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Customer Stories

How health plans build better networks with Blueprint.

Real results from network operations teams across Medicare Advantage, Medicaid, Exchange, and D-SNP.

Featured Story

Medicare AdvantageSunrise Health PlanArizona

We went from having no idea if we'd pass adequacy to knowing our gap count by county, every single morning.

— Director of Network Development, Sunrise Health Plan

Challenge

Sunrise was expanding their MA network into 14 new Arizona counties ahead of a CMS filing deadline. Their team was managing provider outreach in spreadsheets across 3 different staff members, with no real-time view of adequacy status.

Result

With Blueprint, they consolidated their entire pipeline into a single platform, set up automated outreach campaigns for gap counties, and ran daily adequacy scores. They passed their first submission with zero gap notices.

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Key Results

14

Counties tracked in real time

0

Adequacy gap notices at submission

3 weeks

From import to fully operational

More Stories

Results across every line of business.

Challenge

Failed Texas Medicaid adequacy review twice using tools that didn't understand state-specific rules. Provider data scattered across three systems.

Result

Blueprint's Medicaid adequacy engine knew Texas HHSC rules out of the box. Unified all data in one import and passed on the first submission — 22 days from import to passing score.

1st attempt

To pass adequacy review

22 days

Import to passing score

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Exchange / QHPCascade Select

Washington + Oregon

Challenge

One FTE managing simultaneous Exchange/QHP builds in two states via Excel. No cross-state adequacy visibility.

Result

Blueprint's multi-state workspace let one team member manage both builds from a single dashboard, achieving 100% adequacy on first submission in both states.

2 states

Zero extra headcount

100%

First-submission adequacy

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Medicare AdvantageSunrise Health Plan

Arizona

Challenge

Adequacy gaps discovered 3 weeks before CMS deadline. Emergency contracting across 15 counties at premium rates.

Result

Blueprint's real-time adequacy scoring surfaced gaps at Week 4 of a 16-week build, saving $47k in emergency contracting costs.

6 weeks

Faster contracting cycle

$47k

Emergency costs avoided

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Challenge

First-ever D-SNP build — team had MA experience but had never navigated NCD-aligned specialty requirements or dual-eligible standards.

Result

Blueprint's D-SNP configuration loaded Ohio NCD requirements automatically. Heartland passed CMS model of care review on the first submission.

1st try

Model of care review passed

10 weeks

Gap visibility before deadline

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Medicare AdvantagePacific Providers Alliance

California

Challenge

58-county California MA build with a 4-person team. 35 competing MA plans constraining provider supply in key specialty categories.

Result

Blueprint's parallel campaign management and county-level scoring let a 4-person team achieve adequacy in 47 of 58 counties on first submission.

47/58

Counties adequate first submission

4 FTEs

Team for a 58-county build

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MedicaidBluegrass Health

Kentucky

Challenge

Same 14 Appalachian counties generating deficiency notices every year due to behavioral health shortages and incomplete good-faith documentation.

Result

Blueprint's outreach log and exception package export turned 14 chronic shortage counties into properly documented good-faith filings in 3 weeks.

0

Deficiency notices (first time in 3 yrs)

3 wks

Gap to filed exceptions

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In Their Words

What network ops teams are saying.

Blueprint cut our adequacy review surprises from a quarterly nightmare to a non-event. We know our gaps every morning.

VP of Network Operations

Regional MA Plan

The campaign sequences alone saved our contracting team 15 hours a week. That's time we used to spend on follow-up emails.

Network Development Manager

We passed our first Medicaid adequacy review on the first submission. Blueprint made it possible.

Director of Provider Relations

Your build could be next.

Schedule a 30-minute demo and we'll show you Blueprint on a real network build for your state and LOB.