Mid-State Health Network

Name

Mid-State Health Network

Legal name

Mid-State Health Network

Website

https://midstatehealthnetwork.org

Company type

Private

Founded year

2014

Operating status

Operating

Headcount range

51–100 employees

Ownership category

akta.pro rank

Product category

Behavioral Health Managed Care

NAICS

Outpatient Mental Health and Substance Abuse Centers (621420), Offices of Mental Health Practitioners (except Physicians) (621330)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

Behavioral Health Benefit Administration (MBHO Core) (HLAEAHAA)

akta.pro secondary industries

Behavioral Health Utilization Management & Care Authorization (HLAEAHAD), Behavioral Health Care Management & Case Management (HLAEAHAE), Substance Use Disorder (SUD) Benefit Management (HLAEAHAF), Behavioral Health Population Health, Quality & Outcomes Measurement (HLAEAHAI)

Keywords

• Behavioral health services
• Substance use treatment
• Medicaid managed care
• Mental health coordination
• Behavioral health network

Headquarters

HQ city

Lansing

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure, Others

Revenue model

1. Medicaid Capitation Payments: MSHN receives capitation payments from the Michigan Department of Health and Human Services (MDHHS) for providing Medicaid-funded specialty behavioral health services across its 21-county region.
2. Federal Block Grant Funding: Receives federal block grant funding for substance use disorder prevention and treatment services.
3. PA2 State Funding: State-funded services through Michigan Public Act 2 for substance use disorder services.

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

Mid-State Health Network (MSHN) is a Pre-Paid Inpatient Health Plan (PIHP) that manages and coordinates publicly-funded specialty behavioral health and substance use disorder services across a 21-county region in Michigan. The organization contracts with the Michigan Department of Health and Human Services (MDHHS) to administer Medicaid-funded behavioral healthcare, delegating mental health service delivery to 12 Community Mental Health Service Programs (CMHSPs) and directly managing a SUD provider network of 121+ providers and an Access Line for residential, recovery housing, and withdrawal management placements.

Product overview

Mid-State Health Network (MSHN) is a Pre-Paid Inpatient Health Plan (PIHP) providing regional behavioral health and substance use disorder coordination across 21 Michigan counties. The organization operates as a platform of coordinated services rather than a single product, encompassing core service delivery through SUD Access, Mental Health Services Coordination, Harm Reduction, Women's Specialty Services, and Gambling Disorder Services; support services including the SUD Care Navigator and Veterans Navigator; consumer services such as Customer Service, Appeals and Grievances, and Member Handbooks; compliance services including QAPIP and external site reviews; and provider network services including a Provider Directory, Provider Trainings, and SUD Provider Network contracting. The network delegates mental health to 12 Community Mental Health Service Programs (CMHSPs) while directly managing SUD services.

Differentiator

Problem solved

Functional benefit

Products and services

• SUD Access Services Centralized access coordination for substance use disorder services including residential treatment, recovery housing, and withdrawal management through the MSHN Access Line (844-405-3095). Access Specialists help eligible Medicaid beneficiaries navigate options and find appropriate support across the 21-county region.
• Mental Health Services Coordination Delegated access and coordination of mental health services through 12 Community Mental Health Service Programs (CMHSPs) covering 21 Michigan counties, including outpatient counseling, psychiatric services, crisis intervention, and community living supports for Medicaid beneficiaries.
• Harm Reduction Services Community harm reduction programming offering fentanyl awareness, naloxone distribution, syringe service programs, and overdose prevention resources aimed at reducing negative health consequences associated with drug use.
• SUD Care Navigator Care navigation and coordination support for priority populations including MDOC referrals, individuals at risk of losing child custody, pregnant individuals, and intravenous drug users, focused on reducing barriers and gaps in accessing SUD treatment.
• Veterans Navigator Outreach and support program providing cultural sensitivity and behavioral health navigation for veterans, service members, and military families to improve access to mental health and SUD services.
• Women's Specialty Services Gender-responsive SUD treatment across residential, intensive outpatient, outpatient, recovery supports, and medication-assisted treatment levels of care, with programming that allows children to remain with mothers during treatment and priority admission for pregnant women.
• Gambling Disorder Services Connection to problem gambling resources including the Disassociated Persons List, National Council on Problem Gambling, Michigan Association of Problem Gambling, and treatment provider training for gambling disorder.
• Appeals and Grievances Process Formal appeals process (60 calendar days to file; 30 days standard resolution; 72 hours expedited) and grievance process (no time limit) for adverse benefit determinations and service dissatisfaction for Medicaid beneficiaries.
• Customer Service Department Front-door customer service for MSHN available Monday-Friday 8:00 am to 5:00 pm to assist beneficiaries with questions, complaints, grievances, local appeals, Medicaid Fair Hearings, recipient rights, and resource information.
• Quality Assessment and Performance Improvement Program (QAPIP) Annual quality and compliance program meeting MDHHS standards including compliance monitoring, external site reviews by MDHHS and HSAG, performance measure validation, and consumer satisfaction surveys using MHSIP and YSS instruments.
• Member Handbook Consumer Services Handbook provided upon service entry and annually, covering confidentiality, coordination of care, emergency access, grievance procedures, language accessibility, recipient rights, and service array information in English and Spanish.
• SUD Treatment and Prevention Provider Network Contracted SUD provider panel for MSHN covering prevention, early intervention, withdrawal management, residential, outpatient, medication-assisted treatment, and recovery supports. Providers join via Contract Request process requiring Universal Credentialing through MDHHS.
• Provider Training Program Regional training grid with mandatory topics for SUD and CMHSP staff, Lunch and Learn series, MCBAP-eligible CEUs, quarterly provider meetings, and recorded training sessions on compliance, quality, and clinical topics.

Quantifiable outcome

• Services provided across 21 Michigan counties
• +1 more outcomes

Named customers5 records

Segments5 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Six partnerships are on record, tiered core and minor.

• PCE SystemscoreTechnology or IntegrationPCE Systems is MSHN's Electronic Health Record (EHR) vendor. MSHN works with PCE Systems to meet CMS standards for safe sharing of healthcare information while protecting privacy. The partnership includes Web Service API Documentation and Provider Directory API endpoint hosting.
• Bay-Arenac Behavioral Health AuthoritycoreStrategic or Co-development PartnerCMHSP Participant serving Bay and Arenac counties. Part of the 12-member collaborative that forms MSHN's Provider Network for delivering Medicaid-funded specialty behavioral health services.
• Clinton-Eaton-Ingham Community Mental Health AuthoritycoreStrategic or Co-development PartnerCMHSP Participant serving Clinton, Eaton, and Ingham counties. Part of the 12-member collaborative that forms MSHN's Provider Network.
• Community Mental Health for Central MichigancoreStrategic or Co-development PartnerCMHSP Participant serving Clare, Gladwin, Isabella, Mecosta, Midland, and Osceola counties. Part of the 12-member collaborative that forms MSHN's Provider Network.
• Michigan Department of Health and Human Services (MDHHS)coreOthersMDHHS is the state agency that contracts with MSHN as a PIHP to deliver Medicaid-funded specialty behavioral health services. MSHN operates under contract with MDHHS and adheres to all MDHHS guidance, requirements, policies, and practice guidelines.
• Health Services Advisory Group (HSAG)minorOthersExternal quality review organization contracted by MDHHS to measure and report on PIHP performance. Conducts Performance Measure Validation, Performance Improvement Project, and Compliance Monitoring reviews.

Scale indicators5 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Magellan Health: National managed behavioral health company (now part of Centene) providing behavioral health benefit management, specialty care management, and integrated physical-behavioral programs. Broad incumbent peer operating a substantially larger version of MSHN's core managed care function.
• Carelon Behavioral Health: National MBHO (formerly Beacon Health Options) under Elevance Health that manages behavioral health benefits for commercial and Medicaid plans across many states. Broad incumbent offering overlapping managed care and utilization management capabilities to MSHN's regional PIHP scope.
• Optum Behavioral Health: UnitedHealth Group's behavioral health managed care arm, providing utilization management, network administration, and care coordination for Medicaid and commercial populations nationally. Broader-scope incumbent operating in the same MBHO category as MSHN but at national scale.

Direct peers

• Northern Michigan Regional Entity: Michigan PIHP serving a 21-county service area in northern lower Michigan and the Upper Peninsula. Directly comparable to MSHN in mission (Medicaid behavioral health PIHP), scope (multi-county regional), and governance (collaborative of CMHSPs).
• Southwest Michigan Behavioral Health: Michigan PIHP coordinating behavioral health services across counties in southwest Michigan. Shares the PIHP model, MDHHS contract structure, CMHSP collaborative governance, and managed behavioral health benefit administration as MSHN.
• Network180: Kent County's Community Mental Health Authority functioning as a PIHP for behavioral health services in greater Grand Rapids. Directly comparable to MSHN's CMHSP Participant entities and the broader PIHP model MSHN coordinates.
• Community Care Behavioral Health Organization: Pennsylvania-based managed behavioral health organization that contracts with county governments to administer Medicaid behavioral health benefits — a structural analog to Michigan's PIHP model. Closest non-Michigan comparator to MSHN's regional managed care role.
• Oakland Community Health Network: Michigan PIHP managing Medicaid behavioral health services for Oakland County residents. Operates the same PIHP model as MSHN — MDHHS contract, CMHSP-style provider network, managed behavioral health benefit administration — making it a direct regional peer.
• NorthCare Network: Michigan PIHP serving the Upper Peninsula. Operates the same Pre-Paid Inpatient Health Plan structure as MSHN, with a CMHSP-based provider network delivering Medicaid-funded behavioral health and SUD services.
• Detroit Wayne Mental Health Authority: Largest of Michigan's ten PIHPs, also operating under contract with MDHHS to manage Medicaid behavioral health benefits in its region. Directly comparable to MSHN in governance structure (community-led), funding model (Medicaid capitation), and service mix (mental health + SUD), differing primarily in geographic scope and population size.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Facebookfacebook.com/midstatehealthnetwork
• LinkedInlinkedin.com/company/mid-state-health-network

Compliance7 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Mid-State Health Network