Projects &
small tools.
CMS Research
Built from CMS's own public files.
Medicare payer research
Which company is the biggest Medicare payer? It depends entirely on whether you mean health plans or drug plans. Built from CMS's monthly files.
Read the numbers →Medicaid payer research
Nearly seventy million people get Medicaid through a private health plan, and the same four Medicare payers run almost a third of it. Eight years of state-by-state books, swollen by the pandemic, cut back by the unwinding. Built from CMS's annual files.
Open the report →Dual-eligible research
Six and a half million people get their Medicare through a plan built for people who also have Medicaid. Who sells it, whose Medicare book leans on it, and how deep the integration runs. Built from CMS's monthly files.
Follow the seam →Interactive Guides
How the money works. No companies, just the mechanics.
How MA plans get paid
The benchmark, the star bonus, the bid, the rebate: an interactive walk through the machine that pays Medicare Advantage plans, running on CMS's real 2026 county ratebook. No companies, just the mechanics.
Follow the dollars →What a star rating does
Four stars is not a vibe. It is a half-star score that trips three separate payment gates, gets paid a year late, and tells two different stories depending on whether you average by contract or by member. No companies, just the rating.
Work the dial →How a risk score is built
The average Medicare member scores exactly 1.0, and every dollar in the machine is multiplied by that score. Assemble a member, watch diagnoses become payment categories through hierarchies and interactions, and follow the score into real county dollars. Runs CMS's actual model, verified against CMS's own engine.
Build the member →Whose patient is this?
Every value-based contract starts by deciding which patients count, and different contracts count differently. One synthetic clinic, three attribution rules side by side, including the real Medicare Shared Savings Program assignment methodology: the plurality math, the tiebreakers, the quarterly churn. No companies, no real patients, just the rules.
Run the roster →