Industry · Public Sector & Federal Civilian
State Medicaid data-quality architecture, CMS-0057-F compliance readiness, and civilian-agency operational excellence.
Eyebrow: Industry · Public Sector
H1: State health agencies operate at federal standard. Their architecture must too.
Sub: The CMS Outcomes Based Assessment methodology now includes more than 500 critical and high-priority T-MSIS measures that state Medicaid agencies must meet. The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) requires impacted payers to return prior-authorization decisions within 72 hours (expedited) and 7 calendar days (standard). with API compliance deadlines beginning January 1, 2027. Public-sector operators are not asked to be as compliant as private industry. They are asked to be more.
Primary CTA: Request a public-sector engagement → /engage/rfp
Medicaid serves approximately 77 million people at $673 billion in FY2020, per GAO's foundational data-quality finding. The T-MSIS DQ measurement catalog is public and enumerated, the operational question is whether your state's data pipeline, submission architecture, and continuous-improvement rhythm are designed to *pass* the OBA measurement, not merely to *submit* against it.
We advise on the architecture, not the submission.
CMS-0057-F is the compliance milestone shaping state Medicaid, MA, CHIP, and QHP payer architecture through 2027. Underneath the API standards sits an operational reality: prior authorization workflows, provider directory freshness, and patient access data flows must be redesigned end to end. We build the operational architecture that the API surface depends on.
Federal Lean is not a private-sector import. The EPA published a Lean Government Metrics Guide in 2009; DoD's cross-agency efficiency effort projected $178 billion in five-year savings. The GAO High Risk List documented ~$100 billion in financial benefits from high-risk-area improvements over two years. Public agencies that adopt operational excellence do not experiment. They operationalize a proven federal practice.
WisDOT DBE certified · NMSDC recertified 2026 · SDVOSB verified
We hold a public engagement record with the Wisconsin Department of Health Services on DQI/DQA-adjacent work. Wisconsin evaluates BadgerCare Plus on 19 HEDIS measures and Medicaid SSI on 14, publishing an annual HMO Report Card.
Our founder is a 2026 Wisconsin Titan 100 honoree. the peer group of 100 top CEOs and C-level executives employing more than 64,000 people across $14 billion in aggregate annual revenue.
A four-week read of the agency's current data-quality, interoperability, and operational architecture, benchmarked against the relevant CMS, T-MSIS, and TEFCA standards.
A prioritized, dependency-mapped rebuild plan, sized to the agency's civil-service reality, not an aspirational plan sized to a private-sector consulting firm's calendar.
Continuous coaching, measurement-cadence redesign, and civil-service-appropriate change management. The 15–30% improvement range that private hospitals see is achievable in public agencies when the plan respects the operating constraints.
Every architecture decision, every measurement, every improvement, documented at the standard state auditors, CMS reviewers, and legislative oversight demand.
Public-sector consulting, delivered at federal standard.
Primary CTA (gold): Request a public-sector engagement → /engage/rfp Secondary: Download the Federal Capability Statement → /about/capability-statement
Start with a four-week architectural diagnostic in your operating context.
Request a diagnostic