ProviDRs Care
ProviDRs Care is a physician-owned Kansas PPO that leases its 11,000+-provider network to insurance carriers, TPAs, and self-funded employers across Kansas and the broader Midwest, and offers the NexUS value-based, level-funded health plan for small and mid-sized employer groups.
- Company typePrivate
- Founded1985
- HeadquartersWichita, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What ProviDRs Care does
ProviDRs Care is a physician-owned Preferred Provider Organization (PPO) founded in 1985 as the Wichita Preferred Providers Association (WPPA) under the Medical Society of Sedgwick County and rebranded to its current name in 2009. The company, operating through its legal entity WPPA, Inc., leases its statewide Kansas provider network of 11,000+ providers and 140+ hospitals to insurance carriers, third-party administrators (TPAs), and self-funded employer groups, and has extended in-network coverage into Missouri, Nebraska, Iowa, Illinois, South Dakota, and Colorado through reciprocal alliances with HealthLink Open Access III, PHP's Freedom Network Select, Midlands Choice, Cofinity, and the national First Health network.
The core technology stack comprises an online provider directory and self-service member tools, an EDI claims processing system routing through nine clearinghouses (ZirMed, Imspro/Xclaims, Office Ally, Emdeon, McKesson/RelayHealth, Capario, ENS/Ingenix/OptumInsight, ASK/EDI Midwest, and Availity RCM) under Payer ID 48100, and a claims/utilization data analytics service for self-funded employer groups. Product offerings include the NexUS Health Plan, a value-based, level-funded plan introduced in 2018 for Kansas employers with 4+ enrolled employees; Lifestyle Health Plans for the rest of Kansas; level-funded group plans administered through Medova Healthcare; and the underlying PPO network access itself. Credentialing is delegated to Medical Provider Resources, and ProviDRs Care functions as a claims repricer rather than a payer.
Revenue is generated through three primary streams: recurring network access fees from payers and TPAs (subscription model), per-claim repricing transaction fees, and plan administration revenue from level-funded group plans. Distribution is hybrid: a Business Development team sells directly to mid-market employer groups in defined Kansas counties, while appointed brokers and agents extend reach across small and mid-sized employers, and TPAs serve as enterprise channels. The company is headquartered in Wichita, Kansas, employs 11-50 people, and operates without external venture or private equity investment.
ProviDRs Care firmographics
Firmographics- Name
- ProviDRs Care
- Legal name
- WPPA, Inc.
- Website
- https://providrscare.net
- Company type
- Private
- Founded year
- 1985
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- ProviDRs Care is a physician-owned Kansas PPO that leases its 11,000+-provider network to insurance carriers, TPAs, and self-funded employers across Kansas and the broader Midwest, and offers the NexUS value-based, level-funded health plan for small and mid-sized employer groups.
- Ownership category
- akta.pro rank
ProviDRs Care industry classification
Industry- Product category
- Healthcare PPO Network Management
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Direct Life, Health, and Medical Insurance Carriers (52411)
- SIC
- Hospital & Medical Service Plans (6324), Services-Computer Programming, Data Processing, Etc. (7370)
- akta.pro primary industry
- Regional & Local PPO Networks (HLAEANAB)
- akta.pro secondary industry
- Multi-Specialty PPO Provider Networks (HLAEANAC)
Keywords
Where ProviDRs Care is headquartered
LocationHeadquarters
- HQ city
- Wichita
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
ProviDRs Care business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Network Access Fees: ProviDRs Care charges payers, insurance companies, and third-party administrators access fees to lease their provider network. The network is leased by insurance companies and TPAs.
- Claims Repricing Services: ProviDRs Care reprices medical claims for providers and payers. They are not a claims payer but facilitate the repricing process to negotiate reduced rates between providers and payers.
- Plan Administration: ProviDRs Care administers level-funded group health plans (NexUS Health Plans) for employers, including plan management and broker/agent commissions.
Go-to-market motion3 records
Distribution channels4 records
Marketing channels6 records
ProviDRs Care product offering
Product offeringCore offering
ProviDRs Care operates a physician-owned Preferred Provider Organization (PPO) network that provides in-network healthcare access through 11,000+ providers and 140+ hospitals across Kansas, with extended Midwest and national coverage through partner networks. The company leases this provider network to self-funded employer plans, insurance carriers, and third-party administrators, while also administering value-based health plans such as the NexUS Health Plan and Lifestyle Health Plans for Kansas employers. Supporting services include EDI claims processing, claims repricing, credentialing, and data analytics for self-funded groups.
Product overview
ProviDRs Care is a physician-owned Preferred Provider Organization (PPO) offering a comprehensive healthcare network solution. The core product is the ProviDRs Care Network, which provides in-network access to 11,000+ providers and 140+ hospitals across Kansas with expansion to multiple Midwest states and nationally. The company's key plan offerings include the NexUS Health Plan (value-based plan for Kansas employers in specific counties) and Lifestyle Health Plans (for employers statewide). Level-funded group plans are administered through Medova Healthcare partnerships. Additional services encompass employer solutions, provider solutions, broker services, EDI claims processing through multiple clearinghouses, and data analytics for self-funded groups. The company publishes the ProviDRs Pulse newsletter and operates provider directories for members to find in-network care.
Differentiator
Problem solved
Functional benefit
Products and services
- NexUS Health Plan Value-based, level-funded group health plan for Kansas employers in Sedgwick, Harvey, Butler, Reno, Cowley, Sumner, and Kingman counties; requires 4+ enrolled employees (2+ for chamber-sponsored plans).
- Lifestyle Health Plans
Companies that use ProviDRs Care
Customer profileNamed customers6 records
Segments5 records
Ideal customer profiles3 records
ProviDRs Care technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration9 records
Feature5 records
ProviDRs Care partnerships and signals
Strategic signalPartnerships
Eight partnerships are on record, tiered core.
- Medical Provider ResourcescoreMedical Provider Resources, a credentialing verification organization, performs all credentialing for providers participating in the ProviDRs Care Network. They send credentialing requests on behalf of ProviDRs Care and handle the credentialing process for network providers.
- Vision Care PluscorePartnership formed July 1, 2014 with Vision Care Plus to provide their eye care network to ProviDRs Care members. This partnership increased eye care panel in Kansas by more than 300%. Vision Care Plus was formed in 1987 and includes independent optometrists in Kansas.
- Cofinity NetworkcoreCofinity is one of Colorado's leading stand-alone healthcare networks with statewide provider access. Through this partnership, ProviDRs Care can add the Cofinity network to clients' benefit plans, providing access to over 120 hospitals, more than 2,000 ancillaries, and 20,000+ health care professional service locations in Colorado.
- HealthLink Open Access IIIcoreHealthLink Open Access III partnership enables ProviDRs Care to offer Midwest PPO network access in Missouri, Nebraska, Iowa, Illinois, and South Dakota, extending coverage beyond Kansas borders.
- PHP Freedom Network SelectcorePHP's Freedom Network Select partnership combined with HealthLink and Midlands Choice creates a seamless Midwest PPO network, offering employers competitive advantages with convenient, affordable, and quality healthcare network access.
- Midlands ChoicecoreMidlands Choice partnership completes the Midwest PPO network alliance, allowing ProviDRs Care to combine four networks into one powerhouse solution for employer groups seeking multi-state coverage.
- Century Health Solutions, Inc.coreAcquisition agreement closed June 15, 2015, where ProviDRs Care acquired Century Health Solutions' PPO including client service contracts and majority of participating provider agreements. Century is an affiliate of Stormont-Vail HealthCare. The acquisition added more than 2,000 providers, 10 hospitals, and 83 medical facilities in northeast Kansas, particularly the greater Topeka area.
- Medova HealthcarecoreMedova Healthcare administers a level-funded group plan using ProviDRs Care Network. Bret Emberson, Business Development Associate, is responsible for marketing this plan to employers in specific Kansas counties.
Scale indicators5 records
Recent moves13 records
Expansion highlights6 records
ProviDRs Care competitors and assessment
Company assessmentBroad incumbents
- First Health Network (CVS Health/Aetna): First Health is a nationwide PPO network used by payers for travel/out-of-area coverage and is one of ProviDRs Care's network partners for nationwide reach. Comparable as a large-scale PPO network lessor targeting TPAs, payers, and employer plans.
- Zelis: Zelis provides healthcare network management, claims cost management, and analytics services to payers, TPAs, and self-funded plans. It overlaps directly with ProviDRs Care's network-leasing, claims-repricing/EDI, and analytics offerings.
- Blue Cross and Blue Shield of Kansas (BCBSKS): BCBSKS is the dominant incumbent PPO/health plan network in Kansas and competes head-to-head with ProviDRs Care for Kansas employer group business and providers. Both operate a statewide provider network and sell or lease it to employer/self-funded plans.
- Aetna (CVS Health): Aetna operates large national PPO networks and is the parent of multiple networks that serve as ProviDRs Care's partners (First Health, Cofinity). Competes with ProviDRs Care for Kansas employer groups and self-funded plans.
- MultiPlan: MultiPlan is the largest U.S. independent PPO network and cost-management company, leasing provider networks to payers, TPAs, and self-funded plans. It is the most direct comparable business model to ProviDRs Care, just at vastly greater national scale, and competes for the same payer and TPA network-lease relationships.
Regional players
- HealthLink (Anthem): HealthLink operates a multi-state Midwest PPO network and is one of ProviDRs Care's explicit network partners (HealthLink Open Access III). It is comparable as a regional PPO network lessor that brokers access to employer groups in neighboring states.
- Midlands Choice: Midlands Choice is a Midwest PPO network serving Iowa, Nebraska, and surrounding states and is a listed network partner of ProviDRs Care. Both lease PPO network access to employer plans and TPAs across the Midwest with comparable regional network-lease economics.
- Cofinity (Aetna): Cofinity is a Colorado-based PPO network that ProviDRs Care explicitly partners with to extend coverage westward. Comparable as a state-anchored PPO network lessor in an adjacent geography serving employer/self-funded plans.
Others
- Cotiviti: Cotiviti provides payment-accuracy and analytics services for health plans and self-funded employers, similar to ProviDRs Care's claims/utilization data analytics offering. Comparable as a data-and-analytics vendor that monetizes claims data in the self-funded employer market.
Direct peers
- Medova Healthcare: Medova Healthcare administers a level-funded group health plan that uses the ProviDRs Care Network and is marketed by ProviDRs Care's Business Development team. Comparable as a closely tied administrator of self-funded/level-funded plans built on top of a leased PPO network.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
ProviDRs Care social profiles
Digital presenceProviDRs Care financial estimates
Financial estimateRevenue estimate
Valuation estimate
ProviDRs Care leadership team
Management profileNumber of profiles
Profiles10 records
ProviDRs Care funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
ProviDRs Care 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 ProviDRs Care
What does ProviDRs Care do?
ProviDRs Care operates a physician-owned Preferred Provider Organization (PPO) network that provides in-network healthcare access through 11,000+ providers and 140+ hospitals across Kansas, with extended Midwest and national coverage through partner networks. The company leases this provider network to self-funded employer plans, insurance carriers, and third-party administrators, while also administering value-based health plans such as the NexUS Health Plan and Lifestyle Health Plans for Kansas employers. Supporting services include EDI claims processing, claims repricing, credentialing, and data analytics for self-funded groups.
Is ProviDRs Care a public or private company?
ProviDRs Care is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was ProviDRs Care founded?
ProviDRs Care was founded in 1985. It employs 11 to 50 people.
Where is ProviDRs Care based?
ProviDRs Care is headquartered in Wichita, United States, in the North America region.
How does ProviDRs Care make money?
Three revenue lines are on record. Network Access Fees are the primary driver. The others are claims Repricing Services and plan Administration.
Who are ProviDRs Care's main competitors?
Broad incumbents on record are First Health Network (CVS Health/Aetna), Zelis, Blue Cross and Blue Shield of Kansas (BCBSKS), Aetna (CVS Health) and MultiPlan. Regional players are HealthLink (Anthem), Midlands Choice and Cofinity (Aetna). Cotiviti is listed as an others. Medova Healthcare is listed as a direct peer.
Does ProviDRs Care have an API?
No public API is recorded for ProviDRs Care.
What industry is ProviDRs Care in?
ProviDRs Care's product category is Healthcare PPO Network Management. Its primary akta.pro industry code is HLAEANAB, Regional & Local PPO Networks, with a secondary code of HLAEANAC, Multi-Specialty PPO Provider Networks. Its NAICS code is 524292 and its SIC code is 6324.