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Sevenya Healthcare
Provider-side advisory · East Coast to the Pacific

The payer has done this a thousand times. Your team has done it twice.

We’ve sat on the health plan side of that table. Now we sit on yours — and we stay long after the deal is signed.

Sevenya negotiates on behalf of provider organizations — hospitals, ACOs, physician groups, and health systems — then builds the operating structure that makes the contract actually perform.

What you learn on the fourth build

Everyone can name the destination. The value is in the grind between here and there — and in knowing which problems are coming before they arrive.

Success resets the benchmark against you
Perform well and your next-period target is rebased on the savings you just delivered. Model year three before you sign year one.
You will be measured on patients you have never seen
Attribution logic decides who counts as yours. Most organizations read it after the first settlement, not before.
The gain-share has to survive your own CFO
Shared savings that quietly cannibalize inpatient revenue do not hold. If the math is not honest internally, the model breaks in year two.
Care management capacity is the real constraint
Not the contract, not the technology. Staffing ratios and caseload math determine whether any of it works.
Start where you sit

Different doors, one conversation.

Hospitals & health systems

Your commercial rates are flat, a dominant payer is dictating terms, and the board wants a value story that does not just shift revenue out of the hospital.

Where we start

Physician groups & CINs

You are being asked to take risk without the data, the care management staffing, or the governance to carry it — and the gain-share math has never been explained to your members.

Where we start

Investors & portfolio companies

You are underwriting a provider asset or a risk-bearing platform and need someone who can tell you whether the value-based thesis survives contact with the actual contracts.

Where we start

Consultants & referral partners

You have a client who needs provider-side contracting or network work that sits outside your lane. We take the piece, credit the relationship, and hand it back.

How we partner
In our words

Why we started Sevenya.

Sometimes it is easier to hear it than to read it.

What we believe

Fee for service is ending. Most transition plans are still a slide deck.

Commercial and governmental payers have been remarkably clear. The organizations that struggle are rarely the ones that misread the direction — they are the ones that signed a risk arrangement before they had the people, data, and governance to carry it.

That gap is the whole reason we exist. Decades of experience from the payer side of the table, now working for you — through negotiation and past it.

What we are

Operators who have run the network, signed the contract, and answered to the board for the result.

What we are not

A benchmarking deck, a staffing agency, or a firm that will tell you risk is easy.

How we work

Small senior teams. No junior bench billed at partner rates. We stay through implementation.

Who we represent

Providers and the employers who buy from them — and occasionally a payer serious about working better with providers.

Recently published
Policy & signals

What we are reading, and what we make of it.

All policy analysis
Policy analysisJune 2026 · 10 min

Coverage is shrinking, cost-sharing is rising, and primary care use is falling

What a decade of employer-coverage data means for value-based networks — and the case for a first-dollar primary care layer underneath the deductible.

From the piece

Higher deductibles are a headwind to timely primary care. They shift care to higher-cost modalities and reduce the possibility of primary care winning in value-based contracts.

Read the analysis
The Sevenya Ten · this week
UnitedHealthcare drops prior authorization on 1,700 codes
Sevenya’s take: Read the Medicare Advantage line twice, then put the same list in front of every other payer you contract with. That is a negotiation worth running now, while the pressure is still fresh.
The uninsured are back in the data
Sevenya’s take: Bad debt is a 2027 budget line now, not a 2027 surprise, and it belongs in this year’s planning rather than next year’s variance report.
Carriers are leaving whole markets
Sevenya’s take: When a carrier exits a market, every provider contract underneath it goes back to the table at once — on the state’s timeline, not yours.