Work05 / Executive mandate

Healthtech, care management, VBC, payer-facing, and provider enablement teams

Payer Strategy and Value-Based Care

Payer and value-based-care GTM support across reimbursement logic, VBC economics, managed care narratives, care-gap proof, and buyer-ready value realization.

Read the operating brief

The buyer problem

The issue underneath the visible activity.

This is the problem leadership must make legible before adding more pipeline, tooling, headcount, or implementation burden.

The product may create value, but the buyer does not yet see the economics, reimbursement path, proof gates, or implementation model clearly enough to act.

What gets built

A working management system, not a recommendation left in a deck.

The scope is organized around the artifacts, operating rules, and decision cadence the team needs to keep using after the engagement.

  1. 01

    Payer-facing narrative around cost, quality, access, care gaps, and operational feasibility.

  2. 02

    Value-realization model that separates verified proof from assumptions and opportunity ranges.

  3. 03

    Account and partner prioritization based on buyer pain, economics, and launchability.

  4. 04

    Executive materials that help CEOs and CFOs decide what to fund next.

Proof patterns

What leadership should be able to observe.

  1. 01

    VBC contract logic across payer/provider contexts.

  2. 02

    HEDIS/Stars, RAF/HCC, CMS-HCC V28, Managed Medicaid, Medicare Advantage, CKCC/KCC, and care-gap economics fluency.

  3. 03

    Claims-informed opportunity mapping converted into provider and service-line decisions.

Decision questions

What the executive room must answer.

  1. 01

    Which payer pain is urgent enough to create action?

  2. 02

    What value proof will survive CFO scrutiny?

  3. 03

    What implementation burden could block the sale after agreement?

Trust boundary

What this mandate will not pretend away.

Related proof

These records are contextual proof paths, not blanket client-outcome claims. Evidence class and claim boundary are shown from the public case record where available.

01

Employer outcome

Databricks Claims Forensics / Referral Leakage

Claims signal -> account strategy
Claim boundary

Aggregate results are reported in the September 12, 2026 executive resume. The $125.9M leakage figure is a modeled opportunity and $22M downstream LTV is an estimate, not realized or booked revenue. Account-level and patient-level records remain private.

02

Operating architecture

Dementia Care / GUIDE GTM System

Policy signal -> launchable wedge
Claim boundary

A strategy and commercialization build, not a claim of employment, contracted deployment, or realized client outcome.

03

Employer outcome

Dialysis Network Growth

Referral friction -> field cadence
Claim boundary

Public-safe aggregate outcomes only. Facility, patient, payer, and referral-source records are excluded from the site.

Connected context

Related mandateProvider Network Growth StrategyRelated mandateGovernment Payment Integrity and Policy-to-Workflow Design

Start a serious conversation

Make the buyer problem clear enough to build, prove, and fund.

Discuss an operating mandate