Health Care Management Administrators Inc

What Health Care Management Administrators Inc does

Healthcare Management Administrators, Inc. (HMA) is a privately held third-party administrator (TPA) founded in 1986 and headquartered in Bellevue, Washington. The company administers self-funded health benefit plans for employers headquartered in Washington, Oregon, Idaho, Utah, and Michigan, offering eligibility management, claims processing and payment, customer service, stop-loss coordination, COBRA administration, population health management, payment integrity, and wellness services. HMA does not underwrite insurance; revenue is generated through administrative fees paid by self-funded employers, with pricing customized to employer census, claims history, plan design, and stop-loss terms via multi-year contracts.

HMA's core operational differentiator is its provider network: the company operates the largest provider network in the Pacific Northwest with over 76,000 physicians across WA, OR, ID, and UT, wrapped with the PHCS National Network (MultiPlan) for nationwide coverage of 780,000+ physicians, plus a national dental network covering 241,000+ dentists. A specialized Tribal Administration Services line applies Medicare-Like Rates to facility and professional claims for Tribal employers under PRC pricing and CHEF coordination, yielding up to 70% billed-charge discounts. The technology platform integrates Availity (EDI clearinghouse, payer ID HMA01), HealthSparq (provider search), HealthX (provider/employer portals), PayStation (COBRA payments), Healthcare Bluebook (cost comparison), and DocuSign (e-forms), with member-facing delivery through the myHMA Member Portal and the HMA Mobile App for iOS and Android.

HMA distributes services through a direct enterprise sales team and a broker/agent channel that has been central to its 35+ year history. The company is privately held with no disclosed funding events, M&A activity, or institutional investment, and is led by President and CEO Lindsay Harris. Multi-year Washington Best Workplaces recognition (Puget Sound Business Journal, Built In Seattle) and a 40th anniversary milestone in 2026 underscore a long-tenured, stable operating profile focused on the Pacific Northwest and adjacent markets.

Name

Health Care Management Administrators Inc

Legal name

Healthcare Management Administrators, Inc.

Website

https://accesshma.com

Company type

Private

Founded year

1986

Operating status

Operating

Headcount range

251–500 employees

Short description

Health Care Management Administrators Inc is a privately held third-party administrator founded in 1986 and headquartered in Bellevue, WA. It administers self-funded health benefit plans for employers in the Pacific Northwest and Michigan, with a specialized Tribal PRC pricing service line.

Ownership category

akta.pro rank

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Services-Health Services (8000)

akta.pro primary industry

Care Management & Population Health Program Administration (HLAEALAG)

Keywords

• Third-party administrator
• Self-funded health plans
• Health benefits administration
• Claims processing services
• Provider network management

Headquarters

HQ city

Bellevue

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. TPA Administrative Fees: HMA charges administrative fees to self-funded employers for managing their health benefit plans. Fees cover eligibility management, customer service, claims processing and payments, claims reporting, and wellness services. The revenue model is service-based, not insurance premium-based.
2. Cost-Containment & Population Health Services: Additional services including data mining for payment integrity, population health management programs, and customized population health strategies are offered as part of the TPA service suite, bundled with plan administration.

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels6 records

Core offering

Healthcare Management Administrators (HMA) is a third-party administrator (TPA) that administers self-funded health benefit plans for employers in the Pacific Northwest (Washington, Oregon, Idaho, Utah) and Michigan. Services include eligibility management, claims processing and payment, customer service, reporting, population health and wellness programs, stop-loss coordination, and COBRA administration, anchored by the proprietary HMA Preferred Network of 76,000+ physicians and a national PHCS wrap for 780,000+ physicians.

Product overview

Healthcare Management Administrators (HMA) is a third-party administrator (TPA) serving self-funded employers in Washington, Oregon, Idaho, Utah, and Michigan. The core offering is self-funded health plan administration, centered on the HMA Preferred Network (76,000+ physicians in the Pacific Northwest, wrapped with PHCS for national reach of 780,000+ physicians) and the HMA National Dental Network (241,000+ dentists). Member-facing products include the HMA Mobile App and Member Portal for claims, benefits, ID cards, and live chat with Customer Care and Care Navigators. Add-on services encompass Telehealth (24/7/365 virtual care), Care Navigator support, Population Health Services with payment integrity data mining, Tribal Administration Services (PRC/CHEF for Tribal employers at Medicare-Like Rates), HMA Advantages wellness discount program (Fitbit, Walgreens, Active & Fit Direct, etc.), Web Enrollment, COBRA Administration, and a Member Forms Suite with DocuSign e-signature. The ecosystem is further integrated with Availity (EDI/claims clearinghouse), HealthSparq (provider search), MultiPlan (national provider search), HealthX (provider portal), PayStation (COBRA payments), Healthcare Bluebook (cost comparison), and DocuSign (electronic forms).

Differentiator

Problem solved

Functional benefit

Quantifiable outcome

• Up to 70% discount on billed charges for tribal group health plans through Medicare-Like Rate pricing
• +3 more outcomes

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration10 records

Feature8 records

Partnerships

Eight partnerships are on record, tiered minor and core.

• American Specialty Health (ASH) / Active & Fit DirectminorGTM or Marketing PartnerHMA offers the Active&Fit Direct program to members, providing access to a national fitness network with over 9,900 fitness centers. Members pay a $28 enrollment fee plus monthly membership fees. ASH subsidiary American Specialty Health Fitness, Inc. administers the program.
• WalgreensminorGTM or Marketing PartnerHMA partners with Walgreens to offer the Smart Savings program, providing members with a 20% discount on Walgreens brand over-the-counter health and wellness products. Discounts are refreshed quarterly and require printed barcodes at point of sale.
• Fitbit (Google)minorGTM or Marketing PartnerHMA offers Fitbit device discounts to members (up to 15% off) plus 6 months of Fitbit Premium at no cost. Members access the exclusive store via a dedicated link to help promote health tracking and wellness.
• PHCS National Network (MultiPlan)coreTechnology or IntegrationHMA wraps its regional Pacific Northwest network with the PHCS National Network to provide nationwide provider coverage to self-funded plan members, covering over 780,000 physicians nationally.
• HMA National Dental NetworkcoreTechnology or IntegrationHMA provides national dental network access to members through a partnership covering over 241,000 dentists, offering broad and seamless dental coverage.
• Availity (Claritev)coreTechnology or IntegrationHMA uses Availity as its primary EDI clearinghouse for electronic claims (payer ID HMA01) and provider credentialing/contracting tracking via Availity Essentials Payer Spaces. Providers submit claims through Availity using payer ID HMA01.
• HealthX (Securex)coreTechnology or IntegrationHMA uses HealthX platform for providers to view member claims, coverage, and Explanation of Payment (EOP), and for employers to access member claim and coverage information.
• Healthcare BluebookminorGTM or Marketing PartnerHMA provides members with access to Healthcare Bluebook's shop-and-compare procedure cost tools, enabling members to evaluate costs for medical procedures before receiving care.

Scale indicators6 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• UMR: UMR is the largest TPA in the United States and a UnitedHealthcare subsidiary. It directly competes with HMA in administering self-funded employer health plans, offering similar claims, network, and population health services but at significantly greater national scale.
• WebTPA: WebTPA is a major national third-party administrator serving self-funded employer health plans. It competes head-to-head with HMA on claims administration, provider network access, and cost-containment services for mid-market and large employers.
• HealthEZ: HealthEZ is a TPA focused specifically on self-funded employer health plans, offering claims administration, network management, and member engagement tools. It is a direct competitor to HMA in the mid-market self-funded segment with comparable service scope.
• MedBen: MedBen is a regional TPA offering self-funded health plan administration with a focus on cost containment and data analytics. It competes with HMA for mid-market employers seeking a high-touch, data-driven TPA relationship.
• Employee Benefit Management Services (EBMS): EBMS provides third-party administration of self-funded health plans for employers across multiple states. It is comparable to HMA in service breadth, including claims processing, network access, and population health programs.
• Allied Benefit Systems: Allied Benefit Systems is a TPA administering self-funded employer health plans with national provider network access and cost-management services. It competes with HMA for multi-state employer clients seeking integrated TPA solutions.
• Lucent Health Solutions: Lucent Health Solutions provides third-party administration, stop-loss, and care management for self-funded employer health plans. It overlaps with HMA's service portfolio and competes for similar mid-market and regional employer clients.
• Maestro Health: Maestro Health is a TPA offering self-funded health plan administration alongside benefits technology and population health services. It is comparable to HMA in delivering integrated administration with member-engagement tooling.
• HealthComp: HealthComp is a third-party administrator serving self-funded employer health plans with integrated claims, network, and population health management. It is comparable to HMA in scope and competes for similar mid-market and large employer accounts.

Broad incumbents

• Premera Blue Cross: Premera is the largest health plan in the Pacific Northwest and a broad incumbent that offers administrative services for self-funded employer plans alongside its core fully-insured products. It competes with HMA in the same regional employer market with a wider product portfolio.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/healthcare-management-administrators
• Xx.com/hmacareers

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Health Care Management Administrators Inc