Your network team runs this build. Blueprint makes sure they never run it blind.
Blueprint is the CRM built for health plan provider network teams. Pipeline management, LOI tracking, credentialing workflows, and campaign outreach — all in one place. As your team works the build, adequacy scoring updates automatically in the background.
Used by Medicare Advantage, Medicaid, Exchange/QHP, and D-SNP teams
The problem every network team knows.
You don't find out you have a gap until it's expensive to fix.
Gaps hide in the details
With 22 HSD specialty types across dozens of counties, one missing provider in one category can fail your entire submission. Spreadsheets don't tell you where you stand.
You find out too late
Most teams discover adequacy gaps in the final 3 weeks before deadline — when emergency contracting is the only option and costs double.
Your data is everywhere
Provider status in email threads. LOI tracking in one spreadsheet. Credentialing in another. No one has the full picture, and no one can answer “are we adequate?” in real time.
The Guide
One CRM. Every provider. Every county. Every deadline.
Blueprint gives your team one place to manage the entire build. The pipeline, the campaigns, the credentialing, the outreach — all running in one system, with your full roster visible at a glance. No spreadsheets. No email threads. No guessing.
And as your team works the pipeline — moving providers from Outreach to LOI Signed to Contracted — Blueprint Analytics scores your adequacy automatically. You don't run a separate report. The score just updates.
Step 1 of 3
Work your pipeline. Your adequacy score follows.
Every action your team takes in Blueprint CRM — contracting a provider, advancing an LOI, clearing credentialing — instantly updates your county adequacy score in Blueprint Analytics. You're not reconciling two systems. They share a single data layer, so the score updates as you work.
- Import from NPPES or upload your existing list — live in 3 days
- Move providers from Outreach → LOI → Credentialing → Contracted in one click
- Each stage move re-scores the county — you see the gap close in real time
- Assign outreach to team members; full contact history logged automatically
| Specialty | Maricopa | Pima | Pinal | Coconino | Cochise |
|---|---|---|---|---|---|
| Cardiology | ✓ | ✓ | ⚠ | ✗ | ✗ |
| Primary Care | ✓ | ✓ | ✓ | ⚠ | ⚠ |
| Oncology | ✓ | ✓ | ✗ | ✗ | ✗ |
| Behavioral Health | ✓ | ✓ | ⚠ | ⚠ | ✗ |
| Nephrology | ✓ | ✓ | ✓ | ✗ | ✗ |
| OB/GYN | ✓ | ✓ | ⚠ | ✗ | ✗ |
Step 2 of 3
Your adequacy score, live. Every time you add a provider.
Every provider you contract updates your score. Every county turns from red to green. You see exactly what you need to close — weeks before deadline, not days.
- CMS MA time-distance standards pre-loaded for all 22 HSD specialty types
- County adequacy updates in real time as you add and contract providers
- Gap prioritization ranks which providers will move your score the most
- Generates submission-ready HSD tables when you're done
The scoring is not a black box.
Blueprint's adequacy scoring is built on the same data CMS and state agencies use to evaluate submissions. Here's exactly what powers it.
CMS HSD Reference File
Updated each filing windowFor Medicare Advantage builds, Blueprint pulls directly from CMS's official Health Service Delivery (HSD) Reference File — the same document CMS uses to evaluate your submission. It defines all 22 specialty categories, time-distance thresholds by county, and the minimum provider-to-member ratios for every service area.
State Medicaid & Exchange Rules
50 states supportedFor Medicaid MCO and Exchange/QHP builds, Blueprint maintains state-specific adequacy standards sourced from each state's managed care regulations, SERFF filings, and state contract templates. Rules vary by LOB, waiver type (e.g. LTSS, D-SNP alignment), and county urbanicity classification. We track rule changes quarterly.
Provider-to-County Mapping
NPI registry + FIPS mappingBlueprint matches each provider's primary practice address to their service counties using NPI registry data and CMS county FIPS codes. Time-distance is calculated from the provider's practice location to the county population centroid and compared against CMS thresholds — the same methodology CMS uses to evaluate HSD submissions.
Live Score Updates — No Manual Refresh
Real-time on every stage changeEvery time your team moves a provider through a pipeline stage — from LOI Sent to LOI Signed, or from Credentialing to Contracted — Blueprint immediately re-scores every county that provider serves. You are never looking at stale data. The score on screen is always current.
Methodology
Blueprint's scoring is aligned with CMS's published HSD evaluation criteria and has supported first-submission approvals across Medicare Advantage, Medicaid, Exchange/QHP, and D-SNP builds.
We don't invent our own standards. We encode the rules regulators already use — so the score you see in Blueprint is the score CMS and your state agency will apply to your submission. What you see is what they see.
Step 3 of 3
Close gaps before they become emergencies.
Blueprint's outreach campaigns let you contact multiple providers at once, track every response, and see your adequacy score update as each LOI converts.
Import
Upload your provider list from NPPES or CSV. Blueprint maps each provider to their counties and specialties automatically.
Score
Your starting adequacy score runs on day 1. You see every gap by county and specialty type immediately.
Prioritize
Blueprint ranks your gaps by severity and shows you exactly which providers to recruit first for maximum adequacy impact.
Outreach
Launch campaigns to target providers across gap counties. Track LOI status, credentialing progress, and notes in one place.
Submit
Export your HSD tables, adequacy certification, and good-faith documentation. File with confidence.
What happens when you can't see your gaps in time.
The cost of late gap discovery isn't just embarrassing. It's expensive.
Emergency contracting
Providers contracted in the final 2 weeks typically cost 30–40% more. You're negotiating from desperation, not strategy.
CMS deficiency notices
A single unclosed gap can trigger a deficiency notice — delaying your approval, flagging your plan for additional review, and damaging your CMS relationship.
Starting from scratch
Without a documented build process and audit trail, next year's build starts at zero. Same counties, same gaps, same panic.
Blueprint teams file with confidence.
What it looks like when the build works.
“Blueprint gave us the first real-time view of our adequacy gap.”Read case study
“We identified 21 gaps on day one. Blueprint showed us exactly what to close first.”Read case study
“Blueprint made the difference — not because we suddenly had more providers, but because we finally had documentation that CMS accepted.”Read case study
Ready to run your next network build in Blueprint?
Your team is live in 3 days. Your pipeline is running. Your adequacy score updates automatically as you work.