74 Million And Counting: 9 Startups Disrupting Medicaid

Startups are working to improve enrollment, reduce paperwork, and minimize healthcare disparities faced by Medicaid patients. |Startups are working to improve enrollment, reduce paperwork, and minimize healthcare disparities faced by the Medicaid population.

When the Affordable Care Act went into effect 7 years ago, entrepreneurs took notice. It not only allowed for the creation of health insurance marketplaces like Oscar Health and Stride Health, but spurred companies such as Omada Health, a wellness management platform, to be built on top of the new infrastructure for value-based care.

One of the areas of interest for entrepreneurs was government programs like Medicaid and Medicare. Below, we take a look at startups building analytics platforms, communication tools, and billing software to help providers and patients alike better navigate the Medicaid marketplace.

We used the CB Insights database to identify 9 private companies working to improve the management and utility of Medicaid services.

1. IkaSystems

IkaSystems helps health plans such as Medicaid to automate key functions by managing medical and drug utilization effectively, measuring quality metrics, implementing collaborative care management programs, and streamlining overall administration.

Select Investors: Essex Woodlands, Providence Equity Partners, Valhalla Partners

Total Disclosed Funding: $140M

2. Nuna

Nuna has developed a centralized cloud database platform to track the 74 million Medicaid patients in the United States. The company has already partnered with the Centers for Medicare and Medicaid Services to collect data from all 50 states and the District of Columbia. Nuna is using this data to track emerging disease clusters, billing patterns, & care patterns.

Select Investors: Kleiner Perkins Caufield & Byers

Total Disclosed Funding: $90M

3. BeneStream

BeneStream works with employers to ensure employees have access to government benefits to which they are entitled, such as food stamps, Medicaid, and Child Health Plus. The company analyzes the pay of every employee and then offers to enroll low-income personnel into Medicaid.

Select Investors: BlueCross BlueShield Venture Partners, Sandbox Industries, Kapor Capital, Serious Change Fund

Total Disclosed Funding: $9.59M

4. MediQuire

MediQuire targets the Medicaid population by providing a data analytics platform that combines free text notes, scanned documents, and other patient data from the EHR in order to report clinical performance. This allows clinics to more accurately report performance on metrics used for value-based payment programs and help reduce healthcare disparities.

Select Investors: Blueprint Health, FCA Venture Partners, Volcano Capital

Total Disclosed Funding: $4.9M

5. Healthify

Healthify is a software tool for care managers, community health workers, and social workers to coordinate referrals with community-based organization such as a Medicaid Managed Care Organization. The platform allows providers to follow-up and track referrals with the end goal of implementing value-based care.

Select Investors: New York Digital Health Accelerator, Blueprint Health, Kapor Capital, Primary Venture Partners

Total Disclosed Funding: $3.22M

6. HealthCrowd

Mobile healthcare messaging startup HealthCrowd enables all departments of a payer organization to deliver relevant, actionable communication to health plan members at scale.

Select Investors: Healthy Ventures, 37 Angels, Startup Capital Ventures, Band of Angels

Total Disclosed Funding: $2.64M

7. Health: ELT

Texas-based Health: ELT provides engagement, logistics, and technology services for healthcare providers serving the Medicaid population. The company has developed an online dashboard and mobile app to enable care coordinators and other staff to view member assessment due dates, collect data, and streamline scheduling, among other capabilities. The product is intended to improve compliance and reduce paperwork and inefficiencies.

Select Investors: Undisclosed

Total Disclosed Funding: $730K

8. iTherapyDocs

iTherapyDocs provides HIPAA compliant documentation and billing software that simplifies electronic health documentation and billing for Medicaid waiver programs. Their software enables clinics to more easily comply with Medicaid billing rules by clearly displaying what is required and which sections can be customized for every treatment plan.

Select Investors: Undisclosed

Total Disclosed Funding: $100K

9. WellPass

WellPass uses mobile technology to build personal connections between providers and high-risk Medicaid patients to improve outcomes and quality of care.

Select Investors: New York Digital Health Accelerator