Idaho Physician Network

What Idaho Physician Network does

Idaho Physician Network, Inc. (IPN) is a regional provider network and healthcare administrative services company headquartered in Boise, Idaho, with a regional office in Idaho Falls. Founded in 1993 by Boise-area physicians and merged with Primary Health, Inc. in 1998, IPN operates the largest independent provider network in Idaho, contracting with more than 14,000 providers and serving more than 150,000 members across 30+ payor, third-party administrator (TPA), and employer relationships. The company's coverage spans all Idaho counties plus Baker and Malheur Counties in Oregon and Asotin County in Washington.

IPN's core offering is its contracted provider panel, delivered alongside technology-enabled administrative services: EDI Direct Connect and VyStream for claims repricing, an online provider directory, NCQA-aligned credentialing and recredentialing, and reporting/population health data feeds. The company holds NCQA Certification in Credentialing and Recredentialing (2014), NCQA Accreditation (2018), and was the first organization in Idaho to receive URAC Health Network Accreditation (2009), collectively positioning it to serve commercial, TPA, and government payor customers including PacificSource, Cigna, Health Net Federal Services, Moda Health, and CorVel.

IPN generates revenue through three primary streams: per-employee-per-month (PEPM) access fees paid by payors and TPAs, percent-of-savings (POS) fees on repriced claims (where network discounts generate savings versus billed charges), and credentialing services revenue. The company is 60% owned by PacificSource Health Plans (since 2009) and 40% by independent physician shareholders, with 11-50 employees supporting the regional operation.

Name

Idaho Physician Network

Legal name

IPN, Inc.

Website

https://ipnmd.com

Company type

Private

Founded year

1993

Operating status

Operating

Headcount range

11–50 employees

Short description

Idaho Physician Network operates the largest independent provider network in Idaho, contracting 14,000+ providers across all Idaho counties plus parts of Oregon and Washington to deliver network access, claims repricing, and credentialing services to 30+ payors, TPAs, and employers serving 150,000+ members.

Ownership category

akta.pro rank

Product category

Healthcare Provider Network Management

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Provider Network, Credentialing & Contracting Support (BPAAAFAI)

akta.pro secondary industries

Provider Directory & Network Identity (HPD, NPI, credential linking) (HLACABAF), Provider Credentialing, Licensing & Compliance Enablement (multi-state) (HLALAKAM)

Keywords

• Provider network management
• Claims repricing services
• Healthcare credentialing
• Provider directory services
• Medical network access

Headquarters

HQ city

Idaho Falls

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, Marketing or Sales, Others

Revenue model

1. Network Access Fees: IPN charges access fees to payors (insurance companies, TPAs, employers) for access to the provider network. Two fee structures are offered: Per Employee Per Month (PEPM) or Percent of Savings (POS). Fees are determined by factors such as number of employees and benefit differentials.
2. Credentialing Services: IPN credentialed providers undergo credentialing process for all IPN contracted payors through a single application, simplifying payor qualification for providers.

Pricing tiers

Go-to-market motion3 records

Distribution channels4 records

Marketing channels5 records

Core offering

Idaho Physician Network operates a statewide independent healthcare provider network connecting 14,000+ providers with 30+ payors across Idaho, Oregon (Baker and Malheur counties), and Washington (Asotin County). It delivers NCQA-certified credentialing, claims repricing via EDI Direct Connect and a VyStream-hosted online platform, and a weekly-updated online provider directory, monetized through access fees (PEPM or Percent of Savings) charged to contracted payors.

Product overview

Idaho Physician Network (IPN) is a healthcare provider network management platform offering a unified suite of services centered on its provider panel network. The core offering comprises the Provider Panel (statewide healthcare network), Claims Repricing (EDI-based repricing system), Provider Directory (weekly-updated searchable directory), and Credentialing Services (NCQA-certified provider credentialing). Additional offerings include Access Fees (PEPM/POS pricing structures) and Reporting Services (Geo Access, Disruption, Network Comparison, and Claim Repricing reports). The platform connects providers, payors, and patients through collaborative relationships for efficient and cost-effective healthcare delivery.

Differentiator

Problem solved

Functional benefit

Products and services

• Provider Panel Network Statewide healthcare provider network covering medical, behavioral health, and vision practice areas, with 14,000+ providers across all Idaho counties plus Baker and Malheur Counties in Oregon and Asotin County in Washington. Sold to payors and providers through managed care contracts.
• Claims Repricing

Named customers5 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

Feature3 records

Partnerships

Four partnerships are on record, tiered core and moderate.

• VyStreamcoreTechnology or IntegrationVyStream hosts IPN's claims repricing system, providing real-time online claims entry and repricing capabilities for contracted payors.
• Idaho Medical AssociationmoderateStrategic or Co-development PartnerIPN maintains strong working relationships with Idaho Medical Association for provider collaboration and educational opportunities.
• Idaho Medical Group Management Association (IMGMA)moderateStrategic or Co-development PartnerIPN maintains collaborative relationships with IMGMA for provider network support and educational conferences.
• EDI Direct Connect PartnersmoderateTechnology or IntegrationPayors can transmit batched claims in ANSI 837 format to secure FTP sites for automated 24-hour claims repricing processing.

Scale indicators5 records

Recent moves8 records

Expansion highlights2 records

Direct peers

• Evolent Health: Evolent Health partners with payors and providers to manage specialty and primary care networks, including network design, performance, and value-based contracts. Its network operating model and payor customer base closely resemble IPN's positioning.
• Privia Health: Privia Health builds and operates physician networks and medical group infrastructure for value-based care across multiple states. Its payor contracting, credentialing, and provider enablement platform parallels IPN's role as a network management intermediary between providers and payors.
• Astrana Health (formerly Apollo Medical Holdings): Astrana Health operates IPAs and provider networks under value-based and delegated arrangements with payors. Its model of managing contracted physician groups for multiple payors is similar in mechanism and customer profile to IPN's network management business.
• Zelis Healthcare: Zelis provides network management, claims cost management, and payment integrity solutions to health plans and TPAs. Its provider network access, repricing, and directory services closely mirror IPN's core product set, making it a strong functional peer.
• MultiPlan: MultiPlan operates one of the largest independent preferred provider organization (PPO) networks in the U.S., offering payors access to contracted providers, claims repricing, and network-based cost management — directly analogous to IPN's payor-facing provider network and repricing services.

Broad incumbents

• Tivity Health: Tivity Health operates provider networks and wellness programs for payors and employers, including network access and chronic care solutions. It is broader in scope than IPN but shares the core concept of monetizing curated provider networks via payor/employer contracts.
• PacificSource Health Plans: PacificSource is IPN's 60% parent and a regional health plan. As the dominant customer and strategic anchor, it shapes IPN's payor contracting model and network design priorities, making it the most directly comparable incumbent on the payor side.

Emerging players

• agilon health: agilon health partners with primary care physicians and payors to operate value-based care networks. While more focused on risk-bearing PCP enablement, its payor-facing network model and contracted-provider framework overlap meaningfully with IPN's offering.

Regional players

• Heritage Provider Network: Heritage Provider Network is a California-based MSO/IPA managing large regional provider networks under delegated payor contracts. It is structurally comparable to IPN as an independent, regionally anchored provider network serving multiple payors.
• Blue Cross of Idaho: Blue Cross of Idaho is the dominant regional health plan in IPN's home market. As a payor that operates its own network alongside contracted networks like IPN, it is a structural regional peer on the supply-side of network access services.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

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 Idaho Physician Network