Case Studies

Challenges solved, lessons learned

Provider Directory Accuracy State Health Plan

More Than Meets the ROI

For a New York health plan, smarter provider network management was a better investment than they imagined.

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Service Area Expansion Regional Health Plan

Growing Nowhere Fast

Expansion opportunities abounded — but so did challenges.

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Service Area Expansion State Health Plan

A Tale of Two Networks

An accidental A/B test reveals there are two ways to build a network — and one of them’s a nightmare.

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Regulatory Oversight State Insurance Department

Oversight, Meet Insight

A large state regulator finally gets the tools it needs to do the job right.

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Provider Directory Accuracy National Health Plan

Too Bad to Ignore, Too Big to Fix

A vision managed care company confronts a provider data nightmare.

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Network Adequacy Metro Health Plan

“Are We Compliant — or Not?”

It was time to take the guesswork out of CMS and state adequacy requirements.

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Enterprise Workflow Regional Health Plan

Uniting an Enterprise

They set out to solve adequacy — and built a stronger business along the way.

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Service Area Expansion County Health System Plan

Building Their Own HMO

A large urban metro health system finds the partner it needs to go it alone.

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Take the First Step From Adequate to Excellent

We partner with 95 percent of America’s health plans and have experienced the challenges of provider network design, optimization and management. We’ve built our platform by working side-by-side with you and working closely with CMS and more than 30 state regulatory agencies, independent review organizations and brokers. We know what the regulators are looking for and what tools your organization needs to build differentiated and excellent provider networks and member experiences. Contact us today and book a strategy session.

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