Free Adequacy Audit

Get yours free
Blueprint
Back to Case Studies
MedicaidTexas

Meridian Community Health

Passed state adequacy review on the first attempt

Executive Summary

Meridian Community Health had failed Texas Medicaid adequacy review twice before — once with a generic spreadsheet tool and once with a competing platform that didn't understand state-specific rules. Blueprint's Medicaid-specific adequacy engine loaded Texas HHSC requirements out of the box, consolidated provider data from three systems in a single import, and surfaced specialty gaps in rural counties with enough runway to fill them. Meridian passed on their first attempt.

The Challenge

  • 1

    Two prior adequacy submission attempts failed — the previous tools lacked Medicaid-specific adequacy rule logic for Texas HHSC requirements.

  • 2

    Provider data was scattered across three separate systems with no unified view, creating reconciliation delays at every scoring cycle.

  • 3

    State-specific adequacy rules were poorly understood internally, leading to repeated surprises late in the submission timeline.

The Solution

  • Blueprint's Medicaid-specific adequacy engine loaded Texas HHSC rules out of the box — no configuration required by the Meridian team.

  • All three provider data sources unified in a single import, giving the team one accurate, real-time view of their network within days.

  • Real-time scoring showed exactly which specialties were missing in which rural counties, turning guesswork into a prioritized action list.

Key Results

1st

Attempt to pass adequacy review

3

Prior systems consolidated into one

22 days

From import to passing adequacy score

We had tried two other tools before Blueprint. Neither one understood what a Medicaid build in Texas actually looks like. Blueprint knew the rules before we even explained them.

Marcus L., Director of Provider Relations, Meridian Community Health

Build Timeline

How the build unfolded

Week 1

Consolidated 3 data sources — 67 providers imported into Blueprint

Week 2

Texas Medicaid adequacy rules loaded; first full scoring run completed

Week 3

4 specialty gaps identified in rural counties across 6 service areas

Week 5

Targeted outreach launched to FQHCs for rural primary care coverage

Week 8

Full adequacy achieved; submitted to HHSC — passed on first review

Ready to see results?

Your build could look like this.

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