ORA-55378 left a great answer to my question:
Does a high number of SDE_state_lineages slow performance?
But, I realized I don't really understand what lineage length means and how it affects performance? Using the example on this ESRI technical article:
VERSION NAME LINEAGE LENGTH
------------------------- --------------
TOM.WORKORDER_I0C6531 21
TOM.EDITOR_TB 25
ERIK.WORKORDER_I910313 78
BRENT.DESIGN_F831 92
BRENT.DESIGN_F831_ALT_1 94
BRENT.DESIGN_F831_ALT_2 95
SDE.MAPPING_DEFAULT 138
SDE.LANDBASE 169
SDE.DEFAULT 249
ERIK.EDITOR_EH 275
STEVE.EDITOR_SM 289
What do these lineage lengths actually mean? What is the significance of a length of 289?