For digital health companies entering Medicare · ACCESS launches in — days

The Operating System for ACCESS Participants.

1Phi helps digital health companies to Plan, Grow, and Execute in Medicare — purpose-built for CMMI's ACCESS model, with native support for RPM/RTM.

Book a working session →

30 minutes with Medicare models experts. Bring your top priorities — we'll bring the data and implementation insights.

What's at stake

Market size

69M

Digital health just opened up to 69 million Medicare patients.

CMMI's ACCESS model launches July 5, 2026.

Annual per-patient revenue

$180–$2,400

$180–$420 in ACCESS, with a pathway to RPM/RTM at $1,100–$2,400.

Composite revenue depends on patient acuity and engagement.

The risk of sitting out

↗

Your competitors aren't standing still. Without an ACCESS strategy, you may lose existing market share.

We track competitor patient acquisition and provider activity in claims data.

The Platform

One operating system. Three modules. The strategic, tactical, and operational work of Medicare chronic care.

Whether you're already accepted as an ACCESS participant, planning to apply, or engaged as a technology partner, 1Phi is the platform that runs underneath your Medicare strategy. The same data that sizes your market also targets your patients, ranks your providers, and submits your claims.

Plan Market

Strategic · Quarterly

Market sizing across the four ACCESS tracks. Precision patient targeting. ACCESS vs RPM/RTM segmentation. Channel strategy. VBC opportunity sizing.

For Strategy, Product, Finance

Grow Sales

Tactical · Monthly

Track DTC conversion and retention. Execute provider outreach. Develop clinical partners. Manage channels. Monitor competition.

For Marketing, Sales, BD

Run Operations

Operational · Daily

Patient eligibility and onboarding. Outcomes submissions. Claims submissions. VBC reporting. Regulatory monitoring.

For Operations, Revenue, Compliance

Our data advantage

National Claims Intelligence.

1Phi runs on a proprietary data layer built from 100% of national Medicare claims, provider VBC participation across all 50 states, and care management activity by NPI. We combine these assets with simulations, projections, and best practices custom-built for digital health in ACCESS and RPM/RTM — not retrofitted from health-system population health platforms.

Track your competitors' moves

See which patients are appearing in competitor ACCESS and RPM/RTM claims. Track patient acquisition, provider strategy, and clinical outcomes — by quarter, geography, and clinical track.

Calculate your substitute spend

Model the spend you're displacing under ACCESS, project outcomes-adjusted revenue, and confirm claims accuracy against CMS payment rules before submission.

Find your greenfield

Identify geographies with high market share for competitors versus areas where the opportunity is still open. Find provider networks that are VBC-ready and under-served.

Match patients to pathways

Segment patients into ACCESS, transitional, and RPM/RTM candidates based on acuity, disease progression, drug adherence, ED utilization, and engagement propensity.

Sample patient segmentation table showing ACCESS candidates (56.2%), Transitional ACCESS or RPM (34.4%), and RPM candidates (9.4%), with acuity, medication intensity, adherence, ED utilization, cohort size, and VBC overlap columns.

Sample output · Patient segmentation across ACCESS, transitional, and RPM/RTM candidates for a hypertension cohort. Real outputs are calibrated to your clinical areas and revenue model.

Inside the platform

Three modules. One data layer. Every stage of your ACCESS lifecycle.

The work is sequential — but the data flows continuously between modules. A patient identified in Plan becomes a target in Grow becomes a submission in Run.

01 · Plan Market · Strategic · Quarterly

Where should we play, and will the math work?

Plan Market answers the strategic questions before you commit. Validate the size of the opportunity by ACCESS track and geography. Segment your addressable patients across ACCESS and RPM/RTM. Identify the providers worth your outreach budget. Model economics across pathways.

01Market sizing across the 4 ACCESS tracks (eCKM, CKM, MSK, BH)
02Precision patient targeting
03ACCESS vs RPM/RTM segmentation
04Channel strategy
05VBC opportunity sizing

See Plan Market against your tracks →

Plan Market sample: condition prevalence bar chart, top 10 comorbidity profiles, and pairwise lift matrix across FFS Medicare diagnoses.

Grow Sales sample: monthly revenue projections comparing your expected revenue versus competitor composite, with min-max ranges shown as shaded bands.

02 · Grow Sales · Tactical · Monthly

Are we acquiring the right patients at the right cost?

Grow Sales is the compounding intelligence layer. Track DTC conversion. Execute provider outreach against the highest-yield panels Plan identified. Develop clinical partners — we vet virtual care vendors, track their performance, and identify growth opportunities. Monitor competitive entry across the CMS ecosystem.

01Track DTC conversion and retention
02Execute provider outreach
03Develop clinical partners
04Manage channels
05Monitor competition

See Grow Sales against your channels →

03 · Run Operations · Operational · Daily

Bill, report, and stay compliant — without rebuilding your stack.

Run Operations handles the technical complexity so you don't have to rebuild your infrastructure around Medicare. Patient eligibility, outcomes submissions, claims validation, VBC reporting, regulatory monitoring — wired to the data flowing from Plan and Grow.

01Patient eligibility verification and onboarding
02Outcomes submissions
03Claims submissions and validation
04VBC reporting
05Regulatory monitoring

Talk through your operational fit →

Run Operations sample: monthly revenue tracking with net enrollment, substitute spend ratio, and outcomes attainment dials over a 17-month horizon.

Why 1Phi wins

Population-health platforms weren't built for digital health. Data vendors sell commodities. Building internally takes 12–18 months. 1Phi is purpose-built.

Most ACCESS infrastructure was designed for health systems chasing shared-savings dollars or for benefits consultants building one-off models. 1Phi is the only platform with laser focus on digital health companies entering Medicare — with the data assets, financial simulations, and operational support to match.

Vs. pop-health platforms

Pop-health platforms serve established VBC organizations chasing shared savings. They weren't built for digital health companies entering Medicare for the first time, and they don't include the financial simulations, channel strategy, or RPM/RTM composite modeling you need.

Vs. data vendors

Market data vendors sell commodity claims data. They don't include ACCESS-specific financial simulations, competitor patient acquisition tracking, or out-of-the-box operational support for outcomes submissions and VBC reporting.

Vs. building internally

$750K–$1.5M and 12–18 months to build Medicare data fluency — negotiating CMS access, hiring VBC analysts, building segmentation models. 1Phi delivers all of it on day one.

Who it's for

Two kinds of digital health companies.

Consumer-first companies entering Medicare

You've built a category-defining consumer product. ACCESS is your first credible path into Medicare reimbursement. The rules are different from anything your team has worked under — and the cost of building Medicare data fluency in-house is $750K–$1.5M and 12–18 months. 1Phi compresses that to weeks.

RPM/RTM-native companies adapting to ACCESS

You already bill RPM/RTM. ACCESS is reshaping your competitive landscape — and creating an opening to acquire healthier, higher-fit patients. 1Phi helps you defend your existing book, expand into ACCESS where it makes sense, and route every patient to the pathway that pays best.

Why 1Phi

Built by the team that helped four of the ten largest health systems succeed in CMS's VBC models.

Validate Health (acquired by Marsh, 2025) earned its clients $100M+ in additional savings and value through MSSP, REACH, and other Medicare VBC programs — by being first to model the rules and going deep on what makes participants succeed. 1Phi brings that same fluency to digital health companies in ACCESS.

Insider data infrastructure

100% national Medicare claims, provider VBC participation across all 50 states, care-management activity by NPI. Built originally for the nation's largest health systems; now custom-built for digital health.

CMS ecosystem credibility

David Portnoy launched the DDOD program at HHS as an Entrepreneur-in-Residence. 1Phi is a member of the CMS Health Tech Ecosystem.

A founder-led precision team

Seven people. Funded by Validate Health's exit. The same strengths that got our last company there — being first, going deep, and helping clients win in new VBC models.

David X. Portnoy

Chief Executive Officer

Co-founded Validate Health (acquired by Marsh). EIR at HHS, launched DDOD. Pioneered computer simulations of CMS/CMMI models.

Dan Kuhn

Chief Technology Officer

3x CTO. Co-founded Aginity (acquired by PE). Built large-scale data, analytics, and AI platforms across enterprise and consumer products.

Aaron Soto-Karlin

Chief Product Officer

Led population health strategy at Iora / One Medical / Amazon. Stood up cardiometabolic platforms for 108M+ patients at Aetna / CVS.

Let's model your Medicare opportunity.

A 30-minute working session with Medicare models experts. Bring your top priorities — your clinical programs, your geographic targets, your competitive concerns. We'll bring the data and implementation insights. Where it fits, we'll walk you through a sample market read against your tracks: target patients, providers who can reach them, and the financial incentives in play.

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