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.”
Build Timeline
How the build unfolded
Consolidated 3 data sources — 67 providers imported into Blueprint
Texas Medicaid adequacy rules loaded; first full scoring run completed
4 specialty gaps identified in rural counties across 6 service areas
Targeted outreach launched to FQHCs for rural primary care coverage
Full adequacy achieved; submitted to HHSC — passed on first review
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