PLAN

Competitive Landscape Market: Chicago Metro · eCKM · 84,200 benes

Who else is serving this market — and how much of it is still open.

Plan = the landscape with no "you" in the data. Flip to Grow to add your panel as a series.
What this screen answers: a vendor evaluating (Plan) or operating in (Grow) a market needs to know who else is serving these beneficiaries, how much of the market they hold, who is gaining, and what is still open. We detect competitive service directly in Medicare claims: any beneficiary with active care management billing from an entity other than you is classified as competitively served. Every beneficiary in the Market gets exactly one served_by label, and every chart below is a different cut of that classification. Hover any for definitions. Synthetic data; the snapshot is set ~12 months after ACCESS launch, so the blend of ACCESS vs. legacy CM programs is visible.
Target customer lens
Grow mode — same screen, one new series. Your panel (1,247 enrolled patients, matched to this Market) joins every chart as just another entity — one whose data you know perfectly. That is the whole Plan/Grow difference. It unlocks the three analytics that don't exist without a panel: Served Market Share, win/loss switching, and SSA exposure.
Market Composition — who serves the 84,200
served_by classification · service-level (claims-observed)
Each beneficiary falls in exactly one band. Open = no care management billing from any entity — an enrollment play. Incumbent-served = a traditional provider organization (health system, ACO, physician practice) bills CM as part of usual care — a displacement or partnership play, depending on your model. Vendor-served = a digital health company bills CM through its own medical group — usually a direct competitor. Unattributed = CM billing exists but the entity can't be confidently classified.
Program blend within the served population
Of the CM-served benes, how many are enrolled via ACCESS vs. served by legacy CM programs. The distinction is winnability: a legacy-CM bene is winnable (displacement play), while a bene enrolled in a competitor’s ACCESS program is effectively locked.
Share of Served Market
denominator: 23,150 served benes
Installed base — tells you the past. Who already holds the patients that are in care management today. Compare with Share of New (right) to see whether a big installed base is growing or coasting.
Share of New Enrollments — trailing 12 mo
% of new CM starts per month
The leading indicator — tells you who is winning now. Here: incumbents hold the biggest installed base but are losing share of new starts; Meridian and Pulse are taking it. A market can look incumbent-dominated and still be a vendor land-grab.
SSA Exposure — the competitive leg of withhold risk
your panel vs. the 90% SST
Unique to ACCESS, and only computable in Grow: competitive density around your enrolled panel, converted to modeled penalty dollars. SSR = % of your panel not receiving substitute services; it must stay above the SST (90%). This panel shows the SSA leg only — see the penalty-interplay note below.
Projected SSR
91.8%
102 of 1,247 panel benes show overlapping CM billing
Buffer to SST
+1.8 pts
≈ 23 more substitute-served benes to breach
At Risk if Breached
$56.1K
max SSA penalty = 25% of $224.5K withhold
80%85%90%95%100%
Watch: Cook County. 71 of the 102 overlapping benes are in Cook, where Meridian Remote Care is expanding. SSR has declined 0.9 pts over two quarters — competitive density around your panel is the driver, not patient behavior.
Penalty interplay — applied penalty = MAX(clinical, SSA), not the sum. Your outcome performance (OAR vs. the 50% OAT) drives a separate clinical penalty of up to 50% of the withhold. CMS applies whichever leg is larger. If your projected clinical penalty already exceeds the SSA leg, marginal competitive overlap costs nothing until SSA becomes the bigger number; if you're clinically clean, SSA is binding and every overlapping bene is real money. The full revenue-at-risk view (both legs + MAX) belongs to the performance analytic — this panel contributes the SSA leg, because it's the one competition drives.
Win / Loss — trailing 6 mo
panel switching vs. competitor entities
Direct evidence of displacement, in both directions — who you take patients from, and who takes them from you.
Won from competitors
38
31 displaced from provider-run CCM (incumbents) · 7 from vendor entities
Lost to competitors
12
9 to Meridian Remote Care · 3 unattributed
Net +26 over 6 months. Your wins come overwhelmingly from incumbents (displacement play working); your losses concentrate against one vendor in one county. Meridian is the entity to watch — it leads share-of-new and is the destination for 75% of your switching losses.
Competitor Entities
entity resolution: service-level complete · entity-level confidence-scored
Every organization (or rollup) serving benes in this Market. The Reads as column is persona-dependent — switch the lens above and watch the incumbents flip between threat and partner. Revenue is always modeled (their bene volume × published CMS rates); we cannot see any entity's actual reconciliation.
Entity Type Benes Served Share Share of New Program Mix Modeled Rev/yr Trend Confidence Reads as
Rollup rows: "Other provider-run CCM" aggregates the long tail — ~140 small practices and health systems each billing CM for fewer benes than the naming threshold; individually too small to track, collectively the largest incumbent block. "Unattributed CM" holds benes whose CM billing can't be confidently assigned to any classified entity. Named entities here are fictional (synthetic data). Churn: hover an entity name for its 12-month churn (benes whose CM billing from that entity stopped or moved) — a retention signal observable in claims for every entity, both modes.
Contested Map — by county
open <15% · contested 15–40% · dominated >40% served
Where to fight vs. where to walk. Same served_by data as the composition bar, cut by geography. Each bar splits the served share into legacy CM (winnable) and ACCESS-enrolled (locked) — a county can be heavily served yet still winnable if the activity is legacy, or moderately served but sewn up if it's ACCESS. A dominated county means displacement economics, not enrollment economics — usually a walk-away unless you have a specific wedge.
Key Terms
everything on this screen, defined once
Care management (CM)
The billable services competitors deliver: RPM (remote patient monitoring), CCM (chronic care management), RTM (remote therapeutic monitoring), BHI (behavioral health integration). The claims signal this screen is built on. ACCESS billing codes join the list post-launch (July 2026).
served_by
The one classification every beneficiary gets: Open · Incumbent · Vendor · Unattributed · You (Grow). Produced by the competitor-classification building block; every chart here is a cut of it.
Open
No care management billing from any entity. The easiest patients to enroll — no one to displace. An enrollment play.
Vendor
A digital health company (devices, virtual care, apps) billing CM through its own vendor-backed medical group. Claims signature: NPI/TIN clusters dominated by CM codes, often multi-state, no primary-care E/M billing. Usually your direct competition.
Incumbent
A traditional provider organization — health system, ACO, physician practice — billing CM alongside the care it already delivers. Threat or partner depending on your business model (switch the persona lens to see both readings).
Unattributed CM
CM billing observed, but the billing entity can't be confidently classified or named. Kept as a first-class bucket on purpose: wrong names are worse than no names.
Share of Served Market
Entity's served benes ÷ all CM-served benes. Installed base — the past. Denominator is the served population, not the whole Market.
Share of New Enrollments
Entity's share of benes entering CM for the first time, trailing 12 months. The leading indicator — who is winning right now.
Penetration vs. Served Market Share
Penetration = your Panel ÷ the whole Market (1.5%). Served Market Share = Panel ÷ (Panel + all competitively served) (5.1%). The first measures market coverage; the second measures competitive position. Both Grow-only.
Win / Loss (switching)
A bene's CM billing moved between entities in claims. Won = they're now on your panel; lost = they left it. Grow-only.
SSR / SST / SSA
ACCESS mechanics: CMS withholds 50% of payments. SSR (Substitute Spend Rate) = % of your panel NOT receiving substitute services elsewhere. If SSR < SST (the 90% threshold), the SSA penalty takes up to 25% of the withhold. Competitor overlap with your panel directly drives this.
Modeled revenue
Entity bene volume × published CMS rates. A sizing estimate for comparison — never the entity's actual revenue.
Program mix (ACCESS vs. legacy CM)
How an entity serves its benes: ACCESS enrollment vs. legacy fee-for-service CM billing. Observable post-launch only. Strategic signal: migrating into ACCESS = committing to the model (and locking benes); staying legacy = winnable book.
Winnable vs. locked
Legacy-CM benes are winnable — no enrollment lock, displacement converts them. ACCESS-enrolled benes are locked to their entity, assuming per-track exclusivity.
MAX penalty rule
The applied ACCESS penalty is MAX(clinical penalty, SSA penalty) — not the sum. The clinical leg (OAR vs. the 50% OAT, up to 50% of withhold) is your own performance; the SSA leg (up to 25%) is the one competition drives. Whichever is larger applies.
Churn (entity retention)
Share of an entity's book whose CM billing stopped or moved to another entity, trailing 12 months. Observable in claims for every entity, in both modes — a "how are they really doing" signal beyond size and growth.