Ontrak Secures Medicaid Provider Designation in Two New States, Enhancing Direct Service Delivery Capabilities
Ontrak (NASDAQ: OTRK) has secured Medicaid provider designation in two states - one in the Midwest and another in the Southeast. This strategic development enables the AI-powered behavioral healthcare company to operate as a direct value-based provider alongside its existing vendor operations.
The new designation allows Ontrak to align quality outcomes and HEDIS measures with medical cost savings and financial incentives shared with payor partners. Notably, this status permits fees to be categorized under the medical cost ratio rather than administrative vendor fees, and enables billing codes reimbursable at the State level for Medicaid plans.
The company is currently in discussions with a large Midwestern Health Plan regarding potential implementation of its WholeHealth+ solution. These Medicaid approvals strengthen Ontrak's ability to create value-based partnerships with managed care organizations, health systems, and community-based providers across multiple states for Medicaid beneficiaries.
Ontrak (NASDAQ: OTRK) ha ottenuto la designazione di fornitore Medicaid in due stati: uno nel Midwest e l'altro nel Sud-est. Questo sviluppo strategico consente all'azienda di assistenza sanitaria comportamentale supportata dall'IA di operare come un fornitore diretto basato sul valore accanto alle sue operazioni di fornitore esistenti.
La nuova designazione permette a Ontrak di allineare i risultati di qualità e le misure HEDIS con il risparmio sui costi medici e gli incentivi finanziari condivisi con i partner pagatori. È importante notare che questo stato consente di categorizzare le spese sotto il rapporto di costo medico piuttosto che come spese amministrative per i fornitori, e abilita i codici di fatturazione rimborsabili a livello statale per i piani Medicaid.
L'azienda è attualmente in discussione con un grande piano sanitario del Midwest riguardo alla potenziale implementazione della sua soluzione WholeHealth+. Queste approvazioni Medicaid rafforzano la capacità di Ontrak di creare partnership basate sul valore con organizzazioni di assistenza gestita, sistemi sanitari e fornitori comunitari in diversi stati per i beneficiari di Medicaid.
Ontrak (NASDAQ: OTRK) ha obtenido la designación de proveedor de Medicaid en dos estados: uno en el Medio Oeste y otro en el Sureste. Este desarrollo estratégico permite a la empresa de atención médica conductual impulsada por IA operar como un proveedor directo basado en el valor junto a sus operaciones de proveedor existentes.
La nueva designación permite a Ontrak alinear los resultados de calidad y las medidas HEDIS con el ahorro de costos médicos y los incentivos financieros compartidos con los socios pagadores. Es notable que este estatus permite que las tarifas se clasifiquen bajo la relación de costo médico en lugar de tarifas administrativas de proveedores, y habilita códigos de facturación reembolsables a nivel estatal para los planes de Medicaid.
La empresa está actualmente en conversaciones con un gran plan de salud del Medio Oeste sobre la posible implementación de su solución WholeHealth+. Estas aprobaciones de Medicaid fortalecen la capacidad de Ontrak para crear asociaciones basadas en el valor con organizaciones de atención administrada, sistemas de salud y proveedores comunitarios en varios estados para los beneficiarios de Medicaid.
온트락 (NASDAQ: OTRK)는 중서부와 남동부의 두 주에서 Medicaid 제공자 지정을 확보했습니다. 이 전략적 발전은 AI 기반의 행동 건강 관리 회사가 기존 공급업체 운영과 함께 가치 기반 직접 제공자로 운영할 수 있게 해줍니다.
새로운 지정을 통해 온트락은 품질 결과 및 HEDIS 지표를 의료 비용 절감 및 지불자 파트너와 공유되는 재정적 인센티브와 일치시킬 수 있습니다. 특히 이 지위는 수수료를 관리 공급업체 수수료가 아닌 의료 비용 비율 아래로 분류할 수 있게 하며, Medicaid 계획에 대해 주 차원에서 환급 가능한 청구 코드 사용을 가능하게 합니다.
회사는 현재 중서부의 대형 건강 계획과 WholeHealth+ 솔루션의 잠재적 구현에 대해 논의 중입니다. 이러한 Medicaid 승인은 온트락이 여러 주에서 Medicaid 수혜자를 위한 관리 의료 조직, 건강 시스템 및 지역 사회 기반 제공자와 가치 기반 파트너십을 구축할 수 있는 능력을 강화합니다.
Ontrak (NASDAQ: OTRK) a obtenu la désignation de fournisseur Medicaid dans deux États : un dans le Midwest et un autre dans le Sud-Est. Ce développement stratégique permet à l'entreprise de soins de santé comportementale alimentée par l'IA d'opérer en tant que fournisseur direct basé sur la valeur en parallèle de ses opérations de fournisseur existantes.
La nouvelle désignation permet à Ontrak d'aligner les résultats de qualité et les mesures HEDIS avec les économies de coûts médicaux et les incitations financières partagées avec les partenaires payeurs. Il est à noter que ce statut permet de classer les frais sous le ratio de coût médical plutôt que comme des frais administratifs pour les fournisseurs, et permet l'utilisation de codes de facturation remboursables au niveau de l'État pour les plans Medicaid.
L'entreprise est actuellement en discussion avec un grand plan de santé du Midwest concernant la mise en œuvre potentielle de sa solution WholeHealth+. Ces approbations Medicaid renforcent la capacité d'Ontrak à créer des partenariats basés sur la valeur avec des organisations de soins gérés, des systèmes de santé et des fournisseurs communautaires dans plusieurs États pour les bénéficiaires de Medicaid.
Ontrak (NASDAQ: OTRK) hat die Medicaid-Anbieterbezeichnung in zwei Bundesstaaten erhalten - einem im Mittleren Westen und einem im Südosten. Diese strategische Entwicklung ermöglicht es dem KI-gestützten Unternehmen für Verhaltensgesundheitsversorgung, als direkter wertbasierter Anbieter neben seinen bestehenden Anbieteroperationen zu agieren.
Die neue Bezeichnung erlaubt es Ontrak, Qualitätsresultate und HEDIS-Maßnahmen mit Einsparungen bei den medizinischen Kosten und finanziellen Anreizen, die mit den Zahlungspartnern geteilt werden, in Einklang zu bringen. Bemerkenswert ist, dass dieser Status es erlaubt, Gebühren unter dem medizinischen Kostenverhältnis und nicht als administrative Anbietergebühren zu kategorisieren, und ermöglicht abrechenbare Codes auf staatlicher Ebene für Medicaid-Pläne.
Das Unternehmen befindet sich derzeit in Gesprächen mit einem großen Gesundheitsplan im Mittleren Westen über die mögliche Implementierung seiner WholeHealth+-Lösung. Diese Medicaid-Zulassungen stärken Ontraks Fähigkeit, wertbasierte Partnerschaften mit Managed-Care-Organisationen, Gesundheitssystemen und gemeindenahen Anbietern in mehreren Bundesstaaten für Medicaid-Begünstigte zu schaffen.
- Secured Medicaid provider designation in two new states, expanding market reach
- New designation enables billing under medical cost ratio instead of administrative fees
- Potential new partnership with large Midwestern Health Plan
- Enhanced ability to create value-based partnerships across multiple states
- None.
Insights
Ontrak's newly secured Medicaid provider designations in two states represents a pivotal business model expansion that substantially enhances their market position in behavioral healthcare. This regulatory achievement transforms Ontrak from purely a vendor to a direct value-based care provider – a distinction with significant strategic and financial implications.
The most compelling aspect is how this designation fundamentally changes Ontrak's revenue structure. By operating as a value-based provider, their fees can now be classified under medical cost ratio rather than administrative expenses – a critical distinction for payors operating under MLR requirements and administrative cost constraints. Additionally, gaining the ability to bill reimbursable codes directly to state Medicaid programs creates a potentially more stable and diversified revenue stream.
These designations directly advance Ontrak's business development efforts, specifically with a large Midwestern Health Plan prospect. The company's strategic approach of maintaining both vendor and provider models creates operational flexibility to adapt to different customer preferences and regulatory environments across markets.
For behavioral healthcare, where access barriers disproportionately affect vulnerable populations, this model enables Ontrak to deliver integrated services to Medicaid beneficiaries who often face the largest care gaps. This positions the company at the intersection of mental health, technology, and value-based care transformation – addressing both commercial objectives and public health needs in underserved communities.
Ontrak's achievement of Medicaid provider designation in two states represents a structural business transformation with meaningful financial implications. This regulatory milestone enables a dual-track business model where Ontrak can operate both as a vendor and as a direct care provider – significantly expanding their addressable market and revenue opportunities.
The financial advantage is multi-layered. First, provider status allows Ontrak to shift from the administrative expense category to the medical cost ratio, which is crucial for payors facing administrative cost constraints. Second, direct billing capabilities through state-level reimbursable codes creates a new revenue stream outside their traditional vendor model. Third, the value-based care designation enables Ontrak to align financial incentives with quality outcomes and HEDIS measures – creating shared savings opportunities with payor partners.
The immediate business impact is evident in advancing discussions with a major prospect and a large Midwestern Health Plan, demonstrating tangible pipeline acceleration. This expanded operational flexibility gives Ontrak options to customize partnership structures based on payor preferences rather than being to a single business model.
While specific financial projections aren't provided, this evolution represents a fundamental enhancement to Ontrak's market position and revenue potential in the behavioral health space, particularly for accessing the substantial Medicaid market where mental health services are chronically underfunded and underdelivered.
Medicaid affiliation enables Ontrak to operate as a direct value-based provider in addition to its historical operations as a vendor. As a value-based care provider, Ontrak can align the quality outcomes and HEDIS measures with medical cost savings and financial incentives that it shares with payor partners. In addition, classification as a value based provider gives payors greater flexibility to partner with Ontrak through a model that allows for fees to become part of the medical cost ratio rather than an administrative vendor fee. And for Medicaid plans, it will allow for Ontrak to bill codes that are reimbursable at the State level. This shift is further enabling additional pipeline opportunities and provides payors optionality and flexibility in working with Ontrak.
"Securing these new Medicaid designations was a key step in advancing conversations with one of our major prospects, and enables Ontrak to more efficiently address a critical gap in mental health at the core of our solutions; delivering integrated behavioral health services to vulnerable populations," said Brandon LaVerne, CEO. "Collectively, these Medicaid approvals further enable us to create opportunities for value-based partnerships with managed care organizations, health systems, and community-based providers across multiple states for Medicaid beneficiaries."
Operating in the provider model, Medicaid designations are crucial in behavioral health, where access has often been limited for underserved communities. Official recognition in various states allows us to tailor value-based care models to local needs while using insights from other regions. Ontrak will continue to operate as a vendor for existing customers and many new prospects who prefer this model, but will also continue seeking additional state Medicaid affiliations when appropriate to deliver enhanced services to customers or prospects.
About Ontrak Health
Ontrak Health (Nasdaq: OTRK) is a leading AI and technology-enabled behavioral healthcare company whose mission is to help improve the health and save the lives of as many people as possible. Ontrak identifies, engages, activates, and provides care pathways to treatment for the most vulnerable members of the behavioral health population who would otherwise fall through the cracks of the healthcare system. We engage individuals with anxiety, depression, substance use disorder, and chronic disease through personalized care coaching and customized care pathways that help them receive the treatment and advocacy they need, despite the socioeconomic, medical, and health system barriers that exacerbate the severity of their comorbid illnesses. The company's integrated intervention platform uses AI, predictive analytics, and digital interfaces combined with dozens of care coach engagements to deliver improved member health, better healthcare system utilization, and durable outcomes and savings to healthcare payors.
Forward-Looking Statements
This press release contains “forward-looking” statements that are based on the Company’s beliefs and assumptions and on information currently available to the Company on the date of this press release and are made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may include, but are not limited to, the expectations around a Midwestern Health Plan implementing Ontrak’s WholeHealth+ solution, the ability to leverage greater access to reimbursable fees within the medical cost ratio and our ability to close additional pipeline opportunities and convert them to customers. These forward-looking statements reflect numerous assumptions and involve a variety of risks and uncertainties, many of which are beyond our control, which may cause actual results to differ materially from stated expectations. These risk factors include, among others, our ability to effectively improve the quality measures and boost performance scores for our customers and the impact of this solution on increasing the number of, and revenue from, our prospective customers. For a further list and description of the risks and uncertainties we face, please refer to our most recent Securities and Exchange Commission filings which are available on its website at http://www.sec.gov. Such forward-looking statements are current only as of the date they are made and based on information available to us on the date hereof, and we assume no obligation to update any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by law.
View source version on businesswire.com: https://www.businesswire.com/news/home/20250403870594/en/
Company Contact:
Brandon LaVerne
Chief Executive Officer
blaverne@ontrakhealth.com
Investor Relations:
Ryan Halsted
Gilmartin Group
investors@ontrakhealth.com
Source: Ontrak, Inc
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