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Aequalis Payer Intelligence

Aequalis Payer Intelligence

The data is public. The intelligence is not.

MA enrollment, MA risk score, MA Star Ratings, and Medicaid managed care data, transformed into confidence-graded, decision-ready intelligence. Packaged for the decisions each buyer needs to make. Not a dashboard. Not a compliance tool.

aequalis · payer intelligence · market overview
Total MA enrollment
35.0M
+1.0% YoY
Top 5 carrier share
~70%
Concentrated
C-SNP vs D-SNP growth
≈3:1
C-SNP leading
Contracts tracked
4,300+
CMS + PUF
What it answers

The questions Payer Intelligence is built for.

Which markets is a competitor MA plan growing in, and where are they retreating?
How does our network compare on enrollment-weighted Star Ratings across MSAs?
Where is the next wave of C-SNP and D-SNP growth concentrating?
Which plans are gaining enrollment share at the county level, and at what risk score profile?
How does Medicaid managed care enrollment shift after a state reprocurement?
Which regional plans are positioned to lead in our target geographies?
Inside the product

Four ways teams put Payer Intelligence to work.

Each view runs on the same governed data layer. Watch it move, or jump to the one you need.

Enrollment & rank movement

Track every parent organization’s enrollment and rank across years, with M&A history merged so the line stays continuous.

  • Continuous parent-org enrollment, merged across M&A
  • Rank movement year over year, 2020–2026
  • Spot the climbers and the retreats at a glance
Request a walkthrough
aequalis · enrollment rank, 2022–2026
Everything in one layer

Built on one governed data layer.

PUBLIC + CLAIMS SOURCESDECISION-READY OUTPUTSCMS MA EnrollmentMA Star RatingsMA Risk ScoresBenefits & LandscapePopulation projectionsMedicaid Managed CareACA / Exchange PUFCommercial (clearinghouse)Governeddata layerEntity-resolvedM&A-mergedConfidence-gradedEnrollment & rankGeographyCarrier 360AI analyst

Two dozen public and claims feeds (enrollment, quality, risk, benefits, managed care, commercial clearinghouse, and third-party population projections) resolved into one governed model, so every output compares the same thing.

How It Works

01

Ingest

CMS MA enrollment, MA risk scores, MA Star Ratings, Medicaid plan data, ACA marketplace, commercial clearinghouse, population projections

We ingest the public enrollment, risk, and quality data sets that matter for payer strategy: CMS Medicare Advantage enrollment and disenrollment, RAPS and EDPS risk score files, MA Star Ratings, Medicaid managed care enrollment, ACA marketplace performance, commercial plan data from a claims clearinghouse, and third-party population projections.

02

Normalize

Entity resolution, plan/parent hierarchy, geography standardization

Raw data is messy. CMS, state Medicaid agencies, and marketplace data all name the same plan differently. We resolve plans to parents, standardize geographies to MSA and county, and build a unified plan model that makes cross-source comparison possible.

03

Grade

Confidence scoring, cross-source validation

Not all matches are created equal. We assign confidence scores to every plan, geography, and enrollment figure, cross-validate across sources, and flag inconsistencies so our outputs carry a reliability grade alongside every insight.

04

Package

Buyer-specific decision packs

We package outputs into buyer-specific formats: network competitiveness analyses for health plans, market sizing for HealthTech, and diligence packs for PE/VC investors.

See it in action

One governed data layer behind every answer.

Enrollment, risk, quality, and Medicaid: reconciled once, graded for confidence, and packaged for the decision in front of you.

Continuous enrollment history

Parent-org enrollment merged across M&A so every trend line is unbroken from 2020 to today.

County-level resolution

Enrollment density and year-over-year growth down to the county, filterable by parent org.

Cross-LOB footprint

Carrier 360 shows MA, D-SNP, C-SNP, and Medicaid presence side by side in one view.

Ask in plain language

The AI analyst writes and runs read-only SQL, then shows the exact query behind the answer.

Provenance on every figure

Each number carries its data-source basis and a confidence grade, never a black box.

Looking for rate data?

Aequalis Transparency

Rates, payer networks, and utilization, derived from the TiC and Hospital machine-readable files.

Interested in Payer Intelligence?

Tell us what decision you need to make and we'll show you what the data says.

Get Access to Payer Intelligence