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Network Adequacy Intelligence

Network Adequacy, Reimagined for Modern Healthcare.

Build, measure, and optimize provider networks with intelligent network adequacy analytics.

CareGrid brings provider data, network standards, geographic access, regulatory requirements, and advanced analytics together in one intelligent platform - helping health plans understand network performance, identify access gaps, and make faster, data-driven decisions.

Explore CareGrid

The Challenge

The Network You See vs. The Network Your Members Experience

Network adequacy is more than a compliance exercise.

Health plans need to continuously understand whether members have meaningful access to the right providers, specialties, and services - where and when they need them.

But fragmented provider data, complex regulatory requirements, manual analysis, and constantly changing networks make this increasingly difficult.

CareGrid brings these moving parts together to create a comprehensive view of network adequacy and member access.

Understand your network. Identify the gaps. Take action.

  • Fragmented provider data across multiple systems and sources

  • Complex network standards across states, programs, and lines of business

  • Manual analysis that slows network planning and reporting

  • Limited visibility into network gaps and underserved areas

  • Difficulty modeling network changes before implementation

  • Increasing regulatory requirements around provider access and network adequacy

Turn Network Data Into Actionable Intelligence

CareGrid transforms complex provider and network data into clear, actionable network intelligence.

Bring your provider networks, geographic data, adequacy standards, and other relevant information into a unified environment. Measure network performance, visualize access, identify gaps, and evaluate potential changes - all from one platform.

  1. Measure
  2. Analyze
  3. Visualize
  4. Optimize

Capabilities

Complete Visibility Into Your Provider Network

Network Adequacy Analysis

Measure provider network adequacy against configurable time, distance, access, specialty, and geographic requirements. Understand where your network meets requirements - and where opportunities for improvement exist.

Provider Network Intelligence

Create a unified view of providers, specialties, locations, affiliations, network participation, and other relevant attributes. Turn fragmented provider information into a consistent network intelligence layer.

Geospatial Network Analysis

Visualize provider coverage and geographic access across your markets. Identify underserved areas, access gaps, provider concentration, and geographic patterns through intuitive, interactive maps.

Gap Identification & Remediation

Go beyond identifying a network gap. Understand where the gap exists, which providers or specialties are affected, and where additional network coverage may be needed.

Network Scenario Modeling

Evaluate potential network changes before implementing them. Understand the impact of adding, removing, or changing providers and identify the changes that close the biggest gaps.

Regulatory & Compliance Support

Configure network adequacy methodologies and requirements across programs, markets, and regulatory environments. Support ongoing monitoring, analysis, and reporting with consistent, repeatable workflows.

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Beyond Compliance

Go Beyond Measuring Network Adequacy

Traditional network adequacy analysis answers a fundamental question:

Does the network meet the required standard?

CareGrid turns network adequacy from a periodic measurement exercise into an ongoing network intelligence capability.

CareGrid helps answer the questions that come next:

  1. 01Where are the gaps?
  2. 02Why do they exist?
  3. 03Who and what is affected?
  4. 04What happens if the network changes?
  5. 05Where should we focus next?

How It Works

From Data to Network Intelligence

  1. 01

    Connect

    Bring provider, network, member, geographic, and other relevant data sources into a unified environment.

  2. 02

    Normalize

    Standardize and validate provider and network information to create a consistent foundation for analysis.

  3. 03

    Analyze

    Apply network adequacy standards and geographic access methodologies to measure network performance.

  4. 04

    Visualize

    Explore provider coverage, specialty availability, geographic access, and network gaps through interactive dashboards and maps.

  5. 05

    Model

    Simulate potential network changes and understand their impact before making decisions.

  6. 06

    Act

    Turn network insights into targeted actions for provider recruitment, network design, remediation, and compliance.

AI-Powered

Intelligence Built Into Every Network Decision

Network adequacy generates enormous amounts of data. CareGrid helps turn that data into answers.

With intelligent analytics and AI-powered capabilities, teams can explore network performance using natural language, surface important patterns, and quickly investigate areas that require attention.

Ask questions. Find gaps. Explore scenarios. Make informed decisions.

Instead of searching through multiple reports and datasets, teams can interact with their network data and get to the insight faster.

  • “Which counties have the largest behavioral health access gaps?”
  • “Which specialties are failing the required distance standard?”
  • “What happens to network adequacy if these providers are removed?”
  • “Where should we prioritize provider recruitment?”
  • “Which geographic areas have limited access to critical specialties?”

Use Cases

Powering Smarter Network Decisions

Network Adequacy & Compliance

Measure network performance against applicable requirements and identify potential gaps before they become larger issues.

Network Planning

Understand where your network is strong, where it is constrained, and where additional providers may be needed.

Provider Recruitment

Identify geographic and specialty gaps that can inform provider recruitment priorities.

Network Changes

Assess the potential impact of adding, removing, or changing providers before implementing network changes.

Market Expansion

Evaluate network readiness when entering new counties, service areas, markets, or lines of business.

Executive Network Intelligence

Give network, operations, compliance, and leadership teams a shared view of network performance and access.

Who It's For

Built for the Realities of U.S. Healthcare

CareGrid is designed for organizations responsible for building, managing, monitoring, and improving healthcare provider networks.

  1. Health Plans

    Understand network adequacy, provider availability, and geographic coverage across your markets.

  2. Medicaid & Managed Care Organizations

    Analyze provider access across complex service areas and diverse member populations.

  3. Network Management Teams

    Move from manual network analysis to a continuously available network intelligence platform.

  4. Compliance & Regulatory Teams

    Support network adequacy analysis, monitoring, and reporting across applicable requirements.

  5. Provider Network Strategy Teams

    Use data-driven insights to prioritize network expansion, recruitment, and remediation.

  6. Healthcare Leadership

    Gain a clear, enterprise-level view of network performance and member access.

Platform

Intelligence Powered by Lumenore

CareGrid combines healthcare-specific network adequacy capabilities with the data, analytics, AI, and visualization capabilities of Lumenore. Bring provider, network, geographic, and healthcare data together in a unified decision environment.

With Lumenore's intelligent analytics capabilities, CareGrid helps transform complex healthcare data into insights that teams can understand, explore, and act on.

  • Connect data
  • Apply intelligence
  • Discover gaps
  • Take action

Outcomes

Designed for Better Network Management

Reduce Manual Analysis

Replace spreadsheet-heavy network analysis with automated, repeatable workflows.

Improve Network Visibility

See provider coverage, specialty availability, geographic access, and network gaps in one place.

Accelerate Network Analysis

Run consistent adequacy analysis across markets, networks, and configurations.

Model Before You Act

Understand the potential impact of network changes before they are implemented.

Turn Data Into Decisions

Give network teams actionable insights - not just another report.

Scale Across Markets

Support multiple states, programs, networks, and adequacy methodologies within one platform.

One Platform. A Clearer View of Your Network.

CareGrid brings network data, adequacy analysis, geographic intelligence, scenario modeling, and AI-powered insights together in one platform.

Move beyond measuring network adequacy. Start managing network intelligence.