A Payor is an organization that pays for healthcare services. This can include health insurance companies and government healthcare programs.
An MCO (Managed Care Organization) is an organization that helps manage healthcare for a group of members. It can manage things like which doctors members can use, what services are covered, and how healthcare is paid for.
What datado we have?
Intent.Health provides data across several categories to help you find, understand, and research Payors and MCOs in the U.S.
The Organizational Profile helps you find and narrow down Payors and MCOs based on basic information about the organization and where it is located.
You can search and filter organizations using:
Payor Name
Search for a specific Payor or MCO by name.
Web Address
Find an organization using its website.
State
Filter organizations by U.S. state.
City
Find organizations located in a specific city.
ZIP Code
Search using a specific ZIP code.
Radius (Miles)
Find organizations within a certain distance of a ZIP code.
Number of Employees
Filter organizations based on their employee count.
Organizational Profile tells you who the organization is and where it is located.
Once you open an individual organization, you can see more details about that organization, including:
Basic Organization Information
Each organization profile includes basic information such as:
Industry
The industry the organization belongs to.
Group Employees
The total number of employees in the organization or group.
Phone
The organization's main phone number.
Customer Service
The phone number used for customer support.
Country
The country where the organization is located.
Payer ZIP Code
The ZIP code associated with the Payor.
Address
The organization's physical address.
Primary Location
The organization's main location.
CMS Facility ID
The identification number associated with the organization or facility in CMS data.
NPI
The National Provider Identifier associated with the organization.
Website
The organization's website.
LinkedIn, Facebook, and X (Twitter)
Links to the organization's social media profiles.
You can also use our Look Alike feature to find similar organizations.
Plan Type
See the types of health plans the organization offers, such as HMO, PPO, EPO, and POS.
This helps you understand how the organization's health plans work and what kind of plans it provides.
Metal Level
See the health plan levels offered by the organization, such as Bronze, Silver, Gold, and Platinum.
These levels show how healthcare costs are generally split between the health plan and the member.
State, County & Plan ID
The organization profile also shows the state and county where its plans are offered and allows you to search for a specific plan using its Plan ID.
State
The U.S. state where the plan is offered.
County
The county where the plan is offered.
Plan ID
The unique ID used to identify a specific health plan.
Intent Keywords (What the Organization Is Researching)
See the topics, products, and solutions the organization has been researching or showing interest in.
For example, an organization may be showing interest in a certain healthcare technology, service, or solution. This can help you understand what the organization may be looking for right now.
These topics are based on signals from the organization's online activity. Showing interest does not always mean the organization is ready to buy, but it can give you a better idea of what they are currently focused on.
Technology Stack
See the technologies, software, and digital tools the organization uses.
This helps you understand what technology is already part of the organization's setup.
You can also use Look Alike to find other organizations that use similar technologies.
Executive Departments
See the organization's executive departments and the number of executives in each department.
For example, you can see how many executives the organization has across Information Technology, Operations, Finance, Sales, Marketing, Human Resources, Legal, Medical & Health, and other departments.
Click on a department to see the executives within that department. You can then open an individual executive to view the available information and data about that person.
The information available at the executive level can include different types of professional and organizational data and is explained in detail on our Executive Details page.
AI Assistant Ishi
Each organization also has an AI-powered assistant that gives you a quick summary of the organization and helps you explore its data.
You can ask it questions about the organization in a chat format, and get answers based on the information available in Intent.Health
Financial Overview
The Financial Overview section gives you a quick view of the Payor/MCO's financial information.
You can see:
Group Revenue
The total revenue reported for the organization or group.
Total Funding
The total amount of funding the organization has received.
Latest Funding Received
The type of funding or financial transaction from the organization's most recent funding activity, such as Series B or Merger / Acquisition.
Latest Funding Amount
The amount of money received in the organization's most recent funding activity.
Last Raised
The date when the organization most recently raised funding.
You can also use the Look Alike feature to find other organizations with a similar financial profile.
Events
The Events section within each organization profile provides an overview of the organization's healthcare event participation, including past and upcoming events.
Past Events
View healthcare events the organization has attended in the past.
Upcoming Events
View healthcare events the organization is going to attend in the future.
2
Financials
The Financials section helps you find Payors and MCOs based on their financial information.
You can filter organizations by:
Annual Revenue ($)
Find organizations based on the amount of money they make each year.
Total Funding Received ($)
Find organizations based on the total amount of funding they have received.
Latest Funding Received ($)
Find organizations that have received funding recently.
Latest Funding Amount ($)
Filter by the amount of money received in the organization's most recent funding round.
For each financial field, you can enter a minimum and maximum value to narrow your
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Identifiers
The Identifiers section helps you find Payors and MCOs using their unique identification numbers.
You can search by:
IH Payer ID
Intent.Health’s unique ID for each Payor. This is an internal identifier used by Intent.Health to identify the organization.
Plan ID (Standard Component)
The standard Plan ID assigned by CMS (Centers for Medicare & Medicaid Services) to identify a specific health plan.
4
Benefits & Coverage
The Benefits & Coverage section helps you find Payors and MCOs based on how much of a plan's premium is spent on Essential Health Benefits (EHB).
You can filter by:
EHB % of Total Premium
Find organizations based on the percentage of the total premium that goes toward Essential Health Benefits.
82%
5
Premiums
The Premiums section helps you find Payors and MCOs based on the premium charged for their health plans.
You can filter by:
Premium Category
Choose the type of member or household the premium applies to, such as children, adults, or couples at different age levels.
Premium Range ($)
Find organizations based on the price of the premium, using a minimum and maximum amount.
$300
$850
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Event Intelligence
The Event Intelligence section helps you find Payors and MCOs based on their participation in business events and whether they have earnings information available.
You can filter by:
7
Plan Attributes
The Plan Attributes section helps you find Payors and MCOs based on the details and features of the health plans they offer.
You can filter by:
Metal Level
Find plans by their ACA Marketplace level, such as Bronze, Silver, Gold, Platinum, Catastrophic, and Expanded Bronze.
Plan Type
Find plans based on their network structure, such as EPO, HMO, POS, and PPO.
Rating Area
Find plans in a specific geographic area used to determine how the plan is priced.
Child-Only Offering
Find plans that are offered specifically as child-only policies.
Adult Dental Coverage
Find plans that include dental coverage for adults.
Child Dental Coverage
Find plans that include dental coverage for children.
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Deductibles & Out‑of‑Pocket
The Deductibles & Out-of-Pocket section helps you find Payors and MCOs based on how much members may have to pay for healthcare before and after their plan starts paying.
You can filter by:
CSR Tier
Find plans based on their Cost-Sharing Reduction (CSR) tier, which affects the deductibles and other costs members pay.
Individual
Family
Family/Person
Medical Deductible
Drug Deductible
Medical Max OOP
Drug Max OOP
For each amount, you can enter a minimum and maximum value to narrow your search.
Questions teams ask
Payor & MCO data FAQs
What is the difference between a Payor and an MCO?
A Payor is any organization that pays for healthcare services, including commercial health insurers and government programs such as Medicare and Medicaid. An MCO (Managed Care Organization) is a type of payor-side organization that also manages how members receive care, for example through provider networks, covered services and payment arrangements. Many MCOs administer plans on behalf of government programs, so the two terms often overlap.
What Payor and MCO information can I research in Intent.Health?
Each organization profile brings together basic organization information, plan types, metal levels, the states and counties where plans are offered, Plan IDs, intent keywords, technology stack, executive departments, financial overview and the Ishi AI assistant. You can also filter Payors and MCOs by financials, identifiers, benefits and coverage, premiums, event intelligence, plan attributes, and deductibles and out-of-pocket costs.
What is the difference between HMO, PPO, EPO and POS plans?
They describe how a plan's provider network works. HMOs usually require members to use in-network providers and choose a primary care physician who coordinates referrals. PPOs allow out-of-network care at a higher cost. EPOs cover in-network care only, usually without referrals. POS plans combine features of HMOs and PPOs. A Payor's mix of plan types helps you understand how its plans are structured.
What do Bronze, Silver, Gold and Platinum metal levels mean?
Metal levels show how costs are generally split between the plan and the member. On average, Bronze plans cover about 60% of costs, Silver about 70%, Gold about 80% and Platinum about 90%. Catastrophic plans are available to certain enrollees, such as people under 30, and Expanded Bronze plans meet specific coverage requirements while staying within the Bronze level.
What is the difference between the IH Payer ID and the Plan ID?
The IH Payer ID is Intent.Health's internal identifier for each Payor. The Plan ID (Standard Component) is the standard identifier assigned through CMS to a specific health plan. It includes the issuer's ID and the state, so it is useful when you need to find one exact plan rather than an organization.
What is a CSR tier?
Cost-Sharing Reductions (CSRs) lower deductibles, copayments and out-of-pocket maximums for eligible enrollees in Silver plans. Each CSR tier is a variation of a plan with a different level of cost sharing. Filtering by CSR tier helps you compare plans according to what members may pay.
What does EHB % of Total Premium tell me?
Essential Health Benefits (EHB) are the categories of care that marketplace plans must cover, such as hospitalization, prescription drugs and preventive services. The EHB % shows how much of a plan's premium goes toward those benefits. The remainder covers benefits outside the EHB categories.
How is a deductible different from the maximum out-of-pocket?
A deductible is the amount a member pays before the plan starts sharing costs. The maximum out-of-pocket (Max OOP) is the most a member pays in a plan year for covered care, after which the plan pays 100% of covered costs. Intent.Health lets you filter both for medical and drug coverage at the individual, family and family-per-person levels.
Who should I engage when selling to a health plan?
That depends on the offering. Decisions at a health plan can involve clinical, operations, IT, finance, network and member experience leaders, and many evaluations include several of them. Executive Departments help you see how many executives the organization has in each function, so you can investigate which roles are relevant. A department or title alone does not establish purchasing authority.
Do intent keywords or event participation mean a Payor is ready to buy?
No. Intent keywords and event activity can show what an organization is researching or focused on, which is a useful reason to investigate. They do not independently confirm an active purchase, an approved budget or a buying timeline. Validate those through conversations with the organization.
Are the product screens on this page live data?
No. The product screens use recreated, masked examples to show how the Payor and MCO profiles are structured. Field availability varies by organization, plan and source, so review sample organizations from your market in a demo.
About Intent.Health
Intent.Health helps healthcare businesses research and engage the U.S. healthcare market. It connects 30 organization intelligence modules, including Payors and MCOs, with Executive Intelligence, HCP Intelligence, Decision Network, intent signals, propensity analysis and Ishi contextual AI.
Editorial note: Product screens on this page are recreated, masked examples, not live records. Plan, cost-sharing and coverage definitions are general explanations; plan rules vary by state, year and program. Field availability varies by organization and source.
