Updates from Peerakeet
We are thrilled to announce the launch of Peerakeet’s first small-scale pilot. Seven peer support specialists across six states are now using the platform to manage documentation, scheduling, and engagement, giving us real-world signals on what peer infrastructure can look like when it’s built for peers. We are grateful to each specialist who has joined us in this early stage. Their feedback is shaping what comes next.
Most documentation tools were built for clinicians. Peerakeet is built for peers. We help peer support specialists and recovery coaches document their work simply, stay connected with the people they serve, and give program directors the visibility they need to run effective programs. If that sounds like something your program needs, we would love to talk. Reach out at ishan@peerakeet.com.
Making the Financial Case for Peer Services Without Losing the Point
Ishan Shah, Co-Founder and CEO at Peerakeet
What Peers Do That No One Else Can
There is a kind of care that does not show up in appointment slots or diagnostic codes. It happens in a parking lot before a court date, in a text at midnight when someone is close to giving up, in a conversation that starts with “I’ve been where you are” and means it. That is peer support.
Peer specialists bring something that cannot be credentialed or replicated by clinical training alone: lived experience of navigating mental health challenges, addiction, or crisis and coming through. Because of that shared ground, peers reach people that formal systems often cannot. Research recognizes peer support as an evidence-based practice, with studies consistently showing improvements in quality of life, hope, and sustained engagement with care (Mental Health America, 2019; Cooper et al., 2024).
This essay is for program directors who already believe in that work and need language to defend and grow it in rooms where ROI is the first question asked. The goal is not to reduce peers to a budget line. It is to give their work the visibility it deserves.
The Numbers Are There
The financial case for peer services has grown considerably. A study cited by the American Hospital Association found a 43% average reduction in inpatient services, a 30% increase in outpatient services, and a 56% reduction in readmission rates among patients receiving peer support (AHA, 2026). A New York Medicaid analysis found peer support reduced total cost of care by an average of $2,238 per enrolled member per month. A Colorado study found an ROI of $2.28 for every dollar spent (AHA, 2026).
The mechanism behind these numbers is not a mystery. Peer support keeps people connected between appointments, after discharge, and in the moments when formal services are unavailable. That continuity prevents crises, and crisis events are among the most expensive encounters in behavioral health. NCQA has recognized this directly, adding peer support as an eligible follow-up option across four HEDIS measures (NCQA, 2025).
Peer support also expands what a care team can do without proportional cost. Peers extend reach into communities that clinical staff may not access, and they often serve as the bridge that brings someone into treatment in the first place (Shalaby & Agyapong, 2020).
Why the Case Is Still Hard to Make
If the evidence is this strong, why do peer programs still fight for budget every cycle? The answer is structural and it is not a reflection of peer effectiveness.
The core problem is attribution. When someone calls their peer at 10 PM instead of going to the ER, the system records an absence. The care that prevented the crisis is invisible.
This is not a peer problem. Peers are doing exactly what they are supposed to do. The problem is that the systems built to measure care were never designed to see the kind of care peers provide. Notes filed late, forms built for clinicians, records that capture the appointment but not the phone call that kept someone from missing it. The value is real. The infrastructure to prove it has not caught up.
The ROI gap is not a peer gap. It is a system gap.
What Strong Programs Do Differently
Programs that sustain and grow peer services share a few common practices. They give peers tools built for how peer work actually happens, in the field, on the phone, between formal encounters, so documentation reflects care as it is actually delivered. They capture engagement across the full continuum, not just scheduled sessions. And they invest in supervision not as a compliance requirement but as a retention and quality strategy. Burnout driven by administrative burden is preventable. Turnover is expensive, and peer-patient relationships built over time do not easily transfer when a peer leaves.
When making the internal case, the strongest programs hold two things at once: the genuine human value of peer work, and the financial logic that makes it sustainable. These are not in tension. They are the same argument made in different languages.
A Final Note
The ROI of peer services is real and increasingly well-documented. But it is secondary to why peer support exists: because people in recovery have something to offer those still finding their way, and that offering changes lives in ways that no clinical intervention can fully replicate.
The work of program directors is to build the conditions where that can happen at scale. If you are navigating documentation or workflow challenges in your program, we would welcome the chance to learn from your experience. Reach out to Ishan at ishan@peerakeet.com.
References
American Hospital Association. (2026). Peer support issue brief. AHA.
Cooper, R. E., Saunders, K. R. K., Greenburgh, A., Shah, P., Appleton, R., Machin, K., et al. (2024). The effectiveness, implementation, and experiences of peer support approaches for mental health: A systematic umbrella review. BMC Medicine, 22(1), 72.
Mental Health America. (2019). Evidence for peer support. MHA.
National Committee for Quality Assurance. (2025). How peer support can help close the gaps in behavioral healthcare. NCQA.
Shalaby, R. A. H., & Agyapong, V. I. O. (2020). Peer support in mental health: Literature review. JMIR Mental Health, 7(6), e15572.