The Opportunity Atlas is a continuously updated map of where US care delivery is failing in ways CMS and payers already pay to fix. Built for BD, growth, and product leaders in medical device, digital health, and HIT.
Most BD teams pursue named accounts and broad TAM estimates. Meanwhile, specific, reimbursable problems sit unaddressed in public CMS data — waiting for a product like yours. The Opportunity Atlas finds them, ranks them, and ties each one to a path through existing payment.
Each one is something CMS or a payer is already paying to solve. The Opportunity Atlas shows you which markets, which buyers, and how to frame the ask.
Use these as templates. The Opportunity Atlas produces a custom set for your product, segment, and geography.
Dual-eligible CHF cohorts show 18%+ higher 30-day readmits in 14 HRRs, with CCM/RPM utilization below the 10th percentile.
RPM (CPT 99457/99458) + CCM (99490) are already billable. MA plans lose triple-weighted Star points on readmits and care coordination.
“Help your CHF program recover Stars and cut avoidable admits — funded by RPM you’re already eligible to bill.”
MA plan ops · Health system VP of value-based care
See how the Opportunity Atlas builds this — SQL Transformations →Wide HRR-level variation in SNF length-of-stay and 30-day readmits after joint replacement and CHF discharges.
TCM codes 99495/99496 reimburse the hand-off; BPCI-A bundles reward shorter SNF stays; HEDIS PCR drives MA Star revenue.
“Move the right patients home faster — and turn TCM and bundle savings into a paid workflow, not a cost center.”
Health system post-acute leaders · ACO REACH · BPCI-A conveners
See how the Opportunity Atlas builds this — Normalized Care Model →Counties where late-stage colorectal diagnoses are 1.5–2× the national rate and screening rates sit below HEDIS thresholds.
HEDIS COL and MIPS Quality 113 are tied to plan and provider revenue. MA Stars amplify the dollar impact per percentage point.
“Close screening gaps in the counties that are actually dragging your Star and MIPS scores — not the national average.”
MA quality leaders · ACO quality officers · screening device & lab BD
See how the Opportunity Atlas builds this — Public Data Sources →MA contracts where PDC for diabetes, statins, or RAS antagonists is trending toward a Star cut worth tens of millions in rebate.
Part D adherence measures are triple-weighted in Stars — the single highest-leverage revenue lever for MA plans.
“Protect the rebate. Here are the contracts and therapeutic classes one cycle away from losing a Star — and the members driving it.”
MA Stars & quality leaders · PBM clinical ops · adherence-tech BD
See how the Opportunity Atlas builds this — AI / MCP Integration →Markets where commercial and MA cardiac/ortho volumes still sit in HOPD despite CMS expanding the ASC-payable list.
CMS keeps adding cardiac and ortho codes to the ASC list; payers route patients aggressively. BPCI-A rewards lower-cost sites.
“Win the site-of-care shift in the 12 MSAs where payers are already pushing — before your competitor signs the ASC network.”
ASC operators · device sales leaders · payer network strategy
See how the Opportunity Atlas builds this — Human Query →Primary care panels with high behavioral comorbidity but near-zero CoCM billing and weak behavioral access scores.
Collaborative Care (CoCM) codes 99492–99494 are paid by Medicare and most MA plans. CCBHC and MA behavioral measures add upside.
“Stand up integrated behavioral care in the practices that already have the patients — and bill CoCM from day one.”
Primary care groups · MA behavioral leaders · digital behavioral BD
See how the Opportunity Atlas builds this — Extensibility →Specialty referral leakage and prior-auth turnaround times that correlate with denied claims and avoidable ED revisits.
CMS interoperability and prior-auth rules force payer workflow change; MA admin cost ratios reward plans that automate.
“Cut the prior-auth and referral drag CMS is already forcing payers to fix — and show MLR improvement in two quarters.”
Payer ops & UM leaders · health system referral ops · RCM / auth BD
See how the Opportunity Atlas builds this — Ingestion Pipeline →Strategy memos tied to specific cohorts, geographies, and reimbursement paths.
See the flow →Every opportunity mapped to existing CMS, MA, or commercial payment.
See the SQL layer →Each brief is a working strategy memo: cohort, geography, signal in the data, reimbursement path, and the revenue at stake — ready for BD and product teams.
Get a brief for your productBuilt on public, defensible sources. Extensible with your proprietary data.
30 minutes. No slides. We'll show the Opportunity Atlas running against the segment you care about.