DatasetCapitalOperating2025

CMS and claims opportunity atlas

The claims-defined view of where reimbursed demand actually sits: cohort, county, CMS signal, the codes and bundles that pay, and the revenue at stake. It is the intelligence spine under Fund II, and an asset in its own right.

Most healthcare market sizing is a slide. This is a query. A cohort defined out of claims, the counties where the gap is widest, the CMS metric that proves the gap, the CPT and HCPCS codes that pay for closing it, and a capture rate we are willing to defend in writing.

We count it as a portfolio work because it is the thing that decides where capital goes. Every Fund II brief is an output of it, and every venture in Fund I can query it.

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