TurningPoint Healthcare Solutions is a specialty condition management company serving more than 45 million covered lives nationwide across commercial, Medicare, and Medicaid populations. Founded in 2014, we partner with health plans to improve the safety, quality, and affordability of care in high-cost, high-variation surgical categories — including musculoskeletal, cardiology, spine, pain management, sleep, and ENT.
Our model is physician-led and subspecialty-matched. Rather than relying on automated denials or generic clinical criteria, TurningPoint applies fellowship-trained subspecialist review to high-complexity cases — the ones where variation is greatest and the cost of getting it wrong is highest. AI-driven decision support surfaces data and flags gaps; board-certified physicians make the determinations.
The result is a program that reduces low-value care, lowers surgical complication and revision rates, and consistently delivers 15–30% reductions in claims cost — without the provider friction that follows traditional UM approaches. We manage more than $4 billion in healthcare costs annually and maintain a 100% client retention rate, and offer guaranteed savings and full condition-level risk across all specialties.
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