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Table of Contents
The scoreboard CMS posted on Oct 8
What a half-star is worth
Why a services company and why AI now
The wedge is pharmacy
Products two and three: HEDIS, then the surveys
Pricing a product that pays off in 2030
Unit economics
Who buys and when
The raise, the team and the first 36 months
What kills it
Exit math
Abstract
2027 Star Ratings posted Oct 8, 2026. CMS rated 508 MA-PD contracts, 188 at 4+ stars (37%), down from 44% in 2026, and about 71% of MA-PD enrollees are in 4+ star contracts.
Proposed company is an AI-first Stars operator that takes over whole measures and gets paid mostly on movement. Pharmacy first, HEDIS second, CAHPS and HOS last.
The two physical- and mental-health improvement measures rise to triple weight for the 2027 Star Ratings. The Medication Therapy Management Comprehensive Medication Review measure returns for the 2029 Star Ratings, based on measurement year 2027. Results post in October 2028 and affect 2028 quality-bonus payments.
Financing is $7M seed now, approx $28M Series A in late 2027, approx $70M Series B after the first public scoreboard. Target approx $140M revenue by 2031 at 60%+ GM.
Kill list is the curve, CMS rewrites, the courts, PBM data access, the cash lag and one bad AI phone call.
