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Blueprint
About Blueprint

Built by practitioners.
For network-development teams.

Blueprint is a new product, built by a team with decades of hands-on experience running health-plan provider network builds. We built the tool we always wished we'd had — and we're bringing it to the teams who do this work.

How Blueprint Started

The tool we wished we had when we were doing this work.

Our founders built provider networks the hard way — manually scoring adequacy county by county, chasing providers through disconnected credentialing systems, and submitting to CMS with fingers crossed that nothing had changed in the guidance since last cycle.

After years on the health plan side, the pattern was unmistakable: the industry had no purpose-built tool for network teams. Plans were running multi-hundred-million-dollar network programs on spreadsheets. Adequacy failures, audit findings, and enrollment freezes were the predictable result.

Blueprint was built to fix that — starting with the CRM workflow layer every network team needs, adding automated adequacy scoring so gaps surface before submission, and expanding into the market intelligence that helps plans build competitive networks, not just compliant ones.

Medicare AdvantageMedicaidExchange / QHPD-SNP
"We've sat in the same seat our clients are in. We know what a gap notice at 4pm on a Friday feels like. That's why Blueprint is built the way it is."
— David Smith, CEO & Co-founder

2019

Year Blueprint was founded

4 LOBs

Supported from day one

CMS · State · NCQA

Three compliance frameworks built into every adequacy model — not added as an afterthought.

The Problems We Solve

Why Blueprint had to exist.

These aren't hypothetical pain points. They're what our team experienced before Blueprint — and what we hear from every new client on their first call.

01

Spreadsheets were killing productivity

Network teams were maintaining 40-tab Excel files, manually cross-referencing CMS distance standards county by county. A task that should take minutes was taking days — every review cycle.

02

No single source of truth for providers

Credentialing data in one system. Contracting in another. Adequacy scoring in a third — or not tracked at all. Teams stitched together three tools for every submission.

03

Regulatory changes were impossible to track

CMS updates guidance. States update their own standards. NCQA updates its methodology. Without a dedicated compliance layer, plans were always one change behind — and finding out the hard way.

Decades

Combined network-build experience

40

States pre-configured & ready

5

Average time to go-live

4 LOBs

MA, Medicaid, Exchange, D-SNP

How We Work

The principles behind every decision we make.

Accuracy First

Every adequacy score, every gap flag, every provider record — we care about whether it's correct. Not just whether it looks right on a dashboard.

Compliance Is Non-Negotiable

We track CMS, state, and NCQA guidance changes so you don't have to. Regulatory alignment is baked into every release — not bolted on at audit time.

Partnership Over Transactions

We don't disappear after implementation. We show up for your renewal cycle, your audit response, your county expansion, and every regulatory change in between.

Transparent by Design

No black-box scoring. Every adequacy calculation surfaces its methodology. You understand what passed, what failed, and exactly why.

The Team

Practitioners, engineers, and compliance experts.

Everyone on the Blueprint team has worked directly in or alongside health plan network operations. This isn't a product built at arm's length from the problem.

DS

David Smith

CEO & Co-founder

15+ years building and managing provider networks for Medicare Advantage and Medicaid plans. Blueprint was born from watching the same manual spreadsheet cycle play out at plan after plan — and knowing there had to be a better way.

RT

Rachel Torres

CTO & Co-founder

Healthcare data engineer and former technical architect for CMS-facing reporting systems. Led adequacy scoring infrastructure builds at two regional health plans before co-founding Blueprint.

JW

James Whitfield

Head of Compliance

Former CMS contractor and NCQA site visitor. A decade on the regulatory side means James knows exactly how auditors read adequacy reports — and he makes sure Blueprint stays ahead of guidance changes.

PP

Priya Patel

Head of Customer Success

Former network adequacy analyst at a multi-state Medicaid MCO. Priya ran the exact workflows Blueprint automates — which means she helps clients get real value starting on day one.

The Difference

Blueprint vs. the status quo.

Before Blueprint

  • Adequacy scored once at submission
  • Provider pipeline in 4 spreadsheets
  • No visibility into which counties are at risk
  • Campaign tracking in email threads
  • Credentialing status unknown until it's too late
  • Regulatory changes caught after the fact

With Blueprint

  • Real-time adequacy throughout the build
  • Single pipeline with stage tracking
  • County-level risk dashboard updated daily
  • Automated campaign sequences
  • Credentialing integrated into the build workflow
  • CMS, State & NCQA compliance baked in
Our Commitment

What "trusted partner" actually means.

It's a phrase that gets overused. Here's what we actually deliver — the specific commitments every Blueprint client has from day one.

Dedicated implementation lead

Every client gets a named implementation lead who stays with you through go-live.

Annual adequacy reviews

We schedule a compliance review before each CMS deadline cycle — proactively, not reactively.

Audit support included

If a gap notice or audit request arrives, we help you build the response — included in your plan.

Advisory access

Direct access to our compliance and network strategy team — not a ticketing queue.

State expansion guidance

When you're ready to expand, we run the feasibility analysis and map your path forward.

Regulatory change alerts

We monitor CMS, NCQA, and state agency updates and notify you before they affect your network.

No long-term contract requiredCMS, State & NCQA compliantSetup in 5 business daysBuilt on decades of network-build experience

Ready to work with a team that's been there?

Schedule a demo and see how Blueprint handles a real-world adequacy scenario with your state and LOB. No slides — actual product, actual data.

30-min session · real data · no hard sell