Services
Why us?
Blakemore Consulting is a private consulting firm that specializes in delivering network adequacy solutions to Managed Care Organizations. We focus on helping MCO’s execute new-market entry strategies, enhance existing networks, and handle all related contract negotiation needs. In addition, Blakemore Consulting provides consulting services to provider organizations including, but not limited to contract portfolio evaluations, fee schedule comparisons and analyzing new payer offerings.
Benefits of Blakemore Consulting
Overcome your limitation
Blakemore Consulting is designed to serve as a turn-key solution to market entry/expansion contracting initiatives.
Get access to our experience
Blakemore Consulting’s development team has grown organically, based on longstanding industry relationships and specific skill sets required for successful network expansion initiatives, and represents over 150 years of combined network development experience.
Extend in-house capabilities
Internal Quest / J2 Health capabilities allowing for targeted contracting efforts due to aggressive filing timelines.
Gap fill provider prospecting database and Quest / J2 Health pressure testing capabilities.
Dedicated contracting experience/project planning with required Essential Community Providers (RHC, FQHC, Ryan White, etc.)
Ability to work in conjunction with existing Plan staff and State regulatory agencies.
We offer extensive services
Network Development
Comprehensive & integrated network development solutions for all managed care organizations. We have significant experience developing large scale networks to include: TriCare, Medicaid, Medicare Advantage (MA), Qualified Health Plan (“Exchange”), traditional commercial product offerings, and MA/Special Need Plans [Dual Eligible Special Needs (D-SNP), Institutional Special Needs (I-SNP)] lines of business. Our team represents relevant experience in over 40 states, and is geographically dispersed across the United States.
Network Analysis
We empower clients to acquire the knowledge necessary for targeted provider prospecting, focused contracting strategies, and ongoing monitoring of network adequacy. Additionally, our “what-if” network scenarios and “impact analysis” offer a profound understanding of the consequences of including or terminating various provider groups on adequacy metrics, enabling our teams to swiftly adapt to real-time contract updates to meet adequacy demands.
Network Adequacy, Filling & Expansion
Quest Analytics / J2 Health Software: Network Adequacy Reporting, CMS & DOH Filing & Expansion Strategies. Our services grant client’s access to cutting-edge insights within the industry, enabling them to expeditiously assess network adequacy and fulfill submission criteria by crafting customized roadmaps tailored to each client’s unique requirements. We equip our clients with comprehensive information pertaining to membership accessibility, encompassing geospatial mapping, network-to-network provider comparisons, claims disruption analysis, and client-specific criteria such as time, distance, and minimum provider standards.
Provider Contracting & Negotiations
Medicaid, Medicare and Commercial Product Lines, Provider Relations & Contract Negotiations. Our core team has over 150 years of contracting experience for all health care 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 provider types.