§ Insights

Notes from the practice.

Practitioner-level guides on EHR integration, FHIR APIs, HCC risk adjustment, the CMS ACCESS Model, and the data and AI infrastructure that makes value-based contracts perform.

No. 15

How to Eliminate Distributor Chargebacks in Consigned Medical Device Inventory

Distributor chargebacks quietly leak 3 to 8 percent of revenue in medical device manufacturing. Here are the three root causes and how a unified consumption, billing, and contract platform catches them pre-issue.

chargebacksmedical devicesconsigned inventoryreconciliation
July 24, 2026
4 min read
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No. 14

Inventory Shrinkage in Multi-Site Consigned Stock: The Five Signals We Look For

Consigned inventory shrinkage is harder to see than owned-inventory shrinkage. The signals live in the data. Here are the five we look for in every first assessment.

inventory shrinkageconsigned inventorymanufacturingassessment
July 24, 2026
4 min read
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No. 13

The Dead Stock Problem: How Averaging Demand Costs Manufacturers 20% of Revenue

Stocking to the average across a multi-site network guarantees simultaneous stock-outs and dead stock. Classical forecasting cannot fix it. Placement modeling can.

dead stockobsolete inventoryplacement modelingmanufacturing
July 24, 2026
4 min read
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No. 12

From Quarterly to Weekly Demand Forecasting on Microsoft Fabric: A Practitioner Guide

Planners should not be a data pipeline. A two-phase approach returns planner hours in Phase 1 and delivers a consolidated Microsoft Fabric platform with best-fit models and a GenAI layer in Phase 2.

demand forecastingMicrosoft Fabricforecasting automationmanufacturing
July 24, 2026
4 min read
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No. 11

Consigned Inventory Placement with Monte Carlo Simulation: A Manufacturer Playbook

Placement is not forecasting. Monte Carlo simulation over consumption, billing, transfer, and location records produces per-site stocking policies that deterministic optimizers cannot match.

inventory placementMonte Carlo simulationconsigned inventorysupply chain
July 24, 2026
4 min read
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No. 10

AI for Manufacturing Operations: Where It Pays Off and Where It Does Not

Everyone has an AI pilot. Almost nobody has a second one. Here is where AI genuinely changes manufacturing operations, where it does not, and the sequencing that produces measurable outcomes.

manufacturing AIoperational AIsupply chain AIconsulting
July 24, 2026
4 min read
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No. 09

CMS ACCESS Model: Complete Provider Readiness Guide

The comprehensive readiness guide for ACOs and health systems entering the CMS ACCESS Model. Five operational pillars, 18-month timeline, scoring framework, build-vs-buy decisions, and the year-1 operating model.

ACCESS ModelValue-Based CareACOCMS
April 28, 2026
15 min read
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No. 08

FHIR API Readiness for ACOs: USCDI v3, SMART on FHIR, Bulk Data, and Production Hardening

Cluster article on Pillar 1 of the CMS ACCESS Model readiness framework. The technical depth on what production FHIR APIs require for ACO data teams: resource coverage, auth patterns, Bulk Data, and the production hardening non-negotiables.

ACCESS ModelFHIREHR IntegrationACO
April 28, 2026
6 min read
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No. 07

PROMs Collection at Scale: Hitting Sustained 40 to 50 Percent Response Rates

Cluster article on Pillar 2 of the CMS ACCESS Model readiness framework. Instrument selection, four-channel delivery, the patterns that move response rates from pilot levels to ACCESS-eligible scale, and how PROMs surface in clinical workflow.

ACCESS ModelPROMsValue-Based CareACO
April 28, 2026
6 min read
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No. 06

Outcome Attainment Scoring: The Highest-Leverage Element in ACCESS Model PY1

Cluster article on Pillar 3 of the CMS ACCESS Model readiness framework. Why outcome attainment is the genuinely new scoring element, the clinical-content governance that has to ship before the engine can score, and the dashboard layer that closes the loop.

ACCESS ModelOutcome AttainmentValue-Based CareACO
April 28, 2026
6 min read
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No. 05

CMS ACCESS Model Timeline: Application, Build Work-Back, and Five-Year Performance Cadence

Cluster article on the ACCESS Model timeline. Application timing decisions, the 18-month build work-back, performance year 1 operating cadence, and how risk-track economics evolve through performance year five.

ACCESS ModelValue-Based CareACOCMS
April 28, 2026
6 min read
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No. 04

What is the CMS ACCESS Model? A Practical Guide for ACOs

The CMS ACCESS Model launches in 2026. A practical guide for ACOs on the requirements (FHIR APIs, PROMs, outcome attainment) and how to prepare.

ACCESS ModelValue-Based CareACOCMS
April 22, 2026
5 min read
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No. 03

HCC Risk Adjustment Automation with NLP: A 2026 Guide

How HCC risk adjustment works under V28, why manual coding leaves revenue on the table, and what an NLP pipeline on Azure and Microsoft Fabric looks like.

HCCRisk AdjustmentClinical AIMedicare Advantage
April 22, 2026
5 min read
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No. 02

Epic FHIR Integration for ACOs: What Actually Works

A practitioner's guide to Epic's FHIR R4 API for ACO data teams: App Orchard vs. public FHIR, Bulk Data, auth, rate limiting, and common pitfalls.

EpicFHIREHR IntegrationACO
April 22, 2026
5 min read
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No. 01

Building an ACO Data Platform: Architecture & Requirements

Reference architecture for an ACO data platform, lakehouse layers, key data products (attribution, care gaps, HCC, quality measures), and build-vs-buy.

ACOData ArchitectureAzureMicrosoft Fabric
April 22, 2026
5 min read
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§ 10 · Get in touch

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