TPA program work

Definition

Jobs routed through an insurer's program, trading volume for compliance and squeezed pricing.

Why It Matters

It is a referral pipeline and a concentration risk in the same contract. Program work fills the schedule at a lower margin and on the payer's terms, so a firm leaning on one program lives or dies by that program's next rule change or scorecard. Ask what share of revenue comes through each, how long the relationship has run, and what the compliance burden costs in admin time. A shop with its own local demand is worth more than one renting somebody else's.