Trilogy Health Solutions

What Trilogy Health Solutions does

Trilogy Health Solutions, Inc. is a privately held preferred provider organization (PPO) and healthcare network management company headquartered in Brookfield, Wisconsin, founded in 2006 and operating with 11-50 employees. The company builds and operates provider networks across Wisconsin and the broader Midwest, anchoring Trilogy Health Networks with 22 major Wisconsin hospital systems and over 30,000 providers spanning virtually every specialty. Its product suite includes Trilogy Health (broad-access, tiered, and high-performance group health networks), Trilogy Works (Wisconsin's only independent comprehensive workers' compensation PPO network), Trilogy Direct (a Direct Primary Care network model), and two co-branded high-performance networks — EverPointe with Advocate Health for eastern Wisconsin and northern Illinois, and UpWard anchored by UW Health for south-central Wisconsin and northern Illinois. The company also offers healthcare consulting services for Medicare Advantage, Medicaid, and other government programs.

The business operates on a B2B model, selling network access and management services to self-funded and fully insured employers, insurance carriers, and third-party administrators (TPAs), with go-to-market executed through direct enterprise field sales. Revenue mechanics are described as subscription/recurring, with pricing structured as quote-based, fixed-fee arrangements tailored to employer group size and needs. Strategic partnerships are central to the offering: The Alliance extends combined provider coverage to over 90% of Wisconsin, while HPS/PayMedix layers payment-fintech capabilities onto the network. Provider recruitment is handled through a dedicated contracting function.

Underlying technology is described as a healthcare provider network management platform supporting provider directory search, network contracting workflows, and customer-service operations. The company maintains a public website with provider lookup, downloadable product brochures, and contact forms. No proprietary AI/ML capabilities, APIs, SDKs, or published technical differentiators are disclosed in the available data; the platform appears to function primarily as an administrative and contracting backbone rather than an intelligence-driven system.

Name

Trilogy Health Solutions

Legal name

Trilogy Health Solutions, Inc.

Website

https://trilogycares.com

Company type

Private

Founded year

2006

Operating status

Operating

Headcount range

11–50 employees

Ownership category

akta.pro rank

Product category

Healthcare Network Services (Preferred Provider Organization)

NAICS

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

SIC

Services-Health Services (8000)

akta.pro primary industry

Multi-Specialty PPO Provider Networks (HLAEANAC)

akta.pro secondary industries

Tiered-Network POS Plans (HLAEAOAD), Direct Contracting / Narrow Network PPOs (HLAEANAK), Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO)

Keywords

• Preferred provider organization
• Healthcare network services
• Workers compensation PPO
• Direct primary care network
• Group health network products

Headquarters

HQ city

Brookfield

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Supply Chain

Revenue model

1. Network Access and Management Services: Trilogy Health Solutions generates revenue by providing healthcare network access to employers, insurance carriers, and TPAs. The company offers multiple network products including preferred provider networks, workers' compensation networks, and Direct Primary Care networks, serving both self-funded and fully insured customers.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels2 records

Core offering

Trilogy Health Solutions is a Wisconsin-based preferred provider organization that sells healthcare network access and management services to employers, insurance carriers, and TPAs. Its portfolio includes the Trilogy Health PPO network, the Trilogy Works workers' compensation PPO network, and the Trilogy Direct Direct Primary Care network, supported by 22 major Wisconsin hospital systems and 30,000+ providers across the Midwest.

Product overview

Trilogy Health Solutions offers a suite of flexible group health network products tailored for employers, featuring a unified platform with multiple network offerings: Trilogy Health (core group health network), Trilogy Works (workers' compensation PPO), and Trilogy Direct (Direct Primary Care). These core products are complemented by specialized network solutions including EverPointe and UpWard (high-performance networks), Trilogy Health Networks/The Alliance (covering 90%+ of Wisconsin providers), and Trilogy Health Networks/HPS (partnership with PayMedix). The company also offers consulting services for Medicare, Medicaid, and government health programs. The portfolio spans Wisconsin and the Midwest, serving both self-funded and fully insured employer groups.

Differentiator

Problem solved

Functional benefit

Brands

• Trilogy Health Networks: Preferred Provider Network including 22 major Wisconsin Hospital Systems and over 30,000 providers covering virtually every specialty.
• Trilogy Works
• Trilogy Direct
• EverPointe
• UpWard

Products and services

• Trilogy Health Core group health PPO network product offering broad access, tiered, and high-performance network options tailored for employers in Wisconsin and the Midwest.
• Trilogy Works Wisconsin's only independent and comprehensive workers' compensation PPO network providing clients access to substantial aggregate savings through partnerships with high-quality, low-cost providers.
• Trilogy Direct Direct Primary Care (DPC) network model that transforms how employers buy healthcare for employees.
• Trilogy Health Networks Preferred provider network encompassing 22 major Wisconsin hospital systems and 30,000+ providers covering virtually every specialty, providing substantial aggregate savings through fixed-fee arrangements.
• EverPointe Flexible, high-performance network delivering quality care to employers in eastern Wisconsin and northern Illinois at the lowest price in the market, in partnership with Advocate Health.
• UpWard Flexible, high-performance network anchored by nationally recognized UW Health, driving measurable savings without compromising quality for employers in south Central Wisconsin and northern Illinois.
• Consulting Services Healthcare consulting services for new program launches and product development across Medicare Advantage, Medicaid, Special Needs Plans, and other government programs, targeted at health plans and provider-sponsored organizations.

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Four partnerships are on record, tiered core.

• The AlliancecoreStrategic or Co-development PartnerThe Alliance and Trilogy Health Networks partnership provides self-funded employers with even more provider options, covering over 90% of providers in Wisconsin.
• HPS/PayMedixcoreStrategic or Co-development PartnerTogether, Trilogy Health Networks and HPS/PayMedix deliver a competitive, comprehensive network of high-performing providers to support Wisconsin employers and their employees.
• UW HealthcoreStrategic or Co-development PartnerUpWard network is anchored by nationally recognized UW Health, driving measurable savings without compromising quality for employers in south Central Wisconsin and northern Illinois.
• Advocate HealthcoreStrategic or Co-development PartnerEverPointe network delivers quality care to employers in eastern Wisconsin and northern Illinois at the lowest price in the market, in partnership with Advocate Health.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• MultiPlan: MultiPlan is a national PPO network and cost-management company. It is the most direct comparable to Trilogy's preferred provider and high-performance network products, scaled nationally versus Trilogy's regional Wisconsin/Midwest footprint.
• Zelis: Zelis provides healthcare network management, claims cost containment, and network solutions to payers and employers. Its network and cost-management offerings directly overlap with Trilogy's PPO and high-performance network products.
• The Alliance: The Alliance is a Wisconsin-based cooperative health plan network covering 90%+ of Wisconsin providers and is also a Trilogy partner. It is the closest local comparable in terms of Wisconsin provider breadth and self-funded employer focus.
• HPS/PayMedix: HPS/PayMedix provides provider networks and payment/financing solutions for Wisconsin employers. It is a direct partner of Trilogy and operates complementary network and payment infrastructure for the same Wisconsin employer segment.

Regional players

• Quartz Health Solutions: Quartz is a Wisconsin-based health plan offering provider networks to employers in the region. It is a regional comparable focused on Wisconsin/Midwest employer groups, similar in geography to Trilogy though broader in plan type.
• Network Health: Network Health is a Wisconsin-based health insurer serving employer groups in the state. It is a regional peer competing for the same Wisconsin self-funded and fully insured employer customers that Trilogy's networks serve.

Broad incumbents

• Elevance Health (Anthem): Elevance Health operates national Blue Cross Blue Shield plans and large provider networks across multiple states, including the Midwest. It competes with Trilogy on network access for self-funded employers and offers overlapping network products at much greater scale.
• UnitedHealth Group (Optum): UnitedHealth Group operates the largest U.S. health insurer and Optum's national provider network. It competes with Trilogy in Wisconsin and the Midwest for employer-sponsored networks, with dramatically greater scale, claims, and PBM integration.
• Cigna Group: Cigna operates national health plans and PPO networks serving employer groups across the U.S. It is a broad incumbent comparable to Trilogy on employer-sponsored network access, with significant advantages in scale and integration.
• Humana: Humana is a national health insurer with broad provider networks serving employer groups and government programs. It is a broad incumbent competing in the same employer-sponsored network space as Trilogy, particularly relevant given Trilogy's government-program consulting focus.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/trilogy-health-solutions-inc

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 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 Trilogy Health Solutions