A 0–100 composite of how favorable a state's RCM environment is for behavioral health. Higher score = more pain Kipu solves, more leverage in the conversation, higher priority for AE time.
What raises the score (Amplifiers)
- High BH denial rates (above 15%)
- Weak parity enforcement — payers can deny more aggressively
- Fragmented payer mix with high commercial OON exposure
- Complex Medicaid managed care, frequent policy churn
- Growing SUD/MAT demand outpacing billing infrastructure
What lowers it (Limiters)
- No Medicaid expansion — capped addressable market
- Small BH provider footprint
- Concentrated single-payer dominance (low diversification)
- Below-average commercial reimbursement
- Strong existing in-state RCM competitors
80–100 High 60–79 Strong 40–59 Moderate 20–39 Limited 0–19 Low
Scores are reviewed quarterly. The intelligence layer auto-proposes updates when external signals (parity enforcement actions, CMS rule changes, payer policy shifts) move the underlying inputs — see Intelligence Feed.
