West Virginia Completes First U.S. Medicaid Pilot of Digital Contingency Management Program for Addiction Treatment

CHARLESTON, WV (November 27, 2023) — DynamiCare Health, a digital health company, released the results from a first-of-its-kind program to help patients overcome addiction using technology. The pilot, which was conducted by key stakeholders in West Virginia’s Medicaid system, is the first statewide Medicaid pilot of app-based motivational incentives in addiction treatment, a practice known as digital Contingency Management (CM). The pilot was conducted from December 2021 to March 2023 to help WV Medicaid members with stimulant use disorder by a coalition of multiple organizations, including Aetna Better Health of West Virginia, UniCare West Virginia, The Health Plan, WVU Medicine, Marshall PROACT, Southern Highlands CMHC, Anchor Medical, and New River Health. The results of the pilot have been included in WV Office of Drug Control Policy’s 2022 semi-annual report.


“West Virginia has seen a 490% increase in the rate of overdose deaths from stimulants such as methamphetamine in the past 5 years, often in combination with Opioid Use Disorder,” said Garrett E Moran PhD MPA, Associate Director for Services and Policy Innovation (retired) at the Rockefeller Neuroscience Institute of West Virginia University. Moran noted, “There are no FDA-approved medications for StUD. The scientific literature shows that the most effective treatment for StUD is Contingency Management (CM). Despite strong proven efficacy in over 100 randomized controlled trials, CM is rarely used. Using behavioral economics, CM incentivizes patients for staying abstinent from drugs, and for staying engaged in treatment.” 


Moran drafted the initial proposal for the project and convened the stakeholder group. He wrote, “If shown to be effective in West Virginia, this would provide a tool to address an important substance use disorder for which no other proven treatment is available, and thus improve the health of West Virginians while reducing cost of care.”

This pilot was the first Medicaid-based program in the nation to provide full coverage of the most effective, evidence-based, contingency management incentives level, amounting to $599 per patient in cash-equivalent rewards.

WV Office of Drug Control Policy  has reported to the state legislature in its 2022 semi-annual report that, 

“DynamiCare is an app that uses evidenced based practices to treat individuals with stimulant use disorder and includes contingency management protocols, substance use testing by instant oral swabs and breathalyzers, self-guided cognitive behavioral therapy lessons, and peer support services offered via telehealth.”(p. 13-14)

In prior NIH-funded research, CM consistently has doubled rates of abstinence, including in real-world practice with the DynamiCare CM platform. CM is strongly clinically-effective and cost-effective, generating substantial return-on-investment in the first year of treatment. Twice recognized as a medical breakthrough by the FDA, DynamiCare is the only vendor to receive a special Advisory Opinion from the federal government, indicating that the program’s financial incentives do not pose any risk of violating federal anti-kickback laws. 

Now that the project has been completed, DynamiCare is releasing a white paper detailing it outcomes:

  • 93 of 121 eligible patients downloaded & completed all training in the app (77%) 

  • Month 6 retention was 65% of initial patients

  • The state’s recruitment target was exceeded faster than projected.

  • Each month, the average participant completed an average of 6 verified in-person. appointments, 10 self-guided therapy lessons, and 1.7 telehealth coaching calls.

  • The average patient completed 5.3 remote, true-random/true-witnessed substance tests per month. Of program completers, the majority (55%) showed verified abstinence.

  • Success occurred both as a treatment adjunct and in standalone continuing care.

  • Both patients and providers rated satisfaction with the app an 8.9 on a 0 - 10 scale. 


Kelley Bowker, CEO of DynamiCare Health, said, “other states and counties that are seeking to introduce Contingency Management as the uniquely effective solution for the nation’s stimulant crisis can turn to West Virginia, which has led the way in demonstrating that this digital health platform is feasible, reliable, and scalable for improving outcomes in addiction treatment.”


DynamiCare Health

DynamiCare Health is a digital health company dedicated to helping people overcome addiction. The company’s award-winning platform automates contingency management and integrates multiple other evidence-based approaches. Its unique technology provides motivation and accountability for healthy behaviors. In multiple peer-reviewed reports of controlled trials by external investigators, it consistently doubles abstinence rates from stimulants, opioids, alcohol, and tobacco.

Sam Barbero