Lakeshore Regional Entity

What Lakeshore Regional Entity does

Lakeshore Regional Entity (LRE) is a Michigan non-profit Prepaid Inpatient Health Plan (PIHP) that administers and manages behavioral health, mental health, developmental disability, and substance use disorder (SUD) services for Medicaid beneficiaries and eligible uninsured individuals across seven West Michigan counties: Allegan, Kent, Lake, Mason, Muskegon, Oceana, and Ottawa. LRE is one of ten designated PIHPs in Michigan and operates under contract with the Michigan Department of Health and Human Services (MDHHS), functioning as a regional financial and administrative coordinating entity rather than a direct service provider. Service delivery is executed through a contracted network of five Community Mental Health Service Programs (West Michigan CMH, Network 180, HealthWest Muskegon, OnPoint Allegan County, and CMH of Ottawa County) and a broader SUD treatment provider network, supported by a customer services department for eligibility, grievance, and appeals navigation.

LRE's service portfolio includes mental health services, developmental disability services, SUD prevention and treatment (including priority admission for pregnant and parenting women), Home and Community Based Services (HCBS), veteran services with a dedicated navigator, and compliance programs such as the SYNAR tobacco retailer survey and the No Cigs for Our Kids campaign. The organization operates two community-facing prevention sub-brands, Talk Sooner (drug prevention) and Stay Out of the Danger Zone (gambling disorder prevention). On the technology side, LRE has deployed FHIR-based Patient Access API and Provider Directory API, built in partnership with PCE Systems (its EHR vendor), to comply with CMS interoperability mandates and the ONC 2015 Edition Cures Update. The organization maintains HIPAA, HITECH, 42 CFR Part 2, and Michigan Mental Health Code compliance postures.

LRE's revenue model is government-contract based: all funding flows from MDHHS through Medicaid managed care capitation, with no commercial sales motion and no publicly disclosed pricing. The entity is governed by a 15-member Executive Board of Directors drawn from community and business leaders across the seven-county region, consistent with a public-purpose governance model rather than a venture-backed or commercial ownership structure.

Name

Lakeshore Regional Entity

Legal name

Lakeshore Regional Entity

Website

https://lsre.org

Company type

Private

Founded year

2014

Operating status

Operating

Headcount range

11–50 employees

Short description

Lakeshore Regional Entity is a Michigan non-profit Prepaid Inpatient Health Plan that administers Medicaid behavioral health, mental health, and substance use disorder services for beneficiaries across seven West Michigan counties through a network of contracted community mental health providers.

Ownership category

akta.pro rank

Product category

Behavioral Health Managed Care

NAICS

Outpatient Mental Health and Substance Abuse Centers (621420), Administration of Public Health Programs (92312), Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse Facilities (6232)

SIC

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

akta.pro primary industry

Managed Care Entity Administration for Medicaid (MCO/PHP/PIHP/PAHP) (HLAEAEAJ)

akta.pro secondary industries

Employee Assistance Programs (EAP) Management (HLAEAHAB), Behavioral Health Care Management & Case Management (HLAEAHAE), Substance Use Disorder (SUD) Benefit Management (HLAEAHAF), Community Mental Health Centers (CMHCs) & Public Behavioral Health Providers (HLAFACAI)

Keywords

• Behavioral health services
• Mental health management
• Substance use treatment
• Medicaid managed care
• Prepaid health plan

Headquarters

HQ city

Saint Clair Shores

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, Others

Revenue model

1. Government Contract Revenue (MDHHS): LRE operates as a PIHP under contract with the Michigan Department of Health and Human Services (MDHHS) to manage behavioral health, mental health, and substance use disorder services for Medicaid beneficiaries and eligible uninsured individuals in the seven-county region. Revenue is derived from government-funded healthcare programs.

Go-to-market motion1 record

Distribution channels4 records

Marketing channels5 records

Core offering

Lakeshore Regional Entity administers prepaid inpatient mental health, behavioral health, and substance use disorder services for Medicaid beneficiaries and eligible uninsured individuals across seven West Michigan counties under contract with the Michigan Department of Health and Human Services (MDHHS). The organization functions as a coordinating Prepaid Inpatient Health Plan (PIHP), managing financial and administrative oversight of services delivered through a network of contracted Community Mental Health Service Providers (CMHSPs) and SUD treatment providers.

Product overview

Lakeshore Regional Entity (LRE) operates as one of ten Prepaid Inpatient Health Plans (PIHP) in Michigan, providing financial and administrative management for Behavioral Health, Mental Health, and Substance Use Disorder Services. The organization functions as a coordinating entity rather than a direct service provider, working through a network of contracted providers across seven Michigan counties (Kent, Muskegon, Ottawa, Oceana, Lake, Mason, and Allegan). The core service portfolio includes Mental Health Services, Developmental Disability Services, and Substance Use Disorder (SUD) Prevention and Treatment programs, supplemented by Home and Community Based Services (HCBS), Customer Services navigation, and a Provider Network management infrastructure. LRE also offers interoperability infrastructure through Patient Access API and Provider Directory API (both FHIR-based), supporting beneficiary data access and provider directory queries. Specialized programs include the SYNAR tobacco compliance program, No Cigs for Our Kids campaign, Gambling Disorder Prevention, and Veteran Services with dedicated navigator support.

Differentiator

Problem solved

Functional benefit

Brands

• Talk Sooner: Online resource designed to inspire and encourage parents to have conversations about substance use with their children/teens, providing drug trend information, talking tips, and resources.
• Stay Out of the Danger Zone

Products and services

• Mental Health Services Comprehensive mental health services for adults and children with mental illness, delivered through a network of contracted providers across seven West Michigan counties under the PIHP structure.
• Substance Use Disorder (SUD) Services Prevention and treatment services for substance use disorders including harm reduction interventions, inpatient and outpatient therapy, sober living support, and specialized programs for pregnant and parenting women.
• Developmental Disability Services Services for individuals with developmental disabilities, managed through the PIHP structure for financial and administrative oversight across the seven-county region.
• Home and Community Based Services (HCBS) Medicaid services for people with disabilities that ensure equal access to the community, opportunity for independence in making life decisions, and protection of beneficiary rights.
• Customer Services Navigation assistance for individuals through the Mental Health/Substance Use Disorder system, including eligibility questions, complaints resolution, grievance filing, and appeals support, available M-F 8AM-5PM at 1-800-897-3301.
• Veteran Services Specialized programming dedicated to helping veterans find stable housing, access physical and mental health services, and locate military paperwork to achieve benefits, facilitated by a dedicated Veteran Navigator.
• SYNAR Program Federal compliance program conducting annual tobacco retailer surveys to determine illegal sales rates to minors under 18, required for maintaining Substance Abuse Prevention and Treatment Block Grant funds.
• No Cigs for Our Kids Campaign Tobacco compliance campaign focused on reducing youth access to tobacco through retailer education and joint law enforcement sting operations across all seven counties.
• Gambling Disorder Prevention Program Prevention initiative addressing problem gambling through the Stayouttathedangerzone resource, providing tips for responsible gambling and support resources for parents of teens to seniors.
• Provider Network Network of contracted Community Mental Health Service Providers and SUD treatment providers delivering behavioral health services across the seven-county region, supported by provider manuals, contract documents, and credentialing processes.

Quantifiable outcome

• Services delivered across 7 West Michigan counties through 5 Community Mental Health agencies

Named customers2 records

Segments4 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

Feature3 records

Partnerships

Nine partnerships are on record, tiered core and minor.

• PCE SystemscoreTechnology or IntegrationLRE collaborates with PCE Systems as the EHR vendor for interoperability. PCE Systems provides Web Service API infrastructure enabling the Patient Access API and Provider Directory API for CMS compliance. Developer API access is managed through PCE Systems.
• West Michigan CMHcoreImplementation/ SI/ Consulting PartnerCommunity Mental Health agency serving the region, providing direct mental health services to beneficiaries. One of five CMHSPs within the LRE network.
• Network 180coreImplementation/ SI/ Consulting PartnerCommunity Mental Health agency providing mental health services within the LRE regional network.
• HealthWest MuskegoncoreImplementation/ SI/ Consulting PartnerBehavioral wellness agency serving Muskegon County residents as part of the LRE provider network.
• OnPoint (Allegan County)coreImplementation/ SI/ Consulting PartnerCommunity mental health agency serving Allegan County as part of the LRE regional network.
• CMH of Ottawa CountycoreImplementation/ SI/ Consulting PartnerCommunity Mental Health agency providing services to Ottawa County residents within the LRE network.
• Michigan Department of Health and Human Services (MDHHS)coreStrategic or Co-development PartnerLRE operates under contract with MDHHS to manage behavioral health services for Medicaid beneficiaries. MDHHS provides the contractual framework and funding for PIHP operations across the seven-county region.
• TalkSooner.orgminorStrategic or Co-development PartnerOnline resource designed to encourage parents to discuss drug topics with children/teens. Part of SUD prevention initiative providing drug trend information and talking tips.
• StayouttathedangerzoneminorStrategic or Co-development PartnerGambling disorder prevention resource providing tips for responsible gambling and resources for support. Targeted at parents of teens to seniors.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Region 10 PIHP: Michigan PIHP serving southeast Michigan counties under the same MDHHS contract framework. Comparable in role, regulatory exposure, and CMHSP-contracted delivery model.
• Mid-State Health Network: Michigan PIHP serving 21 mid-Michigan counties. Runs the same PIHP model, contracts with regional CMHSPs, and reports to MDHHS — directly comparable in governance and operating design.
• Macomb County Community Mental Health: Michigan PIHP and CMH provider for Macomb County. Combines PIHP managed-care functions with direct service delivery, making it a useful operational comparator.
• Southwest Michigan Behavioral Health: Michigan PIHP covering eight southwest counties. Operates the same MDHHS-contracted PIHP structure, including CMHSP contracting, SUD management, and PIHP-level managed-care administration.
• Detroit Wayne Mental Health Authority: Michigan PIHP responsible for behavioral health services in Detroit/Wayne County. Same PIHP statutory structure under MDHHS, but with significantly larger scale (urban density).
• NorthCare Network: Another of Michigan's ten Prepaid Inpatient Health Plans serving a 21-county Upper Peninsula region. Operates the same MDHHS-contracted PIHP model for Medicaid behavioral health, making it a structurally identical peer for LRE.
• Northern Michigan Regional Entity: Michigan PIHP covering a 31-county northern region with the same MDHHS-contracted managed-care role for behavioral health and SUD services. Closely comparable in structure, scope of services, and compliance obligations.

Broad incumbents

• Magellan Health: Large national managed behavioral health care company with extensive public-sector contracts. Overlaps with LRE in behavioral health benefit administration and utilization management, but at vastly greater scale and as a commercial operator.
• Centene Corporation: Major publicly traded Medicaid managed care insurer with significant behavioral health carve-out exposure through subsidiaries. Comparable in managed-Medicaid and behavioral health benefit administration, but operates commercially and at national scale.
• Optum Behavioral Health: UnitedHealth Group's behavioral health arm, one of the largest U.S. behavioral health managed care platforms. Comparable in benefit administration, care management, and provider network oversight, but embedded in a far larger payer-services ecosystem.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat3 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/lakeshore-regional-entity

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

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 Lakeshore Regional Entity