Priorities and Promising Solutions
for Tech-Enabled Innovation in Medicaid

In the fall of 2018, the CHCF Health Innovation Fund launched
Primed: A Roundtable Series on Tech-Enabled Innovation in Medicaid, convening Medicaid officials, plans, providers, funders, and entrepreneurs at four statewide roundtables. When asked where technology-enabled solutions could have the greatest impact in their Medicaid systems, attendees across all roundtables identified the same four priority areas.

The Health Innovation Fund then issued a Call for Solutions, and companies with tech-enabled solutions addressing those priority areas responded. Some of those companies are featured here, though there are many others also working hard to scale innovations in Medicaid.

Member
Engagement

Finding,
motivating, and
empowering members
to take control
of managing their
health

Data
Actionability

Enabling providers
to draw insights from
data and apply them
to improve the care of
an individual or an entire
patient population

Workforce Capacity

Increasing an
organization’s ability to
recruit, train, retain,
and utilize a workforce
that meets the needs
of its patient
population

Data Exchange

Enabling providers to
seamlessly exchange
useful data about the
patients they share

Member Engagement
  • Advocatia

    Advocatia provides tools and services to hospitals, employers, and other networks to help the uninsured and underinsured find and secure available benefits.

  • ConsejoSano

    ConsejoSano helps payers and providers more effectively engage with their multicultural Medicaid and Medicare patient populations.

  • Kaizen Health

    Kaizen Health helps patients fromthe low-income, aging, disabled, and veteran communities overcome transportation barriers.

  • mPulse

    mPulse Mobile reaches beneficiaries via their mobile phones and engages them in personalized, two-way dialogue about their benefits and health.

  • Solera

    Solera connects individuals at risk for chronic diseases with a diverse network of lifestyle modification programs as a covered medical benefit.

  • Upfront

    Upfront combines data analytics, dynamic content, and automated outreach to help beneficiaries navigate their provider networks.

  • Wellth

    Wellth uses behavioral economics to improve care plan adherence in patients with chronic conditions.

Data Actionability
  • Ampersand Health

    Ampersand Health analyzes data to identify gaps in care and deploys nurses, community health workers, and other local resources.

  • CloudMedx

    CloudMedx uses natural language processing and machine learning to turn data into real-time and retrospective clinical insights.

  • Cureatr

    Cureatr collects and analyzes data not found in electronic health records to give providers a fuller, more actionable picture of each patient’s health.

  • Cyft

    Cyft aggregates and analyzes multiple streams of structured and unstructured data to predict the likelihood of future adverse events and improve care management.

  • Nuna

    Nuna’s technology, data, and analytics solutions help health care payers and providers get the answers they need to make quality care more affordable.

Workforce Capacity
  • AbleTo

    AbleTo provides technology-enabled behavioral health care for people with depression, anxiety, and stress associated with co-morbid medical conditions and life events.

  • CareAcademy

    CareAcademy provides evidence-based online classes for non-medical professional and family caregivers, helping to increase the talent and satisfaction of the caregiver workforce.

  • Cognotion

    Cognotion's online CNA certification platform, which is compliant in 50 states, teaches best practice skills, as well as resilience, empathy, and self-regulation.

  • IntelyCare

    IntelyCare uses AI to help post-acute health care facilities optimize existing nursing staff capacity and quickly augment it when needed.

  • MedSpoke

    MedSpoke combines cloud-based technology and concierge services to digitize and streamline the licensing and credentialing steps that can slow hiring.

  • Nomad Health

    Nomad Health’s online marketplace directly connects clinicians and medical employers, making the hiring process faster, cheaper, and more transparent.

  • Regroup

    Regroup provides integrated telepsychiatry services to health care entities and their patients to supplement existing services.

  • RubiconMD

    RubiconMD’s web-based eConsult platform matches primary care inquiries with specialists for advice, to provide timely care and reduce unnecessary referrals or visits.

  • Workpath

    Workpath helps health care organizations centralize work opportunities, enabling the right team member, contractor, or vendor to perform any task, anywhere.

Data Exchange
  • ACT.md

    ACT.md helps health systems, payers, and community organizations implement customized community care models focused on the social determinants of health.

  • Collective Medical

    Collective Medical facilitates real-time data exchange, clinical alerts, and care coordination for patients who frequently use emergency services.

  • Healthify

    Healthify helps care teams screen patients for social needs, find community services, and coordinate referrals with community-based organizations.

  • Redox

    Redox is the modern API for EHR integration, enabling the easy, fast, and secure exchange of patient health data across systems.

  • Unite Us

    Unite Us builds coordinated care networks to bring health and social service providers together.

  • Verato

    Verato leverages publicly and commercially available data sources to make patient matching more accurate and efficient.

MEDICAID COVERS 1 IN 5 AMERICANS
Total medicaid spending exceeds $500B Annually

ABOUT THE ROUNDTABLES

MORE THAN 100ATTENDEESincluding Medicaid officials, health plans, providers, funders and entrepreneurs

ROUNDTABLE CO-HOSTS

CHCF HEALTH INNOVATION FUND
The CHCF Health Innovation Fund supports health care technology and service companies with the potential to significantly improve quality of care, lower the total cost of care, or improve access to care for low-income Californians.
SPEIRE HEALTHCARE STRATEGIES
Speire Healthcare Strategies is a boutique health care consulting firm providing strategic advisory services at the intersection of policy and strategy.
VILLAGE CAPITAL
Village Capital finds, trains, and invests in entrepreneurs through its programs, studies entrepreneurs through original research, and shares what it knows with leaders in business, finance, and politics.

OTHER MEDICAID INNOVATION PARTNERS

ADAPTATION HEALTH
Adaptation Health is a buyer-side incubator program developing and building thought leadership and value on behalf of state Medicaid programs and managed care organizations.
HEALTHTECH 4 MEDICAID
Founded by a group of more than 40 HealthTech CEOs, HealthTech4Medicaid is on a mission to radically change the pace of innovation in Medicaid.
AVIA MEDICAID TRANSFORMATION PROJECT
Led by AVIA and former Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt, the Medicaid Transformation Project is a national effort to transform health care and related social needs for the most vulnerable.
TOWN HALL VENTURES
Town Hall Ventures works side by side with visionary entrepreneurs to build businesses that transform care delivery and health outcomes for the underserved.

ROUNDTABLE LOCATIONS

TN
MA
DC
CO
Visit chcf.org/primed for more details on the Roundtable findings and solutions.

Note: This infographic is not an endorsement of any of the featured companies or organizations.