The Medicaid Black Book Review Methodology


The Medicaid Black Book is an in-depth, qualitative review of vendors seeking to partner with payers in the Medicaid space. 

Our review consists of 55 different analyses conducted by our team of industry researchers and analysts. These analyses span 5 domains we have found to be critical indicators of successful vendor partners in the Medicaid space: 

  1. Leadership Medicaid Experience
  2. Brand Visibility and Reputation
  3. Clarity of the Value Proposition
  4. Scalability
  5. Funding Model

What do the ratings mean?

Medicaid Black Book ratings are used by subscribers in different ways, and it is up to each subscriber how they choose to incorporate ratings in their overall decision making. We do offer initial guidance on how to use the ratings, as shown in the chart below:

What is included in the analysis?

While much of the review process is proprietary, there is much we can share. For example, the domains are weighted differently in the overall assessment. 

As you can see in the chart of domains, we feel that the Medicaid experience of the leadership team is paramount in predicting how effective a vendor partner will be. Most health plans and state clients tell us that vendors without meaningful Medicaid experience add additional time and cost to the relationship for 2 main reasons: 1) they have to be trained on Medicaid by you and your staff; and 2) they overstate their experience during the sales process which masks risks and costs. 

Note: While funding model is included in the 55 point algorithm research, it is not scored. 

What is the source of data used for the analyses?

Our teams use a wide range of data sources as well as direct interviews.

Can reviewed companies provide context to the analyses?

All companies reviewed in Medicaid Black Book are given an opportunity to conduct an in depth interview with our team. For those that do, an additional 25 points are awarded for transparency. 

Can reviewed companies sponsor or in any way influence reviews in the Medicaid Black Book?

No. Medicaid Black Book is sold strictly as a subscription service and entries can not be sponsored. Reviewed companies are not made aware of results during the optional interview. They are also not given results outside of purchasing their own subscription. 

Can Mostly Medicaid consulting clients be reviewed in the Medicaid Black Book?

Yes. When they are reviewed, we conduct the analysis in draft form and allow them the choice of whether to publish the results. We do not in any way alter the results if they choose to publish them. Any Mostly Medicaid consulting client reviewed in the Medicaid Black Book is clearly labeled as a client to maintain integrity and transparency of the review process.

Can you provide examples of the types of analyses conducted? 

Yes. In addition to in-depth review the leadership experience in healthcare, Medicare and Medicaid, our analysts conduct research to answer questions like there: 

  • Have there been any Medicaid-specific thought leader publications from the leadership team in the past 3 years?
  • Has anyone on the leadership team spoken as an expert at a Medicaid conference in the past 3 years?
  • What is the overall impression of the company in the market?
  • What are the weaknesses of the company as perceived in the market?
  • What are the strengths of the company as perceived in the market?
  • Are there any negative press items in the past 3 years for the company?
  • What do Glassdoor reviews suggest about company culture?
  • Are there any discoverable legal battles or contract disputes?
  • What level of brand visibility does the company currently have?
  • What solutions are offered? (are they unique? hard for a plan to do on their own?)
  • Who else offers similar solutions?
  • What press releases has the company provided in the past 6 months?
  • Is it clear the business problems the solutions offered attempt to solve?
  • Is it clear the way success of solutions is measured? Are the outcomes specific and unique (not just reduce ED, etc)
  • Does the company use buzzwords or otherwise non-unique language in materials?
  • Are solutions clearly tailored to Medicaid plans or do they seem to retro-fitted from other verticals?
  • Is it clear who benefits the most from the solution?
  • Does the company show how the plan can connect solution costs to member outcomes?
  • How many employees do they have?
  • What is the biggest project they have had?
  • What is their current client base?
  • What is the experience of their mid-level operations team?
  • What is the experience of their mid-level product team?
  • What strategic partners do they have that can help them scale?
  • What has been their recent organizational growth path?
  • What is their annual revenue?
  • What type of ownership model?
  • If private, what stage are they in?
  • What is the trend in investment rounds?
  • Who are the major investors?
  • What other healthcare investments does the owning firm have? (are there other firms in the fund that can bring additional help?)