Alliant Health Solutions

What Alliant Health Solutions does

Alliant Health Solutions is a nonprofit healthcare management organization founded in 1970 and headquartered in Atlanta, Georgia, with approximately $60 million in revenue (2024). The company provides professional services supporting the effective administration of healthcare programs and funding for federal and state government agencies, operating four core service lines: Care Management (utilization management, prior authorizations, case management), Quality Improvement (under CMS QIN-QIO and HQIC contracts), Program Integrity (fraud, waste, and abuse detection via the proprietary MedGuard audit system), and Education & Training. It also operates a Commercial ASO division (Alliant ASO) serving commercial health plans, Medicaid managed care entities, and employers covering over 2.25 million lives. Alliant holds the CMS NQIIC designation, URAC accreditation since 1997, HITRUST certification, DCAA-compliant accounting, and ACCME accreditation, reflecting its deep embedding in federal healthcare program administration.

The company is clinically led, with 400+ clinical consultants across 70+ medical specialties and 200+ public health, quality improvement, IT, and health administration professionals — a workforce totaling approximately 600+ professionals that is unusual among government contractors and difficult to replicate. Its technology platform includes the proprietary MedGuard audit system for medical reviews and fraud detection using statistical and database techniques, web-based care management systems for HCBS/Medicaid waiver management, and dedicated web portals for the Georgia Nurse Aide Program and Certified Medication Aide (CMA) instructor registration. Sub-brands include Alliant Quality (quality improvement), Alliant ASO (commercial division), and MedGuard (proprietary audit system). Alliant also operates ESRD Networks 7, 8, 13, and 14 under CMS contract, and in September 2022 was awarded a SAMHSA grant to establish the national Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF).

Alliant's go-to-market is government contractor enterprise field sales, winning contracts through competitive federal and state procurement processes — primarily with CMS, state Medicaid agencies, SAMHSA, and other government health agencies. Its revenue model is professional services under multi-year contracts with quote-based pricing determined through competitive bidding. The company serves approximately 15.7 million lives total (12.06M federal, 1.37M state, 2.25M commercial) across 19 states. Notable customers include CMS (QIN-QIO/HQIC/ESRD prime), state Medicaid agencies, SAMHSA, Georgia Department of Public Health, Georgia Department of Community Health, and Florida Department of Juvenile Justice. As a 501(c)-style nonprofit, Alliant donates 10% of net proceeds to charitable causes (over $3.3 million contributed to date) and has been recognized 14 times in 17 years as one of Atlanta's Best Places to Work.

Name

Alliant Health Solutions

Legal name

Alliant Health Solutions

Website

https://allianthealth.org

Company type

Private

Founded year

1970

Operating status

Operating

Headcount range

101–250 employees

Short description

Alliant Health Solutions is a nonprofit healthcare management organization providing professional services in care management, quality improvement, program integrity, and education to federal and state government agencies, primarily under CMS contracts. The company, founded in 1970 and headquartered in Atlanta, serves approximately 15.7 million lives across 19 states with a clinically-led workforce of 600+ professionals.

Ownership category

akta.pro rank

Product category

Healthcare Quality Improvement Services

NAICS

Social Assistance (624), Direct Life, Health, and Medical Insurance Carriers (52411), Health Care and Social Assistance (62)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321), Services-Health Services (8000)

akta.pro primary industry

Government Program Administrative Services (Medicare/Medicaid ASO/TPA) (HLAEALAO)

akta.pro secondary industries

Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH), Hospital Shared Services, GPOs & System Support Organizations (HLAFAAAO)

Keywords

• Healthcare quality improvement
• Medicaid program integrity
• Clinical care management
• Government healthcare contracting
• Medical review services

Headquarters

HQ city

Dunwoody

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Government Healthcare Program Administration: Professional services supporting effective administration of healthcare programs and funding for healthcare improvement initiatives. Operates as a Network of Quality Improvement and Innovation Contractor (NQIIC) under contract with CMS.
2. Quality Improvement Services: Provides quality improvement services including QIN-QIO and Hospital Quality Improvement Contractor (HQIC) work for federal programs.
3. ESRD Network Services: End Stage Renal Disease Network contracts managing care for dialysis patients across multiple states.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels6 records

Core offering

Alliant Health Solutions is a nonprofit healthcare professional services organization that supports the effective administration of healthcare programs for federal and state government agencies and commercial health plans. The company delivers four core service lines—Care Management, Quality Improvement, Program Integrity, and Education & Training—through government contracts (e.g., QIN-QIO, HQIC, ESRD Networks, COE-NF) and a proprietary MedGuard audit system for fraud, waste, and abuse detection.

Product overview

Alliant Health Solutions is a nonprofit healthcare management organization providing a comprehensive suite of professional services supporting effective administration of healthcare programs. The company operates a platform-plus-modules architecture organized around four core service lines: Care Management, Quality Improvement, Program Integrity, and Education & Training. Key products include the proprietary MedGuard audit system for fraud detection, web-based portals for Nurse Aide and CMA program management, and specialized programs including QIN-QIO, HQIC, ESRD Networks, and the SAMHSA-funded Center of Excellence for Behavioral Health in Nursing Facilities. The company also operates Alliant ASO as a division serving commercial health plans. Services are delivered through data-driven approaches, clinically-led teams, and proprietary technology platforms supporting federal and state government programs across multiple states.

Differentiator

Problem solved

Functional benefit

Brands

• Alliant Quality: Quality improvement services group managing QIN-QIO, HQIC, ESRD Networks, and quality improvement programs
• Alliant ASO
• MedGuard

Products and services

• Care Management Clinician-led services ensuring the right care, in the right setting, for the right duration through medical review services, prior authorizations, case management, and level-of-care determination for government healthcare program beneficiaries.
• Quality Improvement Deploys a robust, agile platform for broad engagement and use of data to drive quality improvement through evidence-based tools and methods to accelerate healthcare improvements for hospitals, nursing homes, and providers.
• Program Integrity Utilizes analysis and reviews to ensure compliance and reduce improper payments, driving out fraud, waste and abuse through the proprietary MedGuard audit system for health plans and government agencies.
• Education & Training Collaborative education programs working with healthcare providers to improve quality and outcomes through targeted education and dissemination of best practices in evidence-based medicine, including ACCME-accredited continuing medical education activities.
• Alliant ASO Administrative Services Organization division dedicated to improving quality, safety and integrity of healthcare through professional services for the private sector, including commercial health plans, supporting utilization management, quality improvement, program integrity, medical reviews, and managed care.
• QIN-QIO (Quality Innovation Network - Quality Improvement Organization) Quality improvement services operating under CMS contract, providing targeted assistance to nursing homes, communities, small and rural practices, and those serving vulnerable populations across Alabama, Florida, Georgia, Kentucky, Louisiana, North Carolina, and Tennessee.
• HQIC (Hospital Quality Improvement Contractor) Hospital quality improvement program supporting hospitals in increasing patient safety, particularly preventing hospital-acquired infections (HAIs) through evidence-based interventions.
• ESRD Networks End Stage Renal Disease Network programs supporting dialysis facilities and patients across eight states (Networks 7, 8, 13, and 14), with focus on quality improvement, patient engagement, and care coordination for dialysis patients.
• Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF) National center established under SAMHSA grant to build capacity in nursing facilities for caring for residents with behavioral health conditions including Serious Mental Illness, Substance Use Disorders, and Co-occurring Disorders, serving 375K+ nursing home residents.
• Nurse Aide Program Portal Web-based portal for Georgia Medicaid's Nurse Aide Program, supporting Certified Nurse Aides, Certified Medication Aides, and Nurse Aide Training Programs with digital form submissions, resource access, and compliance management.
• MedGuard Audit System Proprietary audit system enabling efficient and consistent medical reviews and audits to identify, recover, and prevent inappropriate payments through statistical and database techniques analyzing claims and payment data to detect fraud, waste, and abuse.

Quantifiable outcome

• $165,398 cost savings achieved for Georgia hospital through CLABSI reduction
• +3 more outcomes

Named customers5 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

14 partnerships are on record, tiered core, major and minor.

• Substance Abuse and Mental Health Services Administration (SAMHSA)coreStrategic or Co-development Partner · 1 September 2022Awarded three-year grant to establish Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF), serving as national hub for expanding capacity to care for residents with behavioral health needs.
• Centers for Medicare & Medicaid Services (CMS)coreStrategic or Co-development PartnerPrimary federal agency partner. Alliant operates as a Network of Quality Improvement and Innovation Contractor (NQIIC) under CMS contracts, providing QIN-QIO, HQIC, and ESRD Network services across multiple states.
• State Medicaid AgenciescoreStrategic or Co-development PartnerPartnerships with multiple state Medicaid agencies for program administration, quality improvement, utilization management, and program integrity services.
• Georgia Department of Public HealthmajorStrategic or Co-development PartnerCollaboration on public health initiatives and quality improvement programs for Georgia healthcare facilities.
• Georgia Department of Community HealthmajorStrategic or Co-development PartnerNurse Aide Program administration for Georgia, including Certified Nurse Aide and Certified Medication Aide program oversight.
• Georgia Hospital AssociationminorStrategic or Co-development PartnerQuality improvement collaboration with Georgia hospitals, including joint coaching initiatives.
• Georgia Health Care AssociationminorStrategic or Co-development PartnerPartnership supporting nursing home quality improvement initiatives.
• National Quality ForumminorStrategic or Co-development PartnerParticipation in national quality improvement initiatives and standards development.
• eHealth InitiativeminorStrategic or Co-development PartnerParticipation in health IT and digital health initiatives.
• National Council for Mental WellbeingminorStrategic or Co-development PartnerCollaboration on behavioral health initiatives and substance use disorder programs.
• End Stage Renal Disease (ESRD) NetworkscoreStrategic or Co-development PartnerOperates ESRD Networks 7, 8, 13, and 14 serving dialysis patients across eight states, coordinating care improvement and patient engagement activities.
• Quality Improvement Organizations (QIOs)majorStrategic or Co-development PartnerNetwork collaboration with other QIOs under CMS NQIIC program for quality improvement initiatives.
• Florida Department of Juvenile JusticemajorStrategic or Co-development PartnerMedicaid Redirection Services Program providing utilization management and quality improvement oversight for Medicaid-eligible youth.
• Open Hand AtlantaminorStrategic or Co-development PartnerNonprofit partnership for community health initiatives, with Alliant medical director serving on board. Alliant donates 10% of net proceeds to support such organizations.

Scale indicators6 records

Recent moves8 records

Expansion highlights5 records

Direct peers

• IPRO: One of the largest QIO/QIN-QIO operators in the U.S., serving as a direct competitor to Alliant for CMS quality improvement contracts across multiple regions.
• Health Services Advisory Group (HSAG): Major QIN-QIO contractor competing head-to-head with Alliant for CMS quality improvement contracts, particularly in western and southwestern states.
• Telligen: QIO/QIN-QIO and federal health IT contractor providing quality improvement, population health, and government program administration services comparable to Alliant's core offerings.
• Stratis Health: Minnesota-based QIN-QIO with overlapping CMS quality improvement, utilization review, and provider education services that compete with Alliant in the upper Midwest.
• MetaStar: Wisconsin-based QIO offering quality improvement, utilization management, and program integrity services to federal and state health programs, directly comparable to Alliant's service portfolio.
• Quality Insights: Nonprofit QIO providing CMS-aligned quality improvement, ESRD Network, and chronic disease management services; directly overlaps with Alliant's federal program footprint.

Broad incumbents

• MAXIMUS: Large government services contractor providing Medicaid and Medicare program administration, eligibility, and contact center services — adjacent scale player competing for similar state and federal contracts.
• ICF International: Federal health consulting and IT services firm with a sizable public health practice; competes with Alliant on CMS research, evaluation, and program integrity contracts.
• BFCC-QIO (Kepro / CGS): Federally contracted Beneficiary and Family Centered Care QIO providing utilization review and quality-of-care reviews for Medicare; operates in adjacent QIO domain to Alliant's NQIIC work.
• Booz Allen Hamilton: Top-tier federal health consultant with CMS, VA, and HHS work; competes for larger federal health transformation contracts and could enter Alliant's quality improvement space with more capital.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/channel/UC4uFyOABx6fHiXkz2lLbF7g
• LinkedInlinkedin.com/company/alliant-health-solutions-inc/?viewAsMember=true
• Xx.com/allianthealth

Compliance6 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Subsidiaries1 record

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 Alliant Health Solutions