Commercial payers

HealthScape Advisors understands the difficult challenges that face health plans today and tomorrow. Our firm works with commercial health plans and their strategic partners to develop and refine their business based upon a rigorous assessment of their organization, the unique aspects of the provider and payer landscape within their local market and the strategic direction of the company. Our firm is also a recognized leader in assisting commercial payers with health reform and market transformation strategies to ensure success in the new environment.

Demonstrated Experience and Expertise

We have worked with commercial health plans ranging in size and makeup from large national plans, regional and statewide, to provider-owned health plans, and smaller niche plans.

  • Strategy Development
  • Health Reform Advisory including Risk Adjustment, Medical Loss Ratio, Private and Public Exchange
  • Provider Alignment and Network Transformation
  • Business Performance Improvement and Cost Reduction
  • Integration of Product, Clinical, and Network Strategies
  • Mergers and Acquisitions
  • Government Markets Growth (Medicare, Medicaid, TRICARE, FEHBP)
  • Growth and Diversification Strategies
  • Compliance, Disputes, and Investigations