Provider Services

Enterprise Strategy
Pricing Strategy Development
Payer Strategy Development
Payer Negotiation Strategy & Analytical Support
Innovative Payer Partnership Development
Managed Care Performance Transformation
Value-Based Strategy & Contracting Support

Payer Services

Provider Network Development & Management
Innovative Provider Partnership Development
Value-Based Program Strategy
Insurance Product Development

Developing Medicare Advantage Products for a Provider-Sponsored Health Plan

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A provider-sponsored health plan was entering the Medicare Advantage segment. The organization needed support with its product development strategy in a tight timeframe relative to the CMS regulatory bid process.  The organization’s leadership asked for support in developing competitive Medicare Advantage products and managing the overall product launch process.


Ridgeline started the project by supplementing the Medicare Advantage product landscape analysis completed by our client’s team with additional analysis focused on determining the optimal product positioning based on its competitive position, expected changes from other plans, core medical benefits and supplemental benefits.  Ridgeline developed, refined and finalized product designs for three products in collaboration with the organization’s product team and executive leadership.


The three product designs performed well in their initial annual enrollment period year and were competitively positioned relative to key competitors.  The enrollment achieved in the first year exceeded comparable market entries by other provider-sponsored health plans in the local market.  Further, the premium product offering, which would garner the highest margin per member, generated significantly more membership than anticipated.