Healthcare Highways

What Healthcare Highways does

Healthcare Highways is a privately held Frisco, Texas-based provider network services company that builds and operates curated, high-performance medical provider networks for self-funded and level-funded employer health plans, health systems, payors, third-party administrators, and benefits brokers. Its core network portfolio comprises four regionally focused brands — HCH Plus (Oklahoma), HCH Sync (Texas, Oklahoma, Ohio), Verity HealthNet (Louisiana), and Centrus Health Direct (Kansas City, via a July 2025 joint venture with Centrus Health Kansas City) — collectively providing access to more than 12,000 primary care physicians, 69,000 specialists, and 3,000 facilities and ancillaries. The company also distributes a level-funded health plan product, HCH TrueChoice, targeted at employers with 15-125 employees, and offers add-on modules such as Network Wrap Solutions for out-of-network cost control.

The underlying technology platform supports provider data management, machine-readable file generation, daily-updated provider search, payor ID lookups, claims repricing and analytics, credentialing, and network adequacy analysis. Revenue is generated through a mix of recurring per-employee-per-month access fees on provider network subscriptions, managed services for health system and TPA partners, transaction-based repricing and administration, and subscription-style level-funded plan products distributed via brokers. Distribution is primarily regional and sales-led, combining direct enterprise field sales to self-funded employers and health systems with a broker and consultant channel that serves as the principal route to mid-market employer clients.

The company was founded in 2013 by Michael G. Wilson, who continues to serve as Chief Executive Officer, and employs 51-100 people across a Frisco headquarters, a Plano office, and regional offices in Oklahoma City and Baton Rouge. The business is bootstrapped, with no disclosed institutional or private-equity backing, and was recapitalized in 2019 via the divestiture of its Century Healthcare subsidiary to Fringe Benefit Group.

Name

Healthcare Highways

Legal name

Healthcare Highways, Inc.

Website

https://healthcarehighways.com

Company type

Private

Founded year

2013

Operating status

Operating

Headcount range

51–100 employees

Short description

Healthcare Highways is a Frisco, Texas-based provider network services company operating curated high-performance PPO networks — HCH Plus, HCH Sync, Verity HealthNet, and Centrus Health Direct — serving self-funded employers, health systems, payors, TPAs, and brokers across five states.

Ownership category

akta.pro rank

Product category

Healthcare Provider Network Services

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (525120)

SIC

Hospital & Medical Service Plans (6324), Insurance Agents, Brokers & Service (6411), Services-Health Services (8000)

akta.pro primary industry

Regional & Local PPO Networks (HLAEANAB)

akta.pro secondary industry

Multi-Specialty PPO Provider Networks (HLAEANAC)

Keywords

• Medical provider networks
• PPO network services
• Self-funded health plans
• Claims repricing analytics
• Level-funded employer plans

Headquarters

HQ city

Frisco

HQ country

United States

HQ region

North America

Offices4 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Provider Network Access & Administration: Revenue generated from providing employers and health plans access to curated high-performance medical provider networks. Services include network management, claims repricing, provider data management, and credentialing. Typically structured as per-employee-per-month (PEPM) fees or as part of overall plan administration contracts for self-funded and level-funded employer groups.
2. Level-Funded Plan Products (HCH TrueChoice): Level-funded plan product targeting companies with 15-125 employees. Combines network access with plan administration to offer cost predictability and potentially lower premiums. Revenue model blends subscription elements with claims administration fees.
3. Third-Party Administrator (TPA) Services: Claims administration, repricing, and network management services provided to third-party administrators and payors. Supports multi-payor distribution across commercial health plans.
4. Health System Network Solutions: Revenue from partnering with health systems to build and manage custom provider networks, configure pricing models, and provide employer plan support including plan design, administration, and enrollment.
5. Self-Funded Employer Plans: Self-funded employer groups pay for network access, claims repricing, and administrative services. High-performance provider networks and value-based contracting deliver cost savings that replace traditional carrier networks.

Go-to-market motion3 records

Distribution channels5 records

Marketing channels9 records

Core offering

Healthcare Highways builds and operates high-performance medical provider networks (PPO) and delivers network administration, claims repricing, provider data management, and credentialing services to self-funded and level-funded employer groups, health systems, payors, and third-party administrators. The company also distributes a level-funded health plan product (HCH TrueChoice) for small-to-mid-size employers and provides self-service portals for members, providers, employers, and brokers.

Product overview

Healthcare Highways operates a platform of medical provider network services that connects hospitals, providers, employers, and patients. The core portfolio includes four named provider networks—HCH Plus (Oklahoma), HCH Sync (Texas, Oklahoma, Ohio), Verity HealthNet (Louisiana), and Centrus Health Direct (Kansas City)—alongside the HCH TrueChoice level-funded plan product. The company offers operational services including Provider Data Management, Machine-Readable Files (MRFs) for data exchange, Claims Repricing & Analytics, Credentialing, and Network Adequacy tools. Self-service offerings encompass a Provider Search Tool, Provider Portal, and Member Portal. Solutions are delivered to health systems, employers, brokers, and payors/TPAs, with additional add-on options such as Network Wrap Solutions for out-of-network cost control.

Differentiator

Problem solved

Functional benefit

Brands

• HCH Sync: High-performance network in Texas, Oklahoma, and Ohio focusing on quality through financial alignment with providers.
• HCH Plus
• Verity HealthNet
• Centrus Health Direct
• HCH TrueChoice

Products and services

• HCH Plus Network Broad network solution providing full access to all top providers in Oklahoma, offering comprehensive healthcare coverage across the state with numerous selections of top providers. For self-funded employers, health systems, and payors/TPAs.
• HCH Sync Network High-performance provider network focusing on quality through financial alignment with providers in Texas, Oklahoma, and Ohio markets, including Austin, DFW, Houston, San Antonio, Corpus Christi, East Texas, Lower Rio Grande Valley, Oklahoma statewide, and Cincinnati. For self-funded employers, health systems, and payors/TPAs.
• Verity HealthNet Provider network in Louisiana serving self-funded commercial health plans of all sizes, offered in multiple configurations and quality-based components via Verity First Choice (EPO). For self-funded employers, health systems, and payors/TPAs.
• Centrus Health Direct High-performance network offering enhanced choice in the Kansas City market, connecting employers with leading health systems and independent providers across Kansas and Missouri, powered by HCH Sync. For self-funded employers in Kansas City.
• HCH TrueChoice Level-funded health plan product designed for companies with 15-125 employees seeking cost control, predictability, and potentially lower premiums. Distributed through a dedicated broker portal. For small-to-mid-size employers and benefits brokers.
• Network Wrap Solutions Add-on option to existing health plans providing more cost control and upfront cost clarity for out-of-network care, designed to balance provider choice with financial implications. For self-funded employers and health plans.
• Health System Solutions Solutions for health systems addressing key challenges in repricing, claims management, funding, risk management, and peer review, including network building, customization, service management, pricing configuration, employer plan support, and operational/marketing support. For hospital systems and healthcare delivery organizations.
• Employer Medical Benefit Solutions Solutions for employers including self-funded plans, level-funded plans, and customized medical healthcare solutions to reduce costs and improve benefits. For self-funded and level-funded employer groups.
• Payor & TPA Solutions Comprehensive solutions for payors and TPAs including accurate claims repricing, network management, provider engagement, data analytics, reporting tools, and regulatory compliance support. For insurance carriers and third-party administrators.

Quantifiable outcome

• 15-30% average savings in total cost of care for employer clients switching to HCH high-performance networks from traditional insurance carriers.
• +3 more outcomes

Named customers1 record

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

Feature8 records

Partnerships

Three partnerships are on record, tiered core and minor.

• Centrus Health Kansas CitycoreStrategic or Co-development Partner · 9 July 2025Strategic partnership between Centrus Health Kansas City (a physician-led clinically integrated network) and Healthcare Highways to expand direct-to-employer healthcare solutions in the Kansas City market. The partnership creates Centrus Health Direct, a joint venture offering employers more choice for improved access to high-quality, cost-effective health plan options. HCH Sync technology powers the Centrus Health Direct network, providing high-performance network capabilities across Kansas and Missouri.
• Make-A-Wish North TexasminorOthers · 17 June 2025Healthcare Highways and Make-A-Wish North Texas formed a meaningful partnership built on shared values and employee well-being. The partnership reflects HCH's commitment to community engagement and supporting the health and wellness of North Texas youth.
• CJ CUP Byron Nelson (Momentous Institute)minorOthers · 25 April 2024Healthcare Highways served as Title Sponsor of the 2024 CJ CUP Byron Nelson's Official Wednesday Pro-Am. Funds raised at the PGA TOUR event support the Momentous Institute and the mental, social, and emotional health of North Texas youth.

Scale indicators8 records

Recent moves7 records

Expansion highlights5 records

Broad incumbents

• Cigna Healthcare (Evernorth): Cigna operates national PPO networks and a strong stop-loss/employer benefits franchise, competing directly with HCH for self-funded employer accounts; the Cigna pedigree of HCH's Chief Provider Network Officer (Brian Wallach, who led 125,000+ providers across 22 states at Cigna) underscores the overlap.
• Aetna (CVS Health): Aetna is a national payor offering broad PPO networks and self-funded plan administration — competing for the same mid-market and large employer accounts HCH targets, and a previous employer of HCH's Chief Provider Network Officer.
• MultiPlan: MultiPlan is the largest national independent PPO network and cost-management company in the US, offering network access, claims repricing, and analytics to payors, TPAs, and employers — directly overlapping HCH's core network leasing and repricing business, but at vastly greater scale across all 50 states.
• UnitedHealthcare (Optum): UnitedHealthcare is the largest US health insurer with the broadest national provider network and dominant employer market share; it competes head-to-head with HCH in self-funded employer accounts and is explicitly the incumbent HCH positions against.
• Elevance Health (Anthem Blue Cross Blue Shield): Elevance/Anthem is a national payor with deep Blue Cross Blue Shield network presence in many of HCH's footprint states (Texas, Ohio, Missouri) and competes for self-funded employer business; relevant as the dominant payor alternative HCH seeks to displace.

Emerging players

• Lantern (formerly SurgeryPlus): Lantern provides specialty-focused high-performance networks (surgery, cancer, etc.) for self-funded employers, intersecting with HCH's curated-network thesis but with narrower clinical scope; relevant as a competing point solution employers may consider alongside HCH.

Others

• Centrus Health Kansas City: Centrus Health KC is HCH's joint venture partner for the Centrus Health Direct network in Kansas/Missouri; relevant not as a competitor but as the most direct comparable of the "clinically integrated network + PPO platform" partnership model HCH is replicating across markets.

Regional players

• Blue Cross Blue Shield of Texas: BCBS of Texas is the dominant regional payor in HCH's largest market and competes directly for Texas self-funded employer business; the HCH Sync network is explicitly built as a financial-alignment alternative to BCBS-style broad networks in Texas.

Direct peers

• Zelis Healthcare: Zelis operates a healthcare cost management platform combining provider network access (including its own PPO network), claims repricing, and payments optimization for payors, TPAs, and self-funded employers — directly competing with HCH on network leasing, repricing analytics, and TPA-facing distribution.
• Imagine Health: Imagine Health builds high-performance, curated provider networks for self-funded employers, with an explicit value proposition of delivering measurable cost savings versus broad-network carriers — closely mirroring HCH's HCH Sync positioning and target buyer (mid-market employers seeking payor alternatives).

Market position

Strengths4 records

Weaknesses4 records

Competitive moat6 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/healthcare-highways-inc-

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Subsidiaries2 records

Funding overview

Funding rounds1 record

Investors1 record

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 Healthcare Highways