Networks By Design
Networks By Design is a privately held California corporation that builds customized PPO, MPN, and EPO medical provider networks for B2B clients including workers' compensation payors, self-insured employers, and group health insurers, primarily in California with recent national expansion.
- Company typePrivate
- Founded2015
- HeadquartersTracy, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What Networks By Design does
Networks By Design, Inc. is a privately held California corporation headquartered in Tracy, CA, that builds and manages customized medical provider networks (PPO, MPN, and EPO) for B2B clients. The company serves workers' compensation payors and self-insured employers, group health payors and employers, and auto liability insurers, with its primary footprint in California and a national expansion launched in September 2024 through partnerships with national PPO networks covering more than 2.1 million providers across all 50 states.
The core technology is a proprietary provider network management platform that supports client-driven network configuration by state, zip code, and Taxpayer Identification Number (TIN), filtered by best rate, appeal history, and customer relations. Supporting features include a Provider Directory Search Tool with geographic and specialty filtering, a Telehealth Provider Platform, and a Provider Nomination System where clients request additions with a 2-business-day response. The company emphasizes proprietary medical outcomes data, utilization management guidelines aligned with California's MTUS framework, and exclusive provider contracts containing cost containment provisions such as lien filing timelines and prior authorization requirements.
The revenue model combines recurring subscription-style network access and management fees with professional services revenue from provider recruitment. Pricing is quote-based and not publicly disclosed; contracts appear multi-year. Distribution is exclusively through direct enterprise sales led by the principals, with no consumer or retail channel. Notable customers include Republic Indemnity (workers' compensation) and Hilmar Cheese Company (employer health plan).
Networks By Design firmographics
Firmographics- Name
- Networks By Design
- Legal name
- Networks By Design, Inc.
- Website
- https://netbyd.com
- Company type
- Private
- Founded year
- 2015
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- Networks By Design is a privately held California corporation that builds customized PPO, MPN, and EPO medical provider networks for B2B clients including workers' compensation payors, self-insured employers, and group health insurers, primarily in California with recent national expansion.
- Ownership category
- akta.pro rank
Networks By Design industry classification
Industry- Product category
- Healthcare Provider Networks
- SIC
- Services-Health Services (8000)
- akta.pro primary industry
- Workers’ Compensation PPO Networks (HLAEANAH)
- akta.pro secondary industries
- National PPO Networks (HLAEANAA), Auto/No-Fault PPO Networks (HLAEANAI), Provider Network & Care Management for Commercial Members (HLAEAAAL)
Keywords
Where Networks By Design is headquartered
LocationHeadquarters
- HQ city
- Tracy
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Networks By Design business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales
Revenue model
- Network Access and Management Fees: Revenue generated from providing access to customized provider networks (PPO, MPN, EPO) for workers' compensation, group health, and auto liability clients. Fees likely structured as network access fees or per-member-per-month charges based on the B2B nature of the business.
- Provider Recruitment Services: Provider recruitment services for clients with specific provider nominations, supporting network customization.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Multi-year contract | Custom network solutions with quote-based pricing |
Go-to-market motion2 records
Distribution channels2 records
Marketing channels2 records
Networks By Design product offering
Product offeringCore offering
Networks By Design develops and delivers client-customized medical provider networks in California, including Workers' Compensation MPNs, Group Health PPO/EPO networks, and Auto Liability networks. The company provides payors, insurance carriers, employers, and public entities with access to vetted healthcare providers along with proprietary data management technology to administer and report on network utilization.
Product overview
Networks By Design operates as a client-customized medical provider network company offering three integrated core products: Workers' Compensation Medical Provider Network (MPN), Group Health PPO/EPO Network, and Auto Liability Provider Network. The company recently expanded its National PPO Network (September 2024) offering over 2.1 million providers nationwide. Supporting these core networks are complementary features including a Provider Directory Search Tool with geographic and specialty filtering, Telehealth Provider Platform for remote care, and a Provider Nomination System for client-driven provider recruitment. All networks are built on proprietary medical outcomes data rather than commodity network data, enabling truly client-driven custom network configurations.
Differentiator
Problem solved
Functional benefit
Products and services
- Workers' Compensation MPN
Quantifiable outcome
- Significant medical expense savings through customized network focus on best possible care and treatment
- +2 more outcomes
Companies that use Networks By Design
Customer profileNamed customers2 records
Segments4 records
Ideal customer profiles3 records
Networks By Design technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature4 records
Networks By Design partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- National PPO NetworkscoreNetworks By Design has partnered with national PPO networks to offer clients access to over 2.1 million providers throughout the United States. This partnership enables the company to serve national clients with client-driven custom networks and QA programs beyond California.
Scale indicators6 records
Recent moves6 records
Expansion highlights5 records
Networks By Design competitors and assessment
Company assessmentDirect peers
- Galaxy Health Network: Galaxy Health Network is a privately held PPO/EPO network manager offering customized provider network solutions to payors and employers. Closely comparable in scale and customization-focused business model to Networks By Design.
- Zelis: Zelis provides healthcare network management, claims cost containment, and payment integrity services to payers and employers. Its network and cost-containment offerings overlap directly with Networks By Design's custom PPO/MPN, custom QA, and provider configuration capabilities.
- CorVel Corporation: CorVel is a national workers' compensation managed care company offering provider networks, utilization management, and claims management. It is a direct competitor in California workers' comp MPN and medical cost containment where Networks By Design focuses.
- Evolutions Healthcare Systems: Evolutions Healthcare Systems is a privately held PPO and MPN network management company serving payors, employers, and TPAs with customizable provider networks. Closely comparable in business model and mid-market positioning to Networks By Design.
- USA Managed Care Organization (USAMCO): USAMCO provides managed care, provider network, and utilization management services focused on workers' compensation and group health. It competes in the same California-centric, custom-network niche as Networks By Design.
- MedRisk: MedRisk is a workers' compensation specialty managed care company focused on physical therapy and ancillary provider networks. It overlaps with Networks By Design's workers' comp MPN, particularly in California, on provider network and utilization management.
- One Call Care Management (now One Call): One Call provides workers' compensation network and care coordination services, including diagnostic, physical therapy, and specialty provider networks. It is a direct competitor in workers' comp provider network management.
- Stratose (formerly Coalition America / AMPS): Stratose operates a national PPO network and cost containment services for payors, TPAs, and self-funded employers. It is a comparable custom-network and supplemental network competitor in the same mid-market segment.
Broad incumbents
- MultiPlan (now Claritev): MultiPlan/Claritev is the largest independent PPO network manager in the U.S., offering national and supplemental provider networks to payors, employers, and TPAs. It is the broadest incumbent benchmark for Networks By Design's custom-network value proposition.
- Carelon Health (Elevance Health network services): Carelon (formerly Aspire/CareMore), part of Elevance Health, operates broad national PPO networks (including the legacy First Health network) and integrated care management. It is a scaled incumbent competitor in custom network solutions and national PPO reach.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Networks By Design social profiles
Digital presenceNetworks By Design financial estimates
Financial estimateRevenue estimate
Valuation estimate
Networks By Design leadership team
Management profileNumber of profiles
Profiles4 records
Networks By Design funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Networks By Design M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Networks By Design
What does Networks By Design do?
Networks By Design develops and delivers client-customized medical provider networks in California, including Workers' Compensation MPNs, Group Health PPO/EPO networks, and Auto Liability networks. The company provides payors, insurance carriers, employers, and public entities with access to vetted healthcare providers along with proprietary data management technology to administer and report on network utilization.
Is Networks By Design a public or private company?
Networks By Design is a private company. It is classified as unknown and is currently operating.
When was Networks By Design founded?
Networks By Design was founded in 2015. It employs 11 to 50 people.
Where is Networks By Design based?
Networks By Design is headquartered in Tracy, United States, in the North America region.
How does Networks By Design make money?
Two revenue lines are on record. Network Access and Management Fees are the primary driver. The others are provider Recruitment Services.
Who are Networks By Design's main competitors?
Direct peers on record are Galaxy Health Network, Zelis, CorVel Corporation, Evolutions Healthcare Systems, USA Managed Care Organization (USAMCO), MedRisk, One Call Care Management (now One Call) and Stratose (formerly Coalition America / AMPS). Broad incumbents are MultiPlan (now Claritev) and Carelon Health (Elevance Health network services).
Does Networks By Design have an API?
No public API is recorded for Networks By Design.
What industry is Networks By Design in?
Networks By Design's product category is Healthcare Provider Networks. Its primary akta.pro industry code is HLAEANAH, Workers’ Compensation PPO Networks, with a secondary code of HLAEANAA, National PPO Networks. Its SIC code is 8000.