See every county.
Score every gap.
File with confidence.
Blueprint Analytics runs CMS-framework adequacy scoring across every county in your service area — in real time, throughout your build, not just at submission. For Medicare Advantage, Medicaid, Exchange / QHP, and D-SNP — in one platform.
We've manually pulled zip-code files for dozens of counties the week before filing — and missed gaps that should have been obvious. Blueprint replaces that entire process, so a Cardiology gap surfaces while there's still time to fix it.
— Why we built Blueprint Analytics
Quoted per project · based on counties, LOBs, and submission timeline · get your quote →
79/ 100
Overall Score
5counties
Passing
1counties
At Risk
2counties
Failing
Maricopa
Urban
Pima
Urban
Yavapai
Rural
Coconino
Rural
Cochise
Rural
Mohave
Suburban
2 failing counties — Yavapai needs 3 providers (PCP + Cardiology). Cochise needs 3 (PCP + OB/GYN).View recruitment targets →
3,100+
Counties scored automatically
4 LOBs
MA · Medicaid · Exchange · D-SNP
3
Compliance frameworks (CMS · State · NCQA)
Real-time
Scores update throughout your build
Why Teams Switch to Blueprint Analytics
The old way of scoring adequacy is broken.
Gaps found at submission — not during the build
End-of-cycle adequacy scoring means you find failures when there's no time left to fix them. Blueprint scores continuously so gaps surface in Week 4, not Week 20.
Spreadsheets can't do county × specialty math
Every county × specialty combination requires its own count check and time/distance check against CMS thresholds. For a 25-county service area, that's 200+ calculations — manually.
Three tools. Three exports. Zero coordination.
Most teams run credentialing in one system, contracting in another, and adequacy in a third — then reconcile manually. Blueprint connects all three into one real-time score.
How we determine your score
Three checks. One adequacy verdict.
Every Blueprint score runs the same three-step process — the same logic CMS uses, run before you submit.
We load your federal rulebook
The CMS HSD Reference File is Blueprint's starting point. It tells us exactly how many providers of each specialty you need in each county, and the maximum drive-time or straight-line distance they can be from enrollees — segmented by county class.
We validate every provider you've contracted
Your contracted roster is cross-referenced against NPPES — the national NPI registry. We confirm each provider's active NPI, correct specialty taxonomy, and geocoded practice location. Ghost providers are flagged before they cost you.
We run the county × specialty gap math
For every county × specialty combination in your service area, Blueprint checks two things simultaneously: does your roster meet the provider count standard? Does it meet the time/distance standard? Both must pass. If either fails, you get the exact gap — and a list of providers who would fix it.
The result: a pass/at-risk/fail score for every county × specialty combination in your build.
Not a vague "network score." A specific, actionable verdict — months before CMS submission — with a recruitment list attached to every gap.
From roster upload to adequacy score in minutes.
Walk through the exact Blueprint Analytics workflow — validation, optional data services, adequacy scoring, and export. Click any completed step to revisit it.
Step 1 of 7
Upload Your Provider Roster
Drag & drop your roster CSV here
Required columns: NPI · Provider Name · Specialty · Practice Address · Contract Status
Accepted formats
CSV · XLSX · TSV
Max file size
25 MB · 50,000 rows
Required field
NPI (10-digit)
All uploaded data is processed under your BAA. Provider data never leaves your account.
Built on the actual regulatory standards.
Blueprint Analytics encodes the federal adequacy rules for each line of business — not approximations. Click a LOB to see the specific requirements Blueprint checks against.
Medicare Advantage
42 CFR § 422.116Blueprint encodes minimum provider counts, time/distance thresholds, and county classifications for this LOB.
Full methodology →Three levels of adequacy intelligence.
Start with public-data feasibility. Add your contracted roster for submission-grade scoring. Overlay verification and claims data for Quest-competitive accuracy and exception evidence.
Public Intelligence
Market feasibility before you commit
Best for:
Pre-contract feasibility, new market entry, expansion planning
Data inputs
- CMS HSD Reference File
- Provider Directory APIs
- NPPES
- Exchange PUFs
- TiC files
Outputs
- County-specialty gap analysis
- Provider supply map
- Recruitment target list
- County adequacy risk score
- Build difficulty rating
What Blueprint scores are built on.
Public data is sufficient for feasibility intelligence. Plan-supplied data makes scores submission-grade.
CMS HSD Reference File
Annual MA minimum provider counts + time/distance standards by county class
Provider Directory APIs
CMS-mandated public APIs from MA organizations, Medicaid MCOs, and QHP issuers
NPPES / NPI Registry
National provider identity, taxonomy, practice locations, secondary sites
Exchange PUFs
CMS plan, network URL, service area, and rate files for QHP plan years
Transparency in Coverage
In-network rate files to infer provider–plan relationships and network membership
Client Contracted Roster
Fully executed contracts with provider NPI, specialty, location, and network IDs
HSD Tables (HPMS)
Plan's official HSD submission with provider/facility credits for NMM comparison
Claims / Encounters
Activity verification: confirms providers actually see members (ghost-provider detection)
Public sources require no client data. Plan Data and Verification tiers require data sharing agreement.
Every county. Every specialty. Every gap — with a fix.
Blueprint Adequacy Reports give you a county-specialty scorecard, the specific providers needed to close each gap, and a ranked list of the top recruitment targets — ordered by adequacy impact, not just proximity.
County-specialty scorecard
Pass / At Risk / Failing by county and specialty. Time/distance percentile and provider-to-population ratio shown for each row.
Recruitment target list
In-market providers not yet contracted, ranked by adequacy impact. Shows specialty, location, NPI, and public network affiliations.
Exception evidence starter
For failing counties, Blueprint generates the exception evidence checklist: distance documentation, alternative access, transport arrangements, and telehealth credits.
HSD-style export
Tier 2 and above: export an HSD-formatted table pre-populated from your contracted roster for HPMS/NMM submission prep.
Family Medicine
Failing (need 1)
Internal Medicine
Passing
OB/GYN
Failing (need 1)
Cardiology
At Risk (need 1)
Mental Health
Passing
Hospital
Passing
Top Recruitment Targets — Cochise County
Sierra Vista Family Medicine
Family Medicine · 4.2 mi
Cochise OB Associates
OB/GYN · 6.1 mi
Bisbee Cardiology Group
Cardiology · 9.8 mi
Exception evidence required for rural gaps: drive-time documentation, alternative access documentation, and nearest in-network provider record. Blueprint generates the evidence checklist.
Exception management built in.
Not every gap can be closed before submission. Blueprint generates the exception evidence framework so you go into the process prepared — not scrambling.
Gap identified
County/specialty scored as failing. Blueprint flags it automatically and adds it to your exception queue.
Evidence checklist
Blueprint generates the required documentation: drive-time calculations, nearest alternative provider, telehealth access, transport arrangements.
Document repository
Upload supporting evidence directly to the exception record. Auditable trail of what was submitted and when.
Exception packet export
Generate a regulator-ready exception packet — formatted for CMS exception filing or state adequacy review.
Network Adequacy Market Feasibility Report
Don't have a contracted network yet? Our managed feasibility report tells you — before you spend a dollar on contracting — exactly where your build will face adequacy gaps and which providers would fix them fastest.
Report covers:
Important: Blueprint Analytics is a planning and build-management tool — not a CMS-certified submission system.
Blueprint is designed as a pre-flight check that tells you whether your network will pass adequacy before you file. Official adequacy determinations are made by CMS through HPMS/NMM (Medicare Advantage), state regulators (Medicaid), and CCIIO (Exchange/QHP). Blueprint Analytics does not constitute regulatory advice. If processing any PHI or member data, ensure all data sharing agreements, BAAs, and HIPAA-compliant data handling are in place.
Why we built Blueprint Analytics
“We used to find out about adequacy gaps at the worst possible time — the week before filing. We built Analytics so teams catch them at Week 4 and recruit proactively.”
Catch gaps early
“We built the state Medicaid adequacy rules in so teams don't have to explain them. The HSD report comes out submission-ready, not as another spreadsheet to wrangle.”
Submission-ready by design
Blueprint is a new product, built by a team with decades of hands-on network-build experience.
Analytics is powered by your CRM pipeline.
Every provider you move through the Blueprint CRM — LOI sent, LOI signed, contract sent, contract signed — automatically updates your adequacy score. No exports. No reconciliation. Your pipeline is your adequacy progress.