From raw file to revenue-ready brief.

The flow

1. 1
   Ingest

   Pull CMS claims, quality measures, and CMMI evaluation files. Versioned and provenance-tracked.

2. 2
   Normalize

   Map raw rows into the canonical model: providers, geography, encounters, cost, quality.

3. 3
   Detect

   Run SQL opportunity views — under-utilization, cost outliers, quality gaps — across cohorts and geographies.

4. 4
   Archetype

   Match the signal to a known pattern. Example: longitudinal care collapse for CHF in dual-eligibles.

5. 5
   Map to reimbursement

   Cross-reference CMS, MA, and CMMI payment programs that already pay to fix this gap.

6. 6
   Brief

   Generate a concise opportunity brief: cohort, geography, $ at stake, reimbursement path, and product fit.

7. 7
   Hand-off

   Route to BD for territory targeting and to product for roadmap validation.

What the brief looks like

OPPORTUNITY BRIEF — Q4
Archetype:        Longitudinal Care Collapse
Cohort:           Dual-eligible CHF, age 65+
Geography:        HRR 423 (top 5 of 12 candidates)
Signal:           30-day readmit 18% above benchmark; CCM utilization < 8%
Reimbursement:    CCM (99490/99491), RPM (99453-99458), MA Stars C15/C16
Estimated value:  $42M PMPM avoidable cost; $900M+ national TAM
Product fit:      RPM + care management platform with adherence module
Hand-off:         BD — target ACO REACH participants in HRR 423