CASE STUDY

Mission:

Rapidly build a comprehensive D-SNP (FIDE-SNP) provider network covering 47 Kansas counties, meeting strict 90% CMS adequacy parameters to secure a critical contract.

Challenges Met:

  • Tight Timeline:

    Build a network for an unawarded line of business with a 2025 launch, requiring exceptional speed.

  • High Adequacy Standards:

    Fulfill CMS' demanding 90% adequacy requirement.

  • Complex Contracting:

    Secure agreements with major health systems like Advent Health, Ascension, and Kansas University.

Approach

TOG leveraged its deep industry expertise and established provider relationships to accelerate the network build process. TOG’s skilled negotiators successfully navigated complex contracts and exceeded adequacy targets.

PDF DOWNLOAD CASE STUDY

Results:

  • Record Speed:

    TOG completed the build in a remarkable 16 weeks, surpassing the typical 9-12 month industry timeline.

  • Adequacy Achievement:

    Secured 1,823 out of 1,974 required provider specialties, achieving an impressive 92.4% adequacy in just 10 weeks.