Company Updates
We’ve now built the Peerakeet platform for peer support professionals, designed to make it easier for peers to manage participants, deliver support, and run peer programs effectively.
The current platform includes:
• Participant management tools to track members, engagement, and recovery progress
• Secure messaging and communication between peers and participants
• Session documentation and structured notes designed for peer services
• Assessments and wellness planning, including recovery-focused goal tracking
• Scheduling and tele-support tools for virtual peer sessions
• Resource libraries to help connect participants to services in their community
• Credential and continuing education tracking for peer specialists
• Program dashboards for organizations running peer support services
Our goal is to create the operating system for peer support in addiction and recovery care by giving peer specialists and organizations the infrastructure they’ve never really had.
We’re now preparing to roll the platform out to our first cohorts of peer specialists in the coming weeks. This will allow us to begin testing the system in real-world environments and continue refining the product based on feedback from people actively delivering peer support.
More updates soon as we begin onboarding our first users.
Pulse Insights: Medicaid 1115 Waivers and the Expansion of Peer Support
Natatsha Faruqui, Healthcare Strategy at Peerakeet
Health policy can often feel impersonal, written in the dense federal language of sections, statutes, and demonstration projects. For millions of Americans, one such obscure piece of legislation has inconspicuously reshaped access to care: the Medicaid Section 1115 demonstration waiver.
Behind the policy language lies a powerful idea that recovery does not only happen in hospitals or clinics, but in community centers, support groups, and conversations with people who have lived through the same struggles. Increasingly, it seems Medicaid policy is not only recognizing this truth, but also funding it.
What is a Medicaid 1115 Waiver?
Section 1115 of the Social Security Act allows states to test experimental or innovative approaches to Medicaid delivery and payment systems that would not typically be permitted under federal rules. These projects, termed demonstration waivers, must be approved by the Center for Medicare and Medicaid Services (CMS) and are intended to improve care quality, expand access, and reduce costs.
Unlike standard Medicaid programs which must follow strict federal requirements, 1115 waivers are unique in that they give states flexibility to redesign services. This freedom has allowed states to test new models for substance use treatment, housing supports, behavioral health integration, and community-based recovery services.
Many states have used these waivers specifically in response to the opioid crisis. Take West Virginia, where use of 1115 demonstration waivers has expanded the continuum of care for substance use disorders, adding services such as peer recovery support and residential treatment programs for Medicaid members (West Virginia Bureau for Medical Services, 2021). By 2021, more than 249,000 Medicaid beneficiaries had received substance use disorder treatment through the waiver initiative (West Virginia Bureau for Medical Services, 2021).
It becomes apparent that 1115 waivers function as laboratories for behavioral health policy. They allow states to test whether new services, such as peer recovery specialists, have potential to improve recovery outcomes.
Why Peer Support Matters in Medicaid Policy
Peer support services are unique in that they are delivered by individuals who have lived experience with mental illness or substance use disorders and are trained to support others in recovery. These professionals guide individuals to develop coping skills, navigate healthcare systems, connect to community resources, and overall sustain long-term recovery. Peer support has been shown to significantly improve engagement in care. A systematic review in Psychiatric Services found that peer programs increased engagement with treatment, improved hope and empowerment, and demonstrated reductions in hospitalization rates (Chinman et al., 2014). For people recovering from addictions, peer recovery specialists share practical strategies for maintaining sobriety and navigating the everyday challenge of recovery (Medicaid and CHIP Payment and Access Commission, 2023).
For many years, peer services functioned outside of traditional reimbursement systems, but that began to change in the early 2000s as states quietly began incorporating peer services into Medicaid coverage. Today, more than 40 states allow Medicaid reimbursement for peer support services through state plan amendments or demonstration waivers (Substance Abuse and Mental Health Services Administration, 2023).
The Role of 1115 Waivers in Expanding Peer Services: Why Policymakers are Interested
Waivers often position peer services as an integral part of the behavioral health workforce, establishing them in their rightful place as a complementary force within care teams rather than an optional accessory to be ignored. Under many waiver programs, peer specialists provide support such as recovery coaching, goal setting and wellness planning, community reintegration planning, connection to housing or employment resources, and assistance navigating treatment systems (Medicaid and CHIP Payment and Access Commission, 2023).
For policymakers, peer support offers a rare combination of benefits, walking the delicate balance between being cost-effective, scalable, and associated with improved engagement in treatment (Chinman et al., 2014). Peer support also fills a growing gap in the behavioral health workplace, with projections indicating tens of thousands of missing providers across multiple specialties by the late 2030s, including approximately 99,840 psychologists, 99,780 mental health counselors, and 43,810 psychiatrists needed to meet demand by 2038 (Health Resources and Services Administration, 2024).
Where Peerakeet fits in
Medicaid waivers are often painted to be bureaucratic experiments, but their impact can be deeply human. By allowing states to fund peer support, Section 1115 waivers acknowledge that healing rarely occurs in a vacuum; it happens through connection, with clinicians, families, and communities. What began as a policy experiment has blossomed into a cornerstone of behavioral health care.
Peerakeet is here to help strengthen and sustain this emerging ecosystem of peer networks, patients, and clinicians. As Medicaid programs increasingly recognize peer services as reimbursable components of care, tools that assist in patient engagement, facilitating connection through lived experience, and streamlining the collaboration between peer specialists and clinicians will become an integral component of the recovery landscape.
References
Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65(4), 429–441.
Health Resources and Services Administration. (2024). Projecting health workforce supply and demand: Behavioral health workforce projections through 2038. U.S. Department of Health and Human Services.
Medicaid and CHIP Payment and Access Commission. (2023). Report to Congress on Medicaid and CHIP: Chapter on behavioral health services. Medicaid and CHIP Payment and Access Commission.
Substance Abuse and Mental Health Services Administration. (2023). National model standards for peer support certification. U.S. Department of Health and Human Services.
West Virginia Bureau for Medical Services. (2021). Substance use disorder 1115 demonstration waiver annual monitoring report. West Virginia Department of Health and Human Resources.