Healthpact

What Healthpact does

HealthPact is a privately held, California-based healthcare professional services firm that specializes in Medi-Cal Managed Care enablement. The company partners with physician entrepreneurs, physician practices, community-based organizations, and larger healthcare entities to deliver revenue cycle management, consulting, physician practice transformation, direct payment program advisory, and HEDIS-aligned data management services. Its core competency is regulatory navigation of California-specific Medi-Cal programs — including DHCS, CMS, CalAim, Hospital Direct Payment Programs, P4P, ECM, and EPT — combined with supplemental funding capture; the firm claims its clients have drawn down more than $1 billion in supplemental funding over a ten-year period, with reported client outcomes of a 40% revenue lift, 38% improvement in quality measures, and a 52% increase in supplemental payments.

The service portfolio is built around data-driven strategies rather than proprietary software platforms; HealthPact does not offer a product application, public API, or documented integration ecosystem, and its technology footprint is best characterized as conventional healthcare analytics and RCM tooling. The business model is professional services and managed services, with custom quote-based pricing on multi-year contracts. Go-to-market is entirely direct — phone (800-408-8232), email ([email protected]), and the healthpact.com website — with no channel partners, no public customer logos, and no disclosed headcount or revenue. Geographic scope is restricted to California and the broader US Medi-Cal managed care ecosystem.

The company is privately held with no disclosed ownership, investors, or management team. No funding rounds, acquisitions, partnerships, or leadership changes are on record. Operating signals are limited to an active 2024-copyright website and a consistent service narrative, leaving growth, scale, and momentum largely unverified.

Name

Healthpact

Legal name

HealthPact

Website

https://healthpact.com

Company type

Private

Founded year

2020

Operating status

Operating

Headcount range

1–10 employees

Short description

HealthPact is a privately held California healthcare consulting firm that provides revenue cycle management, physician practice transformation, direct payment program advisory, and HEDIS-aligned data management to Medi-Cal providers.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management

NAICS

Health Care and Social Assistance (62)

SIC

Services-Health Services (8000)

akta.pro primary industry

Medical Billing, Coding & Revenue Cycle (EDAOAJAE)

akta.pro secondary industry

Healthcare-Linked Social Benefits Administration (e.g., Medicaid/Means-Tested Health Coverage) (BPAIAKAH)

Keywords

• Revenue cycle management
• Medical billing services
• Medi-Cal consulting
• Healthcare data management
• Physician practice consulting

Headquarters

HQ city

Redlands

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

Revenue model

1. Medical Billing and Revenue Cycle Management Services: Comprehensive revenue cycle service for healthcare offices and systems, leveraging technology to ensure maximum reimbursement. Revenue generated through professional service fees for billing, claims processing, and revenue optimization.
2. Healthcare Consulting Services: Specialized consulting for startups, CBOs, vendors, and value-driven enterprises in the Medi-Cal sector, supporting state initiatives and enabling organizations to assess service quality and track contributions to payments and programs.
3. Data Management Solutions: Comprehensive data solutions for HEDIS-based programs, DHCS, and CMS initiatives with compliance guidance and advanced analytics for program effectiveness.
4. Direct Payment Program Consulting: Consulting services for hospital and healthcare organization direct payment programs including process refinement, population health management, patient roster organization, and eligibility oversight.
5. Physician Practice Transformation: Data-driven practice transformation services including process refinement, population health management, and revenue enhancement initiatives, with focus on addressing staff burnout.

Pricing tiers

Go-to-market motion2 records

Distribution channels1 record

Marketing channels3 records

Core offering

HealthPact provides healthcare administrative and consulting services with a specialization in the Medi-Cal Managed Care sector. The company delivers medical billing and revenue cycle management, physician practice transformation, direct payment program consulting, and data management for HEDIS-based programs. It serves physician practices, healthcare organizations, and community-based organizations (CBOs) operating within California's Medi-Cal ecosystem.

Product overview

HealthPact offers a suite of healthcare administrative and consulting services focused on Medi-Cal Managed Care. The portfolio consists of five core service offerings: Consulting for startups and value-driven enterprises in the Medi-Cal sector; Medical Billing and Revenue Cycle Management leveraging cutting-edge technology for swift and efficient reimbursement solutions; Physician Practice Transformation using data-driven strategies for process refinement and revenue enhancement; Direct Payment Program Consulting for data-driven process improvement and population health management; and Data Management for HEDIS-based programs with DHCS and CMS compliance requirements. These services work together to help healthcare organizations optimize revenue, enhance quality measures, and manage supplemental payments while reducing administrative burden.

Differentiator

Problem solved

Functional benefit

Products and services

• Consulting Strategic consulting services for healthcare organizations, physician practices, and community-based organizations operating within Medi-Cal Managed Care, leveraging over 50 years of combined experience and direct involvement in shaping 1115 waiver programs.
• Medical Billing and Revenue Cycle Management End-to-end medical billing and revenue cycle management services for physician practices and healthcare organizations operating in the Medi-Cal Managed Care environment.
• Physician Practice Transformation Transformation advisory for physician practices seeking to redesign operations, care models, and clinical workflows to align with Medi-Cal Managed Care program requirements.
• Direct Payment Program Consulting Consulting focused on direct payment program participation, enabling healthcare providers and physician entrepreneurs to navigate and optimize direct payment arrangements within Medi-Cal.
• Data Management Data management services supporting HEDIS-based programs, population health analytics, and reporting for healthcare organizations participating in Medi-Cal Managed Care.

Quantifiable outcome

• 40% increase in revenue for clients
• +3 more outcomes

Segments4 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Scale indicators6 records

Recent moves3 records

Expansion highlights4 records

Direct peers

• Conifer Health Solutions: Conifer Health Solutions provides end-to-end revenue cycle management, value-based care, and population health services to hospitals and health systems. It is a direct peer to HealthPact's RCM and practice transformation offerings, though Conifer operates nationally rather than focusing solely on California Medi-Cal.
• The Chartis Group: The Chartis Group is a healthcare advisory firm providing strategy, operations, and technology consulting to hospitals, health systems, and payers. It is a direct peer in healthcare consulting, though Chartis operates nationally and serves commercial as well as Medicaid segments.
• nThrive (now FinThrive): FinThrive (formerly nThrive) is a healthcare revenue cycle management and analytics vendor serving hospitals and health systems with end-to-end RCM technology and services. It directly overlaps with HealthPact's medical billing and RCM stream and competes for the same hospital customers.
• Sellers Dorsey: Sellers Dorsey is a healthcare consulting firm focused on Medicaid policy, financing, and revenue optimization for safety-net providers and state agencies. It is a close direct peer to HealthPact given its similar focus on Medicaid supplemental payment programs and disproportionate-share hospital strategy.
• ECG Management Consultants: ECG Management Consultants is a healthcare consulting firm specializing in strategy, operations, and revenue cycle for hospitals, physician practices, and academic medical centers. It is a direct peer to HealthPact's physician practice transformation and revenue cycle consulting practices.
• Health Management Associates (HMA): Health Management Associates is a healthcare research and consulting firm specializing in Medicaid, health policy, and publicly financed healthcare programs for states, providers, and plans. It is a direct peer to HealthPact's Medi-Cal consulting and data management offerings, with broader geographic reach across multiple state Medicaid programs.

Emerging players

• Waystar: Waystar is a healthcare technology platform providing cloud-based revenue cycle, claims management, and patient payment solutions. It is an emerging player that competes at the technology layer for the RCM and medical billing workflows HealthPact supports, though Waystar does not replicate HealthPact's Medi-Cal policy advisory work.

Broad incumbents

• R1 RCM: R1 RCM is one of the largest US revenue cycle management companies, providing technology-driven RCM services to large hospital systems. It is a broader incumbent competitor to HealthPact's RCM and physician practice services, with national scale that HealthPact lacks.
• Premier Inc: Premier Inc is a healthcare improvement and consulting company serving hospitals, health systems, and provider organizations with data, analytics, and performance services. It is a broad incumbent that competes for the same provider customers HealthPact targets, particularly on quality improvement and population health initiatives.
• Optum (UnitedHealth Group): Optum is the largest healthcare services and technology platform in the US, with extensive RCM, consulting, and population health offerings. It is a broad incumbent that competes with HealthPact's services portfolio across nearly every line of business, including government/Medicaid programs.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights6 records

Customer concentration

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 Healthpact