A report with the Meadows Mental Health Policy Institute offers recommendations for digital health companies

Across the nation, young people are facing an ongoing mental health challenge, one that was amplified by the COVID-19 pandemic and continues to be impacted by mental health workforce shortages. According to Mental Health America’s “The State of Mental Health in America 2023,” as of June 2022, only one mental health care provider is available for every 350 people in the country. In all, about 152 million people – nearly half the U.S. population – are in what’s referred to as a “mental health workforce shortage area.” Nearly two-thirds of these areas are in rural or partially rural areas.

With Hopelab’s support, our partners at Meadows Mental Health Policy Institute examined the state of youth mental health in Texas, a diverse state with a mix of urban, suburban, and rural communities, and where in the last decade, the Legislature has made unprecedented investments in behavioral health. In “A Texas Solution to a National Challenge: How Telehealth Can Bolster Youth Mental Health in the Near-Term,” Meadows conducted a series of key informant interviews with Medicaid and commercial health plan leaders, as well as leaders from telehealth companies that serve young patients.

Drawing upon analysis of the interviews and additional research, the report highlights several near-term actions state government and health plan leaders can take to facilitate the entry and expansion of telehealth companies in the Texas marketplace. To accelerate the availability of these services there are several possible near-term and low-risk opportunities to begin this work. Leaders and policymakers can prepare now to enact feasible changes during upcoming legislative sessions. Health plans can also take action to make the adoption of high-quality telehealth services more likely, while simultaneously helping to address Texas’ mental health workforce shortage.

Through these interviews and research, the report also offers guidance to telehealth companies on how to better serve Texas young people, which may be a model for entry into other states.

General Guidance

• Health plans want to mitigate or solve known problems within their member population. Explain how your product can address those needs and be amenable to adapting your approach to achieve more targeted impacts the health plan identifies.
• It is easier for health plans to work with companies that can fit within their existing billing structures.
• If a company cannot demonstrate a sustainable business model, it will be difficult for health plans to trust that the entity will be around for the long haul.
• Be willing to accept a standard contract, demonstrate outcomes over a designated pilot period, and then discuss a longer-term value-based contract if appropriate.

Medicaid-Specific Guidance

• As soon as you decide to serve Medicaid members, begin the process of enrolling in Texas Medicaid or your target state’s Medicaid program. Connect with a Medicaid Managed Care Organization (MCO) only after you initiate this process.
• Medicaid MCOs are looking for a certain level of payer experience. In an interview with Woebot Health, Superior’s Tracy Rico noted that she wants a company to have 3–5 years of experience working with health plans before she will consider working with them. Similarly, she looks for companies with at least one year of Medicaid experience – or a company leader who came from the Medicaid world.
• Do not expect an elevated service rate or value-based contract at the start. Lead with an ask for fee-for-service rates, demonstrate improved health outcomes over a designated period, and then work toward higher rates and value-based contracting if desired.
• Your pitch to a health plan is often strengthened if you can connect with an MCO’s medical affairs team or another clinician wishing to pilot a new initiative for a particular need. These connections can often be made at conferences.
• Follow Texas Medicaid or your target state’s request for proposal cycles. MCOs are often looking for new, impactful ways to meet member needs at these times.