Provider-sponsored Health Plans

Unmatched Experience Working with Provider Plans

The Ability to Scale Your Plan

We work with provider-sponsored health plans (PSHPs) serving employee, Medicaid, Medicare and commercial populations. We offer comprehensive services and technology to launch, optimize, grow and operate plans. We are confident in our ability to build a high performing plan and will even explore the opportunity to jointly invest in plans. 

industry perspective

The Emerging Role of Provider-Owned Health Plans in Private Exchanges

As provider-owned health plans fill the void left by fewer choices on the private exchanges, they may help assure the long-term competitiveness and sustainability of the private exchange market for employers both large and small. Read what Eric Parmenter, Vice President of Employer Solutions and Tony Brice, Managing Director of Employer Solutions have to say about this trend and how it could benefit the exchanges.

We Work with PSHPs at All Stages of Maturity

Health Plan Administration and TPA

With roots stemming from one of the nation’s top provider-sponsored health plans, we partner with health systems to launch, optimize and grow highly differentiated plans that are locally owned and managed. Learn More

Population Health Management

Success in value-based care begins with improving quality while lowering the total cost of care. While this tenet is core to your current mission, we help focus your efforts on the patients, populations and care programs proven to make a meaningful difference. Learn More

Pharmacy Benefit Management (PBM)

In addition to offering a highly cost effective PBM, we integrate pharmacy and clinical data with your model of care to streamline prior-authorizations, bring better pharmacy data to the care team and provide a unified experience for patients. Learn More

Risk Adjustment

Physician engagement is the most significant driver of an accurate and efficient risk adjustment program. We over-perform on engagement because we worked with physicians to build a solution that is fast and easy to adopt, and creates real clinical value for patients. Learn More

Technology and Electronic Medical Records Integration

Our integrated software platform combines a core health plan administration platform with an integrated technology solution for population health, utilization management and network management. Learn More