Let us be your constant in the ever-changing world of healthcare.

ABOUT US

BluePeak Advisors, a division of Gallagher Benefit Services, is a national leader in healthcare compliance and operational consulting. Since 2010, we’ve helped health plans, PBMs, Employer Group Waiver Plans (EGWPs), PACE organizations, allied health companies, and health systems/providers navigate the complexities of Medicare Parts C and D, Medicaid, and Commercial programs. Our team includes former CMS regulators, experienced clinicians, and managed care professionals who deliver practical, audit-ready solutions in compliance, operations, STAR ratings, fraud prevention, and data analytics.

We also partner with health systems and provider organizations to strengthen compliance programs, optimize operational workflows, and align with regulatory and contractual requirements. From strategic guidance to hands-on support, we ensure our clients meet regulatory demands, mitigate risk, and achieve operational excellence across the care continuum.

Knowledge. Experience. Trust. That’s the BluePeak promise.

Core Capabilities at a Glance

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Health Plan Compliance & Audit Support

We provide end-to-end support for federal and state audits.

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Operational Strategy & Optimization

We help clients build and refine compliant, efficient operations across all lines of business.

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Interim Staffing, Training & Regulatory Guidance

We offer flexible staffing and training solutions to fill gaps and build internal capacity.

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Performance Improvement & Analytics

We use proprietary tools and data-driven strategies to improve outcomes.

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Client Favorites

Audit Preparation and Onsite CMS and State Audit Support

During an actual CMS audit, BluePeak can assist with universe review and preparation, document and impact report preparations, coaching of staff and questions to ask or not ask CMS. We can be available onsite to support your teams. After the audit, BluePeak can assist with strategies for corrective actions, CAP writing and review, and perform actual remediation work if needed.


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Medicare Bid Development and PBP Review

It’s important that the Plan Benefit Package (PBP) you submit accurately reflects the intended benefit design described and supported by the bid pricing tool. BluePeak has experienced reviewers who have a strong understanding of the bid data entry process and can review the PBP for accuracy, implementation, and compliance.


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Plan Performance in Quality (Stars/HEDIS/Gaps in Care)

NCQA updates protocols annually in accordance with changes from CMS. Now CMS requires a plan receive a 50% or greater score in each element, regardless of passing in the overall score. BluePeak can help you review your MOC and make recommendations and edits to meet all requirements and do a preliminary scoring before submission to NCQA.


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NQTL Reviews (Parity)

BluePeak provides Non-Quantitative Treatment Limitation (NQTL) parity reviews to ensure your organization’s mental health and substance use disorder benefits comply with federal parity requirements and CMS standards.


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What Clients Are Saying…

"...The collaboration was great with this team along with the auditors' steadfast commitments and the results yielded here. We truly appreciate the support."

Product ManagerNational MAPD plan

"BluePeak asked all the right questions to help us effectively prepare for our CMS Program Audit tracer review sessions...Program Audit support prep was invaluable to helping us thoroughly prepare, present with confidence, and drive our positive outcome."

Medical Compliance OfficerFortune 500 Company

"At every point that I've connected with our presentation team, they have been effusive in their praise of the support and expertise that has been provided."

Director, Market OperationsMedicare Advantage Plan

How We Deliver Results

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How BluePeak Developed a High-Scoring Model of Care and a Framework Structure for an Overall Quality Program

How BluePeak Developed a High-Scoring Model of Care and a Framework Structure for an Overall Quality Program

BluePeak guided a Medicare-Medicaid Plan’s transition to a FIDE and CO D-SNP by developing two fully compliant Models of Care (MOCs), aligning operations, and building a framework for long-term performance. Both MOCs achieved near-perfect NCQA scores and secured three-year approvals.
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Puzzle Pieces
Neighborhood & BluePeak Successfully Executing a Competitive Medicare Bid

Neighborhood & BluePeak Successfully Executing a Competitive Medicare Bid

BluePeak guided Neighborhood Health Plan of Rhode Island through its transition from an MMP to a DSNP by providing end-to-end bid strategy, financial analysis, and compliance support. The result was a successful, on-time CY2026 bid submission with no CMS issues and a strong foundation for launch.
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Perfecting Compliance: How BluePeak Helped a Client Achieve a Flawless CMS Audit Score

Perfecting Compliance: How BluePeak Helped a Client Achieve a Flawless CMS Audit Score

BluePeak supported a long-term client through full CMS Program Audit readiness and execution, delivering strategic guidance, real-time support, and cross-functional alignment. The result was a flawless audit outcome with a 0.00 score and no corrective actions.
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Industry Insights

December 3, 2025 in Compliance & Regulatory Updates, Leadership & Organizational Insights, Winter 2025

Annual CPE Audit – Compliance as a Strategic Asset

Annual CPE audits are required by CMS, but their value goes beyond compliance. These audits assess the effectiveness of your compliance program, identify gaps, and prevent fraud, waste, and abuse.…
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December 3, 2025 in Leadership & Organizational Insights, Quality & Star Ratings, Winter 2025

Stars – Driving Growth, Revenue, and Reputation

Star Ratings are more than numbers—they determine your plan’s financial health, market position, and member loyalty. Every interaction matters, from member experience to clinical outcomes and pharmacy adherence. High ratings…
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December 3, 2025 in Medicare Advantage Operations, Member Experience / CAHPS, Winter 2025

Secret Shopping – See Your Plan Through the Member’s Eyes

Secret shopping is one of the most effective ways to understand how your plan performs in real-world scenarios. By posing as prospective members, these evaluations reveal whether your call center…
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