Payer partnerships, compressed—
from 28 months to six.
Carenodes is a boutique advisory for healthcare organizations navigating the payer landscape. We accelerate contracts, credentialing, and clinical integration for providers, digital health companies, and risk-bearing entities.
In contract value negotiated on behalf of clients since 2018.
Median time to first executed payer contract — industry avg. is 28 months.
Commercial, Medicare Advantage, and Medicaid plans in our network.
Of engaged clients secure target payer coverage within 12 months.
We work across the full payer lifecycle — from market entry strategy through contract execution and ongoing optimization.
Payer Strategy & Market Entry
Segment-level opportunity mapping, competitive positioning, and a prioritized 12-month payer roadmap tailored to your clinical model.
ENGAGEMENT
Contract Negotiation
End-to-end representation with commercial, MA, and Medicaid plans. Rate benchmarking, language review, value-based care structuring.
PER CONTRACT
Credentialing & Enrollment
Turnkey CAQH management, delegated credentialing setup, and multi-plan enrollment on accelerated timelines through our payer relationships.
STANDARD
Clinical Integration
Design and implementation of quality programs, risk stratification, and data sharing agreements that unlock value-based payment structures.
RETAINER
Regulatory & Compliance
HIPAA, state-level Medicaid rules, NCQA readiness, and audit support — plain-English guidance from operators, not lawyers.
RETAINER
Fractional Payer Leadership
Embedded senior operators — 1–3 days/week — serving as your head of payer strategy until you're ready to hire in-house.
ENGAGEMENT
A four-phase model built for decisive movement, not endless analysis.
Diagnose
Two-week sprint to map your payer surface area, clinical model, existing contracts, and the specific gaps between where you are and where you need to be.
Position
We build the narrative, the data pack, and the rate model that will land with contracting teams — calibrated to each payer's current priorities.
Execute
Warm introductions, negotiation, red-lining, and close. You see every email and every term sheet; we do the heavy lifting.
Sustain
Ongoing rate optimization, amendment negotiation, and performance reporting — so contracts improve over time rather than decaying.
A selection of recent work. Names redacted where confidentiality requires.
Field notes from the inside of payer contracting.
All insightsThe delegated credentialing play every digital health CEO should know
Most founders treat credentialing as paperwork. The teams that treat it as a lever cut enrollment timelines by two-thirds. Here's the playbook.
2026 MA rate benchmarks: what we're seeing across 47 plans
Our annual rate report, drawn from 160+ contracts negotiated over 18 months. Commercial flat, MA up 3.8%, Medicaid increasingly bifurcated.
The 90-day payer diligence checklist for Series A health co.
Before you raise, before you pitch, before you hire a VP of growth — a concrete list of payer-readiness items that will determine your outcome.