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Blueprint
Medicare Advantage

Build your Medicare Advantage network. Know your adequacy score every week.

Blueprint CRM and Analytics are configured for CMS MA adequacy standards out of the box — time-distance thresholds, HSD specialty categories, and county-level gap tracking for every service area.

The Challenge

Why Medicare Advantage builds are different

1

CMS time-distance rules change yearly

Thresholds shift with each benefit year, making manual tracking error-prone and time-consuming.

2

22 specialty types, gaps hide in the details

MA adequacy requires all 22 HSD specialty categories — a single gap in a single county can fail submission.

3

HPMS submission requires precise HSD documentation

Teams scramble to produce HSD-formatted tables at deadline when no system auto-generates them.

The Solution

How Blueprint handles Medicare Advantage

Pre-loaded CMS MA rules

All 22 HSD specialties, time-distance thresholds by county class, auto-updated for each benefit year.

Real-time HSD output

Blueprint generates submission-ready HSD tables and exception documentation — no scramble at deadline.

Weekly adequacy snapshots

See your score trend across the entire 16-week build without running reports manually.

Purpose-built

Features built for Medicare Advantage

  • NPI-validated provider import
  • HSD specialty auto-classification
  • County urban/suburban/rural classification
  • Time-distance calculation engine
  • Annual benefit year rule update

Live adequacy score

Overall score94%
Specialty coverage88%
Geographic coverage100%

Updated in real time as providers are added

Regulatory context

CMS MA Adequacy Standards — pre-loaded in Blueprint

CMS MA adequacy standards require plans to meet time-and-distance thresholds across 22 specialty categories for each county. Urban counties have tighter thresholds than suburban or rural. Blueprint pre-loads all HSD Reference File thresholds for the current benefit year and automatically scores your network against them as you add providers.

See how Blueprint handles your LOB

Customer story

Blueprint gave us the first real-time view of our adequacy gap. We knew exactly who to recruit before the window closed.

Jennifer R., VP of Network Development, Sunrise Health Plan

FAQ

Common questions

Ready to build?

See Blueprint on your Medicare Advantage build.

Schedule a 30-minute demo and we'll walk through Blueprint on a real network build for your state and line of business.