ACCESS Revenue Simulator PROTOTYPE

Estimate revenue potential and visualize penalty risks for ACCESS Participants

Click buttons for field documentation

Synthetic Data: This prototype uses synthetic data for validation. Payment rates are from CMS published guidance (Feb 2025). Cohort data is illustrative only.

1. Track & Condition Selection

2. Patient Cohort & Rates

0 beneficiaries

Based on selected track, conditions, state, and specialty filters

Your enrollment assumption (subset of eligible pool)

70%

New to track or not controlled in prior 2 years

Payment Rates (CMS Published)

Initial Period
$0
Follow-On Period
$0

3. Performance Scenarios

60%

Target: 50% must meet clinical goals to avoid penalty

95%

Target: 90% must not see other providers for same condition

Projected Financials

Gross Revenue Potential: $0
Withhold Amount (50%): $0
Monthly Cash Flow: $0/mo
Clinical Penalty Applied: -$0 (0%)
Substitute Spend Penalty: -$0 (0%)
*Note: Only the larger of the two penalties is applied
Net Annual Revenue: $0
Realization Rate: 0%
You are meeting both OAR and SSR thresholds. Withhold should be fully released.

Cohort Breakdown (from Data)

Beneficiary counts from synthetic 2024 data

Specialty State Benes % Initial Est. Revenue

Required OAP Measures

Outcome measures for selected track/conditions