As the pandemic continues, substance use disorder (SUD) has been on the rise. Recent data shows over 93,000 reported drug overdoses during 2020, which is the highest on record and nearly a 30% increase from 2019. The shortage of providers in this industry has only worsened the crisis for many individuals, families, and communities. Peer support has been a widely used treatment plan for these conditions (e.g. AA programs), but even these programs are struggling to manage the high demand. An innovative company in the SUD space, Marigold Health, provides a virtual peer support network that has scaled to meet the needs of many individuals with SUD. Shrenik Jain, Founder & CEO, sat down with us to discuss the importance of the virtual aspect of peer support, Marigold’s success working in Medicaid, and what’s ahead for the company.
We face an acute shortage of behavioral health providers, and everyone is struggling with patient engagement. Millions of dollars have been invested to make proactive interventions such as counseling and medication-assisted treatment for substance use disorders more accessible, but still only a small minority of those in need receive services consistently.
Peer support, the use of trained individuals in recovery to support others on a similar journey, has been demonstrated to engage patients who may not be willing or able to utilize other services, and is reimbursed by Medicaid in over 40 states. However, the reach of peer support has been limited – grassroots groups such as 12 Steps aren’t integrated with the larger care team and existing phone-based peer coaching programs cannot serve enough individuals to impact the health of a population.
Marigold’s virtual peer support program combines intensive 1-1 supports with 24/7 access to anonymous group chats where patients support each other. When we enter a market, we build a local team of certified peers who embed in existing primary care and behavioral health providers to sign patients up for our app. Once in our online community, we have a set of technology tools that allow our peers to coordinate with others of the care team to respond to patient needs expressed in groups.
In short, we are a virtual provider focused on driving patient engagement and developing a new workforce of behavioral health providers.
We have seen a lot of success working in Medicaid: Medicaid MCOs often have strong relationships with local providers and government stakeholders that we can partner with then rapidly enroll a large member base. One of our biggest advantages is patient acceptability: 70-90% of patients we approach are willing to enroll and give our text groups a try.
In Delaware for example, Marigold partnered with a Medicaid plan to engage members with substance use disorder (SUD) and increase their utilization of proactive services such as MAT. Within 5 months, 2 DE-based peers had provided support to 900 plan members, almost 13k messages were sent in 15 themed support groups, and we signed referral partnerships with agencies collectively delivering ~80% of methadone care statewide. We structured a bundle (alternative payment model) with the plan that allowed us to rapidly expand eligibility to all members following an initial pilot.
The funding is all going into growth, primarily growing the team as we enter new states. Our goal is to build the most capable peer workforce in the country, whose recovery experience includes a full spectrum of mental health disorders and challenges beyond substance use alone.
In our other departments, we are currently searching for a Clinical Director to report directly to our Chief Medical Officer and further develop programming, as well as a Director of Growth, who will work directly with the CEO to build plan partnerships.