Summit Health Care Solutions

What Summit Health Care Solutions does

Summit Health Care Solutions is a privately held, founder-led professional services firm founded in 2002 and headquartered in Williamsville (Buffalo area), New York. The company specializes exclusively in Nursing Home Medicaid application processing, helping families of nursing home and assisted living residents navigate the application, documentation, and approval process end-to-end. Summit manages the full workflow — gathering 60 months of financial records, interfacing with banks, communicating with state Medicaid agencies, and representing clients through case determination — and offers a 100% money-back guarantee if an eligible applicant's coverage is not obtained.

The firm operates a B2B2C distribution model. Direct-to-consumer intake runs through a phone line and online contact form, while a parallel referral channel is built on relationships with nursing homes, assisted living facilities, and estate planning/family law attorneys across New York State and six additional states (Florida, Pennsylvania, Illinois, Alabama, Tennessee, Georgia). A proprietary web-based case management portal allows facility partners to view real-time case status. Summit monetizes through a flat, one-time professional services fee per case, positioning itself as more affordable than attorney hourly billing and as a higher-success-rate alternative to do-it-yourself applications, where it claims more than 50% of eligible applicants are denied.

Summit is bootstrapped with no disclosed external investors, funding rounds, or M&A activity. The senior team has been built out over 2005-2011 and includes the founder/president (Darlene Maclay, 30+ years healthcare experience), a VP of Operations, a Director of Nursing Home Medicaid, a Controller, and an Administrative Assistant/Intake Coordinator. The company reports having processed over 10,000 successful New York State Medicaid applications since founding, and operates with a headcount of 11-50 employees. Revenue is not publicly disclosed.

Name

Summit Health Care Solutions

Legal name

Summit Health Care Solutions

Website

https://summithcs.com

Company type

Private

Founded year

2002

Operating status

Operating

Headcount range

11–50 employees

Short description

Summit Health Care Solutions, founded 2002 in Buffalo, NY, is a private professional services firm that manages Nursing Home Medicaid applications end-to-end for families and via referral partnerships with nursing homes and attorneys across seven US states.

Ownership category

akta.pro rank

Product category

Medicaid Application Assistance Services

NAICS

Services for the Elderly and Persons with Disabilities (62412), Other Individual and Family Services (62419)

SIC

Services-Social Services (8300), Services-Misc Health & Allied Services, Nec (8090)

akta.pro primary industry

MA Private Fee-for-Service (PFFS) Plans (HLAEACAC)

akta.pro secondary industry

MA Care Coordination & Utilization Management (UM) Programs (HLAEACAK)

Keywords

• Medicaid application services
• Nursing home Medicaid
• Elder care planning
• Medicaid eligibility assistance
• Healthcare administration services

Headquarters

HQ city

Buffalo

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

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

Revenue model

1. Medicaid Application Processing Services: Summit Health Care Solutions charges a flat rate fee for their Medicaid application processing services. The fee is a one-time charge that covers the entire application process from start to finish, regardless of how long the case takes (typically 5-9 months). The company offers a 100% money-back guarantee if they cannot obtain coverage for eligible applicants.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

Summit Health Care Solutions provides end-to-end Nursing Home Medicaid Application Assistance for families of nursing home and assisted living residents. The service covers 60 months of financial documentation gathering, direct interfacing with banks and government agencies, NAMI verification, and full representation through approval. A proprietary web-based case management portal supplements the service for institutional referral partners, providing real-time case status visibility.

Product overview

Summit Health Care Solutions offers a single unified service centered on Nursing Home Medicaid Application Assistance. The core offering is a comprehensive, managed Medicaid application service that handles the entire process from document collection through approval. A proprietary web-based case management portal complements the service, enabling nursing home partners to track case status in real-time. The company positions itself as a specialized Medicaid processor, distinct from law firms or do-it-yourself approaches.

Differentiator

Problem solved

Functional benefit

Products and services

• Nursing Home Medicaid Application Assistance End-to-end managed service that handles the full Nursing Home Medicaid application process for families of nursing home and assisted living residents, including 60 months of financial documentation gathering, interfacing with banks and financial institutions, NAMI verification, ongoing communication with government agencies, and full representation through approval. Backed by a 100% money-back guarantee for eligible applicants.

Quantifiable outcome

• Over 10,000 successful NY State Medicaid applications processed
• +2 more outcomes

Named customers6 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Scale indicators3 records

Recent moves6 records

Expansion highlights4 records

Broad incumbents

• eHealth: eHealth operates a major online health insurance marketplace including Medicare and Medicaid plan enrollment. It is comparable as a digital insurance enrollment platform serving the same family demographic, though with a different revenue model and broader product scope.
• GoHealth: GoHealth is a large health insurance marketplace focused on Medicare and related senior coverage products. It is comparable to Summit as a senior-focused enrollment/benefits intermediary, though it leans on insurance commissions rather than flat-fee Medicaid application services.
• Healthcare.gov (CMS): Healthcare.gov is the federal health insurance marketplace covering Medicaid enrollment in participating states. It is comparable as the dominant public-sector channel for individual Medicaid enrollment and a structural alternative to private application-assistance services like Summit.
• A Place for Mom: A Place for Mom is a large senior-care marketplace connecting families with nursing homes, assisted living, and care services. It overlaps with Summit at the family-in-need-of-nursing-home-care touchpoint and serves as a comparable senior-care referral business with adjacent Medicaid-related content.
• SelectQuote: SelectQuote is an insurance distributor specializing in senior coverage including Medicare. It overlaps with Summit in serving the same family demographic navigating senior-care benefits, but operates as a multi-carrier agent rather than a Medicaid application processor.
• Caring.com: Caring.com is a senior-care resource and referral platform with content and provider directories covering nursing homes, assisted living, and care financing. It overlaps with Summit on family-facing Medicaid/care-finance content and senior care lead generation.

Direct peers

• ElderLawAnswers: ElderLawAnswers is an information and attorney-directory site focused on Medicaid planning, long-term care, and elder-law issues. It is comparable to Summit as a consumer-facing Medicaid planning resource serving families in the same nursing-home Medicaid workflow.

Others

• Patient Advocate Foundation: Patient Advocate Foundation helps patients navigate insurance, access care, and manage healthcare costs. It is thematically comparable to Summit's case-management approach for families facing complex health-system bureaucracy, though not a direct Medicaid application competitor.

Emerging players

• National Council on Aging (BenefitsCheckUp): National Council on Aging operates BenefitsCheckUp, a widely-used free online tool that screens seniors for benefit eligibility including Medicaid. It is a partial competitive substitute because it enables self-service benefit discovery, though it does not perform end-to-end application processing like Summit.
• Medicare.gov / State Health Insurance Assistance Programs (SHIP): SHIPs are federally funded, state-administered programs offering free, unbiased Medicare and Medicaid counseling to seniors. They are comparable as a free public alternative to Summit's paid Medicaid application service, representing both a competitor for cost-sensitive families and a potential disintermediation risk.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/channel/UCTBYWrtBCUI4Kzdehe7YAmg
• Facebookfacebook.com/summitmedicaid
• Instagraminstagram.com/summithcs
• LinkedInlinkedin.com/company/summit-healthcare-solutions

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

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 Summit Health Care Solutions