CORDATO
National Innovation Layer The Model CMMI Pathways Outcomes Why Now What We Are Asking
Concept brief for federal policymakers, CMMI, and ACA stakeholders

A National Preventive Signal Layer for ACA, Medicaid & Medicare

Cordato proposes a wellness-classified, AI-supported health forecast layer that sits above existing programs, predicts physiologic risk before symptoms, and helps reduce avoidable hospitalizations across the country.

Grounded in CMMI’s focus on better care, better health, and lower cost Built for ACA affordability, Medicaid sustainability, and Medicare aging curves
⬇ Download National Innovation Brief (PDF)
The Problem: We Pay for Crises, Not Signals
ACA, Medicaid, and Medicare all face the same structural issue: signal-poor, crisis-driven care creates rising costs and unstable premiums.
Fragmented Signals

Wearables, home devices, and RPM programs generate large volumes of data. Very little of it is converted into early, actionable risk prediction across programs. Signals live in silos instead of a shared early-warning layer.

Crisis-Driven Spend

Across ACA, Medicaid, and Medicare, the largest cost drivers are still inpatient and emergency events. Programs end up paying for deterioration rather than preventing it, even when early physiologic changes are visible days in advance.

Affordability Pressure

ACA premiums, state Medicaid budgets, and Medicare projections all face pressure from preventable events. Policymakers lack a simple way to reduce these events at scale without adding complexity or member burden.

The Cordato Innovation Model
A wellness-classified health forecast layer that predicts physiologic risk and feeds early-warning insights back into existing plans and programs.

What the Innovation Layer Is

Cordato functions as a preventive signal layer: a cloud-based system that ingests continuous wearable signals and daily physiology, builds individual baselines, and detects trend breaks 48–72 hours before symptoms or deterioration.

Instead of changing how benefits are paid, the layer changes when care is triggered. Interventions move several days earlier, when they are less costly, less invasive, and more effective.

Wellness-classification No new billing codes Plan-agnostic Nationally scalable

How It Interfaces with Federal Programs

Cordato does not replace ACA, Medicaid, or Medicare. It sits above and alongside existing programs and provides:

  • Member-level alerts and simple health forecasts
  • Program dashboards on rising risk and preventable events
  • Signals that trigger existing care-management pathways earlier
  • Data to design and evaluate CMMI innovation models
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Wearable signals & vitals
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Baselines & trend breaks
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Risk forecast & alerts
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Earlier outreach & care
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Fewer avoidable events
CMMI and Policy Pathways
Cordato is designed to start in one state, then be evaluated and scaled through CMMI as a national preventive signal infrastructure.
Pathway A

State Pathfinder to CMMI Model

Launch an initial pilot with a willing state, such as a Texas Medicaid RPM replacement, to generate real-world evidence on:

  • Reduction in avoidable hospitalizations and emergency visits
  • Changes in total cost of care per member
  • Care-management workload and burnout

Successful results can inform a CMMI innovation model that offers a similar signal layer to other states and programs.

Pathway B

ACA Marketplace and Premium Stability

Cordato can be offered as a preventive overlay for ACA enrollees, especially in high-deductible and silver-tier plans, with goals that include:

  • Reducing catastrophic claims that destabilize premiums
  • Improving continuity for self-employed and gig-economy members
  • Supporting affordability without redesigning core benefits
Pathway C

Medicare and an Aging Population

For Medicare and dual-eligible populations, the same signal layer can be used to:

  • Identify early deterioration in chronic conditions
  • Prevent avoidable inpatient stays and SNF admissions
  • Support value-based care and ACO models
Texas as a proof point. The Texas Medicaid RPM replacement pilot is structured to show how a wellness-classified signal layer can reduce avoidable events without new codes or hardware procurement. Those learnings can map directly into CMMI evaluation criteria.
What the Innovation Layer Delivers
Different stakeholders experience the same infrastructure in different ways, all anchored on earlier detection and fewer crises.

For Individuals and Families

  • Early warnings before illness becomes an emergency
  • Fewer surprise hospitalizations and medical bills
  • Clear, simple health forecasts instead of hidden risk
  • Support for caregivers and rural members

For State and Federal Programs

  • Reduced preventable hospital and emergency utilization
  • Better visibility into emerging population-level risk
  • Evidence to support premium stability and budget planning
  • A low-friction lever for bending the cost curve

For Plans, ACOs, and Providers

  • Actionable, pre-symptomatic risk signals
  • Earlier, lighter-touch interventions
  • Less burnout from constant crisis response
  • Better alignment with value-based care incentives

For Policymakers and CMMI

  • A concrete, testable national innovation concept
  • Built-in metrics on cost, quality, and equity
  • No need to renegotiate core statutory benefits
  • A practical path to redefining prevention in the ACA era
Why Now: A Narrow Window for Structural Change
The technology exists. The signals exist. The tools through CMMI exist. The missing piece is a simple, scalable, prevention-first layer that aligns with ACA, Medicaid, and Medicare.

From Moneyball to Medicine

Cordato’s methodology is rooted in early Moneyball-style analytics: prediction wins and reaction loses. The same logic that gives sports teams a predictive edge can now be applied to population health.

In healthcare, we have the signals to see risk forming. The policy choice is whether to build the layer that uses them or continue paying for crises that were visible in advance.

  • AI, wearables, and home monitoring are mature enough to support continuous forecasting at national scale.
  • CMMI has the authority and experience to structure, test, and evaluate models that reward prevention.
  • ACA, Medicaid, and Medicare all face the same driver of instability: avoidable events that strain budgets and premiums.
  • A wellness-classified, signals-only layer gives policymakers a way to act now without waiting for new statutes or code sets.

What We Are Asking From CMMI

This page is intended to support early-stage exploration. If the concept is directionally aligned, we welcome the opportunity to:

  • Hold a confidential briefing to walk through the Texas Pathfinder pilot and national model.
  • Work with CMMI staff to define evaluation criteria for a preventive signal layer.
  • Determine whether this concept should advance into a formal CMMI model design process.
National Innovation and CMMI Engagement We welcome confidential briefings with federal policymakers, CMMI leaders, and ACA or Medicare strategy teams.
Cordato — Predictive Health Intelligence | While politicians debate how to fix healthcare, Cordato plays offense.
Email: innovation@cordato.com Website: innovation.cordato.com Texas Pathfinder Pilot: gov.cordato.com