DotCom Therapy is joining the wave of virtual providers jumping into the Medicaid market.
The digital health provider offers behavioral, speech and occupational therapy to the pediatric population. It will begin its Medicaid efforts in Wisconsin and is working with the state’s BadgerCare Plus program, which integrates Medicaid and the Children’s Health Insurance Program (CHIP) for coverage of those aged 19 and under.
“Last year, when we decided to expand our service line beyond the education system into health care, it was a really obvious choice for us to engage with both commercial and Medicaid payers, to make sure that we were ensuring that everyone had access to our services, not just a select few,” Rachel Mack Robinson, president and founder of DotCom Therapy, told Behavioral Health Business.
Founded in 2017, DotCom Therapy has raised roughly $18.2 million, according to crunchbase. The company, which is based in Madison, Wisconsin, got its start working with K-12 schools. It has since expanded into at-home services.
“We’re all coming out of the COVID pandemic with a new lens on how we can leverage telehealth,” Robinson said. “I think a lot of health plans, including Medicaid are starting to see the value in these services in increasing access, especially access to high quality services.”
The BadgerCare Plus program covers about a third of the children in Wisconsin. While DotCom Therapy started with the BadgerCare Plus program, it plans to expand into new state Medicaid programs.
“We were founded and are based out of Wisconsin and on top of that, we know BadgerCare is one of the most innovative Medicaid programs … in all the 50 states and so we really wanted to start there,” Robinson said.
The rate of mental health services for children with Medicaid has declined since 2019. In fact, children under 19 received roughly 23% fewer services for mental health compared to pre-pandemic levels, according to a preliminary utilization data report from the Centers for Medicare & Medicaid Services (CMS).
“There are a lot of factors that have probably prevented other pediatric teletherapy companies from accepting Medicaid – from reimbursement rates, to administrative red tape. But in the end, real innovators with a mission and focus will find ways to sustainably deliver care to kids,” Dr. Andrey Ostrovsky, former Chief Medical Officer for the U.S. Medicaid Program and advisor to DotCom Therapy, said in a statement.