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Medicaid-forward virtual care is on the horizon, report finds

Reproduced from Rock Health; Chart: Axios Visuals

Commercial insurance beneficiaries remain the biggest adopters of digital health tools, but as more payers align with value-based care models and startups begin catering to people who use Medicaid, that's starting to change, a recent Rock Health report finds.

Why it matters: For decades, digital health entrepreneurs largely ignored Medicaid users based on assumptions about profit margins and usage rates, but Rock Health's data suggests people with Medicaid use digital tools at rates that closely tail the average user.

Yes, and: Respondents enrolled in Medicaid reported using telehealth tools beyond live video at slightly higher rates than the survey average, Rock Health researchers Jasmine DeSilva, Gabrielle Dell'Aquilo and Adriana Krasniansky found.

  • That includes texting and talking on the phone with a clinician.

By the numbers: Medicaid serves nearly one in five U.S. residents and represents:

What we're watching: Several startups have begun catering specifically to people who use Medicaid. They include:

  • Cityblock Health, a New York-based hybrid primary care company focused on Medicaid patients and valued at $5.7 billion.
  • Galileo, a New York-based virtual care company that provides Medicaid members with round-the-clock service through its app in Spanish and English.
  • Samesky Health, a Los Angeles-based care navigation platform that focuses on multicultural engagement and health equity.
  • Nuna, a San Francisco-based startup that crunches payer and provider data to help track and improve outcomes.

What they're saying: If you build it (in an accessible manner with deep understanding and respect) they will come.

  • “Communication with specific user groups is also about relationship-building, which must be done ... with an understanding of how culture, social and family values impact how people make decisions," Erik Cardenas, Zócalo co-founder and CEO told Rock health.
  • "To us, this data emphasizes the importance of designing digital health solutions that [meet] consumers in ways that are most secure, accessible and cost-effective for them," DeSilva, Dell'Aquilo and Krasniansky write.
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