There's a massive and underserved population of Americans whose mental healthcare needs are not being met. Twenty-nine percent of Americans on Medicaid have a mental illness, according to a recent report from the Department of Health and Human Services Office of Inspector General. There are barriers to receiving treatment, as roughly one-in-four patients able to find a provider had to travel more than an hour to their appointments.
Tech-enabled solutions like telehealth and digital care platforms offer a solution to these place-based problems. Over the last decade we have seen a significant rise in digital health innovation targeting behavioral health—companies like Headway and Calm—the reality, however, is that these platforms primarily serve commercial populations.
Medicaid patients simply do not have the same options or access to providers. At Acumen America, we believe this can change and we’re always seeking solutions that provide Medicaid beneficiaries with simpler access to care, while also building a business model that works for providers. Medicaid is the largest payer of behavioral health services in the United States—spending over $52 billion annually—yet despite being a “covered benefit” it’s not always an accessible benefit for someone with behavioral health challenges. Only 38% of behavioral health providers serve Medicaid beneficiaries, per the HHS study. Sure, it is technically covered—but that doesn’t mean patients can actually get the care they want and need.
In the last year, we’ve invested in two companies working to address the behavioral health needs of people on Medicaid: Flourish Health and Arise Health. Here’s how they’re doing it.
Flourish Health: helping adolescents with serious mental illnesses
Many of the behavioral health solutions we’ve seen are catered to adults with what the healthcare industry calls “mild-to-moderate” mental illnesses. Acumen America invested in Flourish last year because the company has a distinct vision focusing on teens and young adults with serious mental illness (SMI). We hadn’t seen a digitally-enabled solution scaling to serve that population.
But Flourish isn’t just a digital platform. They combine in-person support with virtual therapeutic and psychiatric services. We’ve seen across the healthcare innovation space how important this in-person touchpoint is. Flourish has found that in-person contact helps accelerate trust building—and then patients can get care on their own terms in their own home. Flourish’s guides provide hands-on support to the individual and their families, while leveraging Flourish’s digital platform to personalize the care plan and leverage the right specialist care remotely.
Flourish provides their services to Medicaid beneficiaries at no cost—this is hugely helpful and goes a long way in breaking down barriers that might stop people from getting help. The company currently operates in North Carolina and Virginia and is rapidly expanding with the goal of covering young people nationwide.
Arise Health: providing historically marginalized communities with eating disorder care
Shortly after our investment in Flourish, we connected with Arise Health, a digital telehealth and care coordination platform with an emphasis on treating underserved BIPOC and LGBTQ+ patients with a diverse range of eating disorders. Fewer than 30% of people with eating disorders—which are categorized as a behavioral health condition by the healthcare industry—seek care. In America, BIPOC communities have similar eating disorder rates to white counterparts, but they are roughly half as likely to be diagnosed.
Where Flourish filled a gap in care for teens and young adults with serious mental illness, Arise saw an opportunity to serve the BIPOC and LGBTQ+ community with a broad range of eating disorders. Arise’s founders Joan Zhang and Amanda D’Ambra Manian had their own struggles with eating disorders and their lived experience shaped the company’s mission and vision: ensuring that Americans have access to nonjudgmental, inclusive, and effective eating disorder care.
LIke Flourish, Arise meets patients where they are, providing culturally competent care. The company assigns patients a “Care Advocate,” who is a point of contact (think of them like a traditional case manager) with a deep and nuanced understanding of eating disorders. The Care Advocate guides and coaches patients through their tailored care, from therapists to dietitians and psychiatrists. Patients also have access to group support and translation services for non-English speakers across over 150 languages.The combination of personal touch and digital platform has proven successful, with one Arise member saying “I finally feel like I'm on the path to healing… to have people who can fully relate to and understand what you're going through and experiencing mentally has been completely game-changing.”
We see a through line between Arise and Flourish: focusing on communities historically overlooked and underserved, meeting patients where they are, building trust with an in-person relationship, and then providing patients with care digitally on their own terms that best suits their needs. We’re really excited about these investments and the impact they have already had in their pilot states. We’re hopeful that entrepreneurs in other categories in the healthcare space will follow their lead and provide people on Medicaid with the care they need.
Learn more about our work with the Medicaid Innovation Collaborative here.
Amon co-leads Acumen America.
