Case Studies

Challenges solved, lessons learned.

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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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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