leveraging Medicaid Match	Unit 3 Approach B. Billing for IIS Data
Module 5	Strategy 2: Optimizing IIS Efficiency	Unit 1 Optimizing IIS Efficiency Introduction	Unit 2 Approach A. Increasing the Use of Shared Services	Unit 3 Approach B: Leveraging Shared Infrastructure	Unit 4 Approach C: Using Open Source Software	Unit 5 Approach D. Implementing Process Automation	Unit 6 Approach E: Modernizing IIS
Module 6	Success Stories from the Field	Unit 1 Success Stories Introduction	Unit 2 Using Medicaid Match to Diversify IIS Funding	Unit 3 Diversifying IIS Funding Through Health Plan Billing	Unit 4 Slowing the Curve to Manage Rising IIS Costs
Module 7	Additional Considerations	Unit 1 Additional Considerations
Module 8	Additional Resources Related to Sustainability	Unit 1 Additional Resources
Module 9	References	Unit 1 References
Module 10	Abbreviations and Acronyms	Unit 1 Abbreviations and Acronyms

Success Stories from the Field

Using Medicaid match to diversify IIS funding

Louisiana Department of Health

At a Glance

Challenge: Rising Immunization Information System (IIS) technology and operational costs created increasing pressure on Louisiana’s immunization program to identify sustainable funding sources beyond traditional federal cooperative agreement funding.

Approach: Louisiana leveraged Medicaid match funding by aligning IIS activities with Medicaid priorities, building strong partnerships with Medicaid leadership, and developing clear metrics and deliverables to demonstrate value to Medicaid beneficiaries and providers.

What made it work: Longstanding collaboration with Medicaid, identification of internal champions, and strategic framing of IIS as critical infrastructure supporting Medicaid goals.

Key takeaway: Medicaid match can provide substantial support for IIS modernization and sustainability when jurisdictions align IIS investments with Medicaid priorities and develop strong cross-agency partnerships.

Public health challenge

Like many jurisdictions, Louisiana faced increasing costs associated with maintaining and modernizing its IIS while relying heavily on federal immunization program funding. Sustaining system operations, supporting interoperability, and meeting evolving public health demands required additional funding sources beyond the CDC cooperative agreement. At the same time, Louisiana needed to demonstrate how IIS investments directly supported Medicaid populations and aligned with Medicaid priorities in order to qualify for federal Medicaid match funding.

Louisiana also faced the complexity of navigating Medicaid match requirements, including differing match rates (90/10, 75/25, and 50/50), annual application processes, and the need to clearly define how IIS activities benefited Medicaid beneficiaries.

Approach

Build strong Medicaid partnerships

Louisiana emphasized long-standing collaboration between the immunization program and Medicaid program as a foundation for success. Medicaid had historically played a significant role in supporting the IIS, including helping populate the system with Medicaid beneficiary data and supporting provider incentive initiatives tied to immunization coverage.

The IIS team also identified Medicaid champions who could help advocate for IIS investments internally and support approval processes. According to Louisiana staff, having champions both within public health leadership and Medicaid was critical to sustaining support over time.

Our success with the Medicaid match was built on years of collaboration and trust.

Align IIS investments with Medicaid goals

Louisiana framed IIS investments as supporting Medicaid priorities and improving services for Medicaid beneficiaries and providers. To support applications for match funding, the IIS team developed metrics, deliverables, and narratives demonstrating how IIS activities benefited Medicaid populations. In Louisiana, the IIS team reports annually to the Medicaid program on two key metrics, including the percentage of Medicaid-enrolled children who are up-to-date on the combined 7-vaccine series and the number of Medicaid providers who are enrolled in the IIS.

The team also worked closely with Medicaid staff who understood CMS expectations and could help refine applications before submission. This collaboration helped Louisiana avoid CMS disapprovals and strengthen alignment with federal requirements.

Using different match levels strategically

In this coming year’s application, Louisiana proposed a 75% federal/25% state match to support state IIS staffing costs. They made their selection among the three Medicaid match levels available to jurisdictions, each depending on the type of IIS activity being supported:

90%/10% match for new development,and add-on enhancements
75%/25% match for operations and maintenance
50%/50% match for administrative activities

The team emphasized that match calculations are based only on the portion of IIS costs attributable to Medicaid populations and not the entire IIS budget, which required careful budgeting and documentation. In Louisiana, they based their cost calculation on a formula that uses the census population of the state as the denominator and the total Medicaid population as the numerator and this resulted in a 45% cost allocation. When the 75%/25% Medicaid match is applied, the state pays 25% of the 45% cost allocation and the Medicaid matching funds cover 75% of the cost allocation. The remaining 55% of the cost allocation formula must come from the state, but it can be paid with federal dollars.

Combining Medicaid match with other sustainability strategies

Louisiana also explored how other IIS revenue streams could support Medicaid match requirements. Program staff noted that revenue generated through billing health plans for IIS data could potentially be used as state match funding, further strengthening IIS sustainability efforts. By combining Medicaid match with additional revenue-generating approaches, Louisiana created a more diversified and resilient funding strategy for IIS operations and modernization.

Diversifying funding gave us more flexibility and a stronger foundation for sustaining the IIS.

Key takeaways

- Build strong relationships with Medicaid early. Longstanding partnerships and internal champions can significantly improve success with Medicaid match applications.
- Align IIS investments with Medicaid priorities. Clearly demonstrate how IIS activities benefit Medicaid providers and beneficiaries.
- Understand match categories and requirements. Different IIS activities may qualify for different federal match rates.
- Develop strong metrics and narratives. Clear deliverables and measurable outcomes strengthen applications and support CMS approval.
- Think strategically about funding sources. Other IIS revenue streams may help support required state match contributions.
- Frame the IIS as essential infrastructure. Positioning IIS as a shared system that supports population health, providers, and Medicaid goals can strengthen long-term sustainability support.

Why it matters

Louisiana’s experience demonstrates that Medicaid match can be a powerful sustainability strategy when IIS programs build strong cross-agency partnerships, align investments with Medicaid priorities, and strategically combine multiple funding approaches to support long-term system operations and modernization.

Using Medicaid Match to Diversify IIS Funding