Expand specialty and surgical access for your members — without adding administrative friction or variable cost.
Longitude partners with Medicaid managed care organizations to extend a curated specialty, surgical, and outpatient network for their enrolled members. The partnership is structured as a cost-stable supplement to the MCO's existing network — a predictable per-member-per-month (PMPM) rate, no additional authorization burden, and no transactional barriers for the member at the point of care.
Specialty access is often the hardest part of the member experience to control.
For Medicaid MCOs, network adequacy requirements can be met on paper while the member experience of reaching a specialist remains difficult — long waits, limited appointment availability, and a retention challenge that plays out in ED utilization, disengagement, and reputational strain. The MCO carries the cost of that friction without carrying the ability to resolve it at the provider-network level alone.
Network Adequacy on Paper
Meeting adequacy standards and delivering consistent specialty access are not the same thing. Many MCOs have adequate directories that don't translate to timely appointments for members who need them.
ED as the Default
When specialty access is delayed or unavailable, the emergency department becomes the de facto specialist — driving up cost, disrupting member care continuity, and generating utilization that the MCO absorbs.
Transactional Friction
Prior authorization volume, specialty claim adjudication, and member navigation complaints are an administrative tax that grows with the number of transactional handoffs between the member, the MCO, and the specialist.
A specialty-access layer that fits inside your existing structure.
Longitude integrates as a specialty-access layer alongside the MCO's existing network. Members maintain their MCO coverage for primary care, prescriptions, inpatient care, and services outside Longitude's covered set. Covered specialty and surgical services route through Longitude under a PMPM arrangement — no claims, no authorizations, no additional paperwork flowing back into the MCO's operations.
- Faster access — routine specialty, surgical, and other outpatient appointments within a defined commitment window
- No pre-authorization for covered services
- A dedicated Patient Advocate who coordinates specialty visits, procedures, and follow-up
- No out-of-pocket cost at the point of care for covered services
- A single relationship for specialty care instead of a directory search
- A cost-stable specialty-care arrangement that replaces variable claim cost with a predictable PMPM rate
- Measurable improvement in member access on the specialty-care metrics MCOs are already reporting
- Reduced transactional volume on authorizations and specialty claims within the covered set
- A structured reporting cadence — utilization, access, and outcomes — that feeds directly into MCO performance reviews and state reporting
- No reconfiguration of existing primary-care or pharmacy operations
Cost neutral isn't an aspiration. It's how the model is designed.
Longitude's PMPM rate for covered specialty services is structured to offset the downstream costs that poor specialty access creates — primarily avoidable ER utilization, preventable inpatient admissions, and the compounding expense of deferred surgical conditions.
You're already paying for specialty care. Longitude changes how — and what you get for it.
Medicaid managed care organizations operating under capitation bear the full cost of deferred specialty access: in ER utilization, in preventable hospitalizations, in HEDIS gaps, and in member churn tied to poor care experience. Longitude doesn't ask you to spend more — it asks you to spend differently, in a model where the incentives actually align with your outcomes goals.
Network Adequacy
Longitude's contracted network of specialists, surgeons, and outpatient facilities provides documented, relationship-based access that, combined with ongoing network development, satisfies network adequacy standards for the most common specialty categories — an increasingly scrutinized compliance area for Medicaid MCOs.
Quality Measure Alignment
Timely specialty follow-up, post-discharge outpatient visits, and appropriate surgical management of chronic conditions are directly tied to HEDIS measures and state quality incentive programs. Longitude creates the access infrastructure that supports improvement in these metrics.
Administrative Simplification
Prior authorization management, specialty claim adjudication, and member complaint resolution for specialty access issues represent a meaningful administrative cost for MCOs. Longitude eliminates or substantially reduces each of these for covered services.
Value-Based Care Compatibility
As state Medicaid agencies move managed care contracts toward value-based arrangements, the ability to demonstrate structured, accountable specialty care relationships becomes a competitive differentiator. Longitude provides that infrastructure without requiring a full ACO or integrated delivery system.
Built for MCOs where specialty access is an active conversation.
Longitude is built for Medicaid MCOs serving populations where specialty access has become a measurable pain point — whether through member complaints, network-adequacy pressure, or the downstream cost of unmet specialty need. If specialty cost and access are active conversations inside your plan today, this is a partnership worth scoping.
Surgical Specialties
Orthopedic surgery, general surgery, ENT, and urology — conditions that, when deferred, generate the highest downstream cost for Medicaid plans.
Outpatient Specialty Visits
Consultant visits, diagnostic evaluation, and ongoing management across all contracted specialty categories — accessible without the referral barriers that characterize most Medicaid specialty networks.
Outpatient Imaging & Laboratory
Contracted outpatient imaging and diagnostic lab services associated with covered specialty care — bundled into the PMPM, not billed as separate episodes.
Outpatient Physical Therapy
PT associated with surgical recovery and musculoskeletal conditions — reducing readmission risk and supporting functional recovery after covered procedures.
Breast Health Services
Screening, diagnostic, and surgical consultation — an area where access delays result in disproportionately late-stage diagnoses and higher total cost of care.
Care Coordination
Patient Advocates bridge the gap between the member's primary care provider, Longitude's specialist network, and the MCO's care management team — reducing the coordination failures that drive avoidable utilization.
Let's talk about what better specialty access would mean for your members.
Whether you're a Medicaid MCO evaluating specialty cost management strategies or exploring ways to improve member access, we're happy to walk through the model in detail.