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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