NetworkIntel™
See Every Competitor’s Network
Move Before They Make It.
Give your network, growth, and strategy teams full visibility into your network and every competitor — down to the NPI level.
- See exactly which providers give competitors their edge — at the hospital, group, TIN, and NPI level
- Map PCP-to-group affiliations across your market — see how primary care is organized and which groups anchor competitor networks
- Detect competitor network buildout months before their service area expansion filings
- Generate keep/add/drop NPI contracting lists in minutes, not weeks of analyst work
- Identify vulnerable counties, contracting gaps, and strategic growth opportunities earlier.
3,300+ Counties
Competitive network position scored nationwide
NPI-Level Scoring
Provider-level benchmarking across every competing plan
4 Network Pillars
Adequacy, competitive intelligence, provider intelligence, and enrollment impact
$2M+ Saved
By one plan identifying outlier hospitals in just two counties
The Reality
Why Network Strategy Still Runs on Incomplete Data
- Plans spend millions designing networks without knowing whether their network is stronger or weaker than competitors in any given county
- Rivals are quietly building network footprint in markets you operate in — and you can’t see it until they announce it.
- Contracting lists are built around adequacy constraints, not intelligence about which specific providers drive competitive advantage
- Ghost providers are creating adequacy risk that stays invisible until a CMS audit finds it
“NetworkIntel integrates multiple provider data sources into a single, usable view—so we can evaluate our network and competitors side by side. The platform delivers actionable insights that improve key performance metrics, and the Medicaid-specific insights have been invaluable.”
The Intelligence
From Strategy to Contracting Action — In One Platform
NetworkIntel is structured as a layered analytical workflow — not a disconnected list of features.
Every step moves from broad strategic picture to individual contracting action.
Beyond Adequacy Standards
- Single composite network score per plan per county — combining breadth, depth, specialty mix, utilization, and quality
- See competitors side-by-side on a heat map. Understand whether a rival runs a narrow high-quality network or a broad lower-performing one
- 350+ configurable specialties, weighted to match what matters most in your specific markets
Provider Directory vs. Actual Access
- Search and filter individual providers by specialty, geography, group affiliation, and quality score
- HealthWorksAI’s proprietary NPI Score measures how attractive a provider makes your network for health plan members — not a cost metric, a competitive appeal metric
- Location confidence scores flag ghost providers before they become a compliance problem
Physician Group Affiliation
- See where competitors are expanding network density before filings become public.
- Identify alternative groups if a target is unattainable. Understand exactly what it costs your network if a key group leaves your network.
Shared Providers, Unique Gaps
- NPI-level breakdown of your network vs. any competitor — common providers, providers unique to you, providers unique to them.
- Identify exactly which providers differentiate winning networks and where the quality gaps are.
How Teams Use NetworkIntel™
From strategic planning to daily contracting decisions, NetworkIntel fits the way
your teams actually work — and when the stakes are highest.
Chief Strategy & Growth Officers
Peak window: January–June (bid season)
- Before approaching any group, see how many NPIs are in it, their specialties, their quality scores, and which hospitals they’re affiliated with.
- Identify alternative groups if a target is unattainable. Understand exactly what it costs your network if a key group leaves your network.
VP Network & Market Expansion
Peak window: January–August (SAE filings and contracting)
- NetworkIntel shows provider penetration rates in every target county before you file — so you know which counties to enter.
- Track network adequacy continuously across all markets so the triennial CMS check confirms your position rather than exposing it.
Network Analysts & Contracting Teams
Peak window: January–June (hospital renegotiations)
- Run NPI-to-NPI and group-to-group comparisons against any competitor.
- Generate keep/add/drop lists with quality and utilization scoring.
- As hospital contract renewals approach, use group-level comparisons to understand leverage — who else has them, what they’re worth, and what walking away actually costs.
Quality & Compliance Teams
Peak window: August–September (AEP preparation and CMS checks)
- Monitor adequacy status across all counties and specialties in real time.
- Identify ghost providers before triennial CMS checks find them.
- In the months before AEP, use network quality scores to identify the markets where network strength is a genuine brand differentiator worth leading with.