For data and AI platform companies
Tune your platform to how health and human services actually runs.
Market penetration and product strategy for firms selling data and AI platforms to CMS, state Medicaid and HHS agencies, and the health plans that carry public risk. Our depth is payer-side — public and private — and as a contractor delivering for state and federal clients.
Product strategy
What these buyers are actually procuring right now.
Roadmaps go wrong when they aim at where the market was. Here is where the money is moving, and what a platform has to be able to say for itself to be in the conversation.
Interoperability has moved past compliance
Mandated APIs largely exist now. Procurement has shifted to whether the data coming through them is usable — quality, completeness, and operations at scale. "Do you support FHIR" is no longer a differentiating question, and answering it as though it were signals you arrived late.
Networks, not point-to-point integration
Solicitations increasingly assume national network participation rather than a catalog of custom interfaces. Buyers are favoring vendors who show up already connected, because every bespoke integration is a cost and a risk they have paid for before.
Administrative cost is the budget line
Plans and agencies are buying against auto-adjudication rates, pended claims volume, appeals backlogs, and payment integrity. AI is being procured for the work surrounding a determination, like triage, documentation, routing, and not for the determination itself, and proposals that blur that line draw scrutiny.
Eligibility modernization is the live market
States are actively buying renewals automation, notice generation, and integrated eligibility, and they are buying it in modules rather than as monolithic system replacements. The procurement path matters as much as the product: modular means smaller entry points and more room for a newer vendor.
Prior authorization is past the API
Compliance builds are underway or done. The differentiated spend has moved to reducing provider burden, focusing on clinical documentation, evidence gathering, and turnaround time. Selling the transaction layer now is selling into a solved problem.
AI terms are in solicitations now
Disclosure of model use, human oversight requirements, training data restrictions, and documentation obligations increasingly appear in the contract language itself, and in scored evaluation criteria. Readiness here is no longer a differentiator. Absence of it is a disqualifier.
Domain coverage
The program domains we work in
A platform is rarely a fit for all of these at once. Part of the work is deciding which one or two you build for, which you partner into, and which you leave alone.
Medicaid and CHIP
Eligibility and enrollment, managed care oversight, encounter data, waiver reporting, and system modernization under federal conditions and enhanced match.
Medicare
Coverage determinations, appeals, quality and risk programs, and the plan-side operations behind Advantage and Part D.
Health plan operations
Claims, provider data, appeals and grievances, member experience. The same problems commercially and in public programs, under different rules.
Behavioral health and SUD
Crisis systems, care coordination, and consent handling under 42 CFR Part 2 that most platforms get wrong on the first pass.
Aging and long-term services
Assessments, person-centered care plans, waiver services, and the provider networks that deliver them.
Child welfare and family services
CCWIS modernization, case practice support, and the data quality reviews that follow every build.
Public health
Surveillance, registries, and reporting pipelines that have to stay standing between emergencies, not just during them.
Economic assistance
SNAP, TANF, and integrated eligibility, where the hard part is program rules and policy logic, not the interface.
Housing and homelessness
Public housing and voucher operations, HMIS and Continuum of Care data, and the eligibility and compliance reporting that HUD funding carries. Its own buying world, and increasingly adjacent to health.
Our approach
Market Reality First. Pipeline Last.
The same discipline we bring to our non-profit clients: understand the operating reality before building the plan. We work in sequence, and we do not skip ahead to the pipeline.
1. Readiness & Market
An honest read on contract access, certifications, security posture, past performance, financial capacity, and capture resources — then the addressable market mapped by program domain, funding stream, and buying authority. Who holds budget, where it comes from, when it renews, and who can actually sign.
2. Platform & Packaging
The tuning work above, turned into roadmap decisions: what to build, what to integrate, what to sunset. Interoperability posture, integration architecture, and where your AI belongs in a regulated workflow — then packaging and pricing against budget cycles and vehicles rather than commercial SaaS norms.
3. Proof & Compliance
The evidence package that gets you through review: security and privacy posture, accessibility conformance, data governance and consent design, reference architecture, model documentation, and pilot designs that produce outcome data a payer or agency will accept.
4. Entry Path & Expansion
Where to lead, where to partner, where to defer. We compare priming at the agency, subcontracting or teaming with an incumbent integrator, and selling direct to plans — then sequence the recommendation into a roadmap with named targets, vehicles, and primes.
How to engage
Strategy
A readiness assessment, a comparison of entry paths, prioritized targets, vehicles and partners, and a sequenced roadmap — delivered as a written strategy and a live executive presentation.
Strategy + Activation
Everything above, plus positioning materials, target partner dossiers, an outreach kit, a preloaded pipeline tracker, and working sessions to put you in front of named buyers and primes.
Both are fixed scope and fixed fee, quoted after a short scoping conversation. Capture and proposal support, teaming agreement negotiation, and GSA Schedule applications are quoted separately.
Let's talk about your platform and your market
No pitch deck. A conversation about where you are trying to grow, what the product would need, and whether the market supports it.