Lessons Learned from the 2022 Medicaid Innovation Collaborative Behavioral Health Cohort

The Medicaid Innovation Collaborative Approach

The Medicaid Innovation Collaborative (MIC) was developed to support the adoption of tech-enabled solutions to advance health equity within Medicaid. Its goal is to enable the Medicaid ecosystem to coordinate, collaborate, and commit to innovation strategies that advance health equity. Using a cohort model, it does so by identifying and connecting state Medicaid agencies and their managed care organizations (MCOs) with innovations to address deep-rooted issues that have led to health disparities within their populations. To ensure that these solutions are scalable, deliver impact, and long-lasting, MIC has developed a sourcing and selection process that engages states, MCOs, and community stakeholders to:

• Identify a health equity goal(s) to address through the initiative;
• Identify and assess tech-enabled solutions that advance these goals; and
• Support the exploration and implementation of these solutions.

In addition to sourcing and evaluating companies, MIC also:

• Conducts research, including focus groups and interviews with Medicaid beneficiaries and providers, to assess the challenges and opportunities associated with the equity challenge(s) identified by cohort states;
• Provides technical assistance to states and MCOs to advance equity goals;
• Supports peer-to-peer learning for both states and MCOs

Framework for Identifying, Evaluating & Selecting Private Sector Innovations for Medicaid

This report provides a high-level overview of the Medicaid Innovation Collaborative (MIC) process through the lens of the 2022 Behavioral Health Cohort, as well as the key lessons learned from these efforts. The three participating states in this cohort- Arizona, Hawaii and West Virginia- focused on addressing equity issues in the adolescent behavioral health (Arizona and West Virginia) and maternal behavioral health (Hawaii) spaces. This brief summarizes the approach MIC used to:

• Understand state Medicaid agency priorities and community priorities related to adolescent behavioral health and maternal health;
• Identify key “Areas of Focus” for tech-enabled solutions to support the states and MCOs address these issues;
• Source over 80 tech-enabled solutions that sought to address the “Areas of Focus”; and
• Connect states and MCOs with a curated subset of these companies in a virtual showcase.

Leveraging both the MIC team’s experience with tech companies, and the deep dive research MIC conducted to understand the issues, the cohort landed on sourcing companies that were well-positioned to address the below “Areas of Focus”:

Adolescent Behavioral Health

• Navigating and coordinating care, services and resources for adolescents and families; and
• Alternative care models: early intervention, crisis response and ongoing follow-up services

Maternal Health

• Enabling, navigating, or coordinating behavioral health care for expecting and new moms

Key lessons learned from the 2022 Cohort initiative include:

• Investing up-front time to understanding equity challenges from multiple perspectives can ensure a more accurate sourcing approach and help with buy-in to consider tech-enabled solutions;
• Incorporating consumer voices in defining the problem and identifying solutions is critical to success; and
• There are a broad range of solutions that may be viable in this ecosystem, including those that go beyond the traditional definition of a “tech company”.

For more details about these activities and insights into the lessons learned from this Cohort, see here.  For a deep dive into the takeaways from the stakeholder interviews that were conducted in each state during the research phase, see here (Arizona and West Virginia/ adolescent behavioral health) and here (Hawaii/ maternal behavioral health).

MIC’s Search & Selection Process

The MIC team facilitates a thorough search and selection process to choose the best solutions for the market that will address the needs of providers, payers and beneficiaries. Facilitating these collaborations is a crucial step in bringing together all of the stakeholders in the Medicaid ecosystem to push forward change. Not only that, partnerships established through MIC have allowed the identification of gaps within the market that can be remedied through tech solutions.

They include:

• Clear definition of goals and desired outcomes. This allows MIC to ensure that potential solutions align with needs. In other words, focus on specifics and on the goal.
• Engage a broad network of investors and entrepreneurs. Novel payment models need to be implemented. With a broad network of people (investors, entrepreneurs, and sector builders) this becomes possible.
• Solicit and incorporate needs and constraints. MIC needs to facilitate processes that will provide certain value across the delivery system.
• Incorporate a beneficiary voice. This is required in order to ensure that solutions reflect on real-time problems, on-the-ground needs, as well as challenges, which in turn increases the chances of end-user adoption.

Lessons Learned

The MIC team learned valuable lessons from the 2022 behavioral health cohort in West Virginia, Hawaii, and Arizona, that can be used to continue to create a more holistic process for addressing health inequities and developing a robust process to source and select tech solutions for Medicaid populations. These include:

1. Engaging beneficiaries is essential to ensuring an equity-centered approach. As part of MIC’s structure, the perspectives of Medicaid beneficiaries are incorporated into the process by conducting deep interviews to understand needs and challenges and the creation of a Consumer Advisory Board. This advisory board ensured their perspective was incorporated into the process. The voice of beneficiaries is of critical importance when it comes to the successful adoption and implementation of new solutions, as evidenced by their perspective in shaping the Request for Information in sourcing solutions.
2. Building a more comprehensive understanding of the challenges of health equity is critical. It is important to understand the unique challenges to accessing behavioral health resources in each of the participating states. The feedback from the beneficiaries helped to confirm or modify the perceptions that states or managed care plans had about their members.
3. A multi-stakeholder sourcing approach strengthened the vendor sector. The iterative process to develop the RFI helped to ensure all the different perspectives were included. Without all these perspectives the RFI may not have identified the right solutions to address the full needs.
4. Optimize the RFI to reduce the applicant and evaluator burden. MIC designed an application process that minimized the barriers to application and reduced the complexity and time for companies to apply.

MIC is excited to continue to support efforts to link Medicaid programs to tech-enabled solutions by building on these lessons learned in future cohorts.