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Medicare AdvantageCalifornia

Pacific Providers Alliance

Managed a 58-county CA build with a 4-person team

Executive Summary

California is among the most complex states for Medicare Advantage network adequacy — 58 counties spanning dense urban metros, inland valleys, and remote rural areas, with 35 competing MA plans driving provider supply constraints. Pacific Providers Alliance needed to build a viable MA network across all 58 counties with a 4-person team. Blueprint's California-specific county classification data, parallel campaign management, and real-time adequacy scoring made the difference between a viable filing and a deficiency-heavy submission.

The Challenge

  • 1

    58 California counties with dramatically different county classifications — from LA's dense urban core to remote Sierra Nevada rural counties — each with different HSD thresholds.

  • 2

    35 competing MA plans had contracted many of the highest-impact specialists in urban cores, leaving limited provider supply in key specialty categories.

  • 3

    A 4-person team managing simultaneous outreach across 200+ target providers across 58 counties with no campaign automation.

The Solution

  • Blueprint's California county classification map pre-loaded, with urban/suburban/rural thresholds automatically applied for all 58 counties by specialty.

  • Recruitment priority ranking highlighted which gap counties had available providers — team focused effort on the 11 counties with the most adequacy impact.

  • Parallel campaign sequences for 8 specialty tracks ran simultaneously; the team reviewed outcomes, not logistics, every morning.

Key Results

47/58

Counties adequate on first submission

4

Team members managing 58-county build

11

Gap counties closed via targeted outreach

California at scale with four people. I don't know how we would have done this without Blueprint's parallel campaign management and real-time county scoring.

Angela P., VP of Network Strategy, Pacific Providers Alliance

Build Timeline

How the build unfolded

Week 1

120 providers imported; 58 counties configured with CA-specific thresholds

Week 3

First gap analysis: 21 county-specialty gaps identified across 8 specialty categories

Week 5

8 parallel outreach campaigns launched; team focuses on top-11-impact gap counties

Week 9

11 priority gaps closed; remaining 10 counties flagged for good-faith documentation

Week 14

Filed 47/58 adequate + 11 good-faith exceptions — passed CMS review

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