Where health plans and health systems finally read from the same chart.
NextGen Partners advises payers and providers on the operational and financial mechanics that determine whether a plan actually works — payment integrity, network economics, and pharmacy strategy included.
Four places margin and quality actually get decided
Each engagement starts with the numbers, not the deck — where a plan's payment integrity, network, or pharmacy strategy is quietly leaking value, and what it takes to close it.
Payment Integrity Strategy
Vendor stacking, edit overlap analysis, and overturn-rate benchmarking to separate real recovery from noise.
Network & Provider Alignment
Contracting and value-based structures that hold up under audit and don't quietly erode provider trust.
Pharmacy & Formulary Economics
PBM strategy, biosimilar positioning, and formulary design built around total cost, not rebate optics.
Operational Due Diligence
Pressure-testing vendor claims and internal reporting before either side signs off on the numbers.
Steady, evidence-first, built to survive scrutiny
Find the real signal
We pull the underlying data ourselves rather than accepting vendor or plan-reported summaries at face value.
Build the fix, not a slide
Recommendations come with the contract language, SLA structure, or workflow change needed to make them real.
Make it hold up
Every recommendation is stress-tested against audit, clawback, and provider-relations risk before it ships.