Expert guidance for payors, providers, and health systems.
Three practice areas, one team: actuarial & risk adjustment, quality program design, and modern healthcare data architecture. We work with the leaders who actually have to ship the results.
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Risk & Actuarial
For Medicare Advantage organizations, ACOs, and integrated delivery systems where every basis point of risk score moves real revenue and real care.
- Medicare Advantage risk adjustment, HCC coding accuracy, and RAF optimization
- RADV audit preparation and defense workflows
- Risk score trending, forecasting, and prospective targeting
- Concurrent and retrospective coding program design
- Risk-share contract modeling for delegated provider arrangements
Engagement signals
You're spinning up a new MA contract. Your RAF score isn't where the actuaries said it would be. You just got a RADV notice. You're standing up an in-house coding capability. You need a second opinion before next year's bid.
Engagement signals
Your Stars rating just dropped a half-cut. HEDIS gap closure is stuck below where it needs to be. You're moving into a value-based contract and need the analytics to actually report on it. CAHPS results don't match what your member-experience team thinks is happening.
Quality Measures
HEDIS, Stars, CAHPS, and value-based contract design — built around the measures that move outcomes and reimbursement.
- HEDIS, Stars, and CAHPS program design and gap closure
- Quality measure spec engineering on claims, clinical, and SDOH data
- Value-based contract analysis and shared-savings modeling
- Provider engagement and gap-closure intervention design
- Member outreach and care coordination workflows
Technology & Data Architecture
The data foundation that risk and quality programs sit on top of. We build the pipelines, lakehouses, and integrations that turn raw claims, clinical, and pharmacy data into something teams can actually use.
- Data platform strategy: Databricks, Snowflake, dbt
- Claims and clinical data pipeline design and implementation
- EHR integration, FHIR, and interoperability
- Master patient and provider index design
- HIPAA-aligned access control and audit architecture
Engagement signals
You're migrating off a legacy data warehouse. Your analytics team is drowning in one-off pipelines. You need to integrate a new EHR or registry feed. You're thinking about a Databricks or Snowflake adoption and want a second opinion. You need a platform that risk and quality teams can both build on.
Engagement models
Three ways to work with us, depending on what you need.
Ongoing advisory
A fractional senior team-member relationship. Standing weekly cadence, async support, and on-call expertise for your risk, quality, or data leaders. Ideal for organizations that need senior judgment without a full-time hire.
Defined scope
Fixed-scope engagements ranging from a four-week readiness assessment to a multi-quarter platform build. Clear deliverables, agreed timeline, agreed price.
Strategic counsel
Board, investor, or executive-level advisory engagements: due diligence, strategy reviews, second-opinion reads on a vendor or platform decision, M&A integration planning.
Tell us what you're working on.
We'll be in touch within one business day. For Formulary Scanner pricing & subscriptions, see the product page.