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Transforming Care Reports Digital Innovators Are Starting to Focus on Medicaid Beneficiaries


Stephanie Hepburn is a writer in New Orleans. She is the editor in chief of #CrisisTalk. You can reach her at​

In last month’s Transforming Care newsletter, Martha Hostetter and Sarah Klein dove into how technology is being leveraged to expand people’s access to behavioral healthcare, specifically for Medicaid beneficiaries. The authors note that digital health innovators have long focused and designed technology directly to and for consumers in the lucrative fitness and wellness sector. Doing so has allowed for clear marketing without innovators having to navigate state Medicaid programs and the multitude of plans that serve them. It also has left out many in-need populations, including people with behavioral health care needs who are financially marginalized or have limited access and mobility. 

Fortunately, digital innovators are shifting toward Medicaid beneficiaries, say Hostetter and Klein. They say this is because Medicaid program expansion and private managed care plans as well as pressure on states to use spending on digital health tools geared to improve services and increase beneficiary access to care. So far, innovations have focused on telehealth tools, chatbots, and other artificial intelligence used to engage beneficiaries with mental health and substance use disorders, who account for nearly half of all Medicaid spending. The populations often struggle to get treatment because of shortages of clinicians who accept Medicaid reimbursement, making it easier for them to fall through the cracks of convoluted systems.

The objective here, say the authors, isn’t to replace human contact, but, instead, to better engage patients and match them with resources or complements and alternatives to traditional care, helping retain people in treatment, track outcomes, better customize services to their needs, and give feedback to providers.

Check out the full article here.