BLAKEMORE CONSULTING
Your Turnkey Solution To Network Development
About Us
Blakemore Consulting serves as a turnkey network development and management consulting firm that represents over 150 years of combined experience in developing large scale provider networks. This includes, but is not limited to: TriCare, Medicaid, Medicare Advantage (MA), traditional commercial product offerings, Qualified Health Plan (“Exchange”), MA/Special Need Plans (D-SNP), Institutional Special Needs (I-SNP)] and ACO Reach lines of business across multiple states.
We can own or assist with the development and execution of new network builds, network expansions, recontracting efforts, network management, and provider relations functions. Our guiding principles establish a focused approach to address the challenges associated with meeting network adequacy and product configuration. The Blakemore Consulting team possesses the ability to interpret, analyze, and furnish network adequacy outcomes, both in established and expansion markets.
Blakemore Consulting maintains the ability to manage end- to-end network expansion contracting initiatives and customizes each Scope of Work based on individual client needs. Contracting roles include, but may not be limited to, initial project planning, provider prospecting, access analysis, contract negotiations, credentialing, system configuration, State/CMS filing(s), ongoing network maintenance, and provider relations support services.
Network Development
The Network Development team has extensive contracting experience for all healthcare provider types including, but not limited to: PCP’s, specialists, behavioral health, independent physician association (IPA), physician hospital organization (PHO), acute care hospitals, specialty hospitals, post-acute hospitals, skilled nursing and rehabilitation homes, and community based service providers, long term services and support (LTSS) providers, and all ancillary providers.
Network Analysis
Through prior provider/market experiences, CMS datasets, local prospecting databases, and Quest Analytics / J2 Health, Blakemore Consulting has a full understanding of network development requirements, available provider options, and supporting access standards for all markets defined within client’s SOW.
Network Adequacy
Through experienced project planning capabilities, local Quest Analytics / J2 Health configuration skills, State adequacy understanding, and provider prospecting tools, Blakemore Consulting is able to interpret, analyze, and deliver network adequacy results in client’s desired service areas. Our experience allows for targeted provider prospecting, focused contracting strategies, and continued network adequacy monitoring. Blakemore Consulting has the capability to provide detailed information regarding membership accessibility in terms of geo-maps, network-to-network provider comparisons, claims disruption, and Client specific time, distance and/or minimum provider standards.
Provider Contracting
Blakemore Consulting provides adjunct staffing support specific to Network Development and Provider Relations services ensuring speed to market for all managed care organizations. Our team represents relevant experience in over 40 states, and is geographically dispersed across the United States.