Healthcare Enablement. Whatever needs doing,delivered as an outcome.
Not every mandate fits a menu. We implement systems, run operations and deliver programs for US health organizations, as one accountable partner with agreed measures and a path to hand it over.
A short call with a senior expert. No patient information needed.
What organizations bring us
- A system to implement
- An operation to run
- A program to launch
- A capability to build
- A mandate that fits no box
How we deliver
- 1Shape the mandate and measures
- 2Build or implement it
- 3Run it under service levels
- 4Hand it over when you are ready
What you get
- One accountable partner
- Outcome-based delivery
- Governed, auditable work
- Capability you own
Built on the standards delivery is judged by
- HIPAA Security Rule
- NIST Cybersecurity Framework
- ONC certification criteria
- HL7 FHIR
- ITIL service management
- SOC 2 and HITRUST practices
Watch 46 seconds
Mandates that fit no menu: how we deliver them as outcomes
Read the film as text
- Mandates that fit no menu.Whatever needs doing, delivered as an outcome.
- Why it mattersJan 1, 2027 federal deadlines for Medicaid community engagement and payer FHIR APIs. Source: CMS One accountable partner for the work that fits no box.
- From mandate to handover.Shape the mandate and measures (we lead). Build or implement it (we lead). Run it under service levels (shared). Hand it over when you are ready (you lead). You keep the capability, not a dependency.
- What you get.One accountable partner. Outcome-based delivery. Governed, auditable work. Capability you own.
- During Health.Whatever needs doing, delivered as an outcome. Tell us the mandate, or Free readiness scorecard, at duringhealth.com.
What is creating new mandates right now
Dated facts, each with its source. This part of the page is refreshed regularly; the rest is built to last.
Jan 1, 2027
state deadline for Medicaid community engagement requirements
CMS issued an interim final rule on June 1, 2026. States and plans need eligibility, verification and reporting operations ready, and many will need outside help to stand them up.
CMS, community engagement requirement fact sheetAs of Oct 20264 APIs
payer FHIR APIs go live on January 1, 2027
Providers that want to benefit need integrations and workflows ready, which is implementation work most teams have not scoped.
Our CMS-0057-F analysisAs of Oct 2026
$50B
Rural Health Transformation Program, awarded to all 50 states
CMS announced awards on December 29, 2025. States are funding technology, workforce and operations projects, which creates work that small rural organizations often lack the staff to deliver alone.
Every number links to its source.
What most organizations get wrong about outside help
Myth
“Outsourcing means losing control.”
Fact
Done well it means clearer control: written scope, service levels, named people, audit rights and a documented path to bring the work back.
Myth
“Go live is the finish line.”
Fact
Most of the value, and most of the failures, come after go live: adoption, upkeep, support and change. Plans that stop at launch miss them.
Myth
“We need a partner for each project.”
Fact
Separate vendors for each project mean separate handoffs and no one accountable for the whole. One accountable partner reduces gaps, if the scope and measures are written down.
Four things you can hold us to.
Systems implementation & maintenance
Stand up and sustain platforms end to end — e.g. HIMS for a hospital or medical college, with ongoing upkeep.
What you get
- Requirements, configuration and integration
- Testing, training and cutover planning
- Go-live support and stabilization
- Ongoing maintenance under service levels
Managed operations & programs
Run business and clinical-adjacent operations as a managed service, accountable to SLAs and outcomes.
What you get
- Operations run as a managed service
- Service levels with named measures
- Regular reporting and governance meetings
- Continuous improvement backlog
End-to-end programs
Design and deliver bespoke programs for a hospital group or institution — scoped to the mandate, not a fixed menu.
What you get
- A scoped mandate with outcomes and measures
- A delivery plan across people, process and technology
- Program governance and risk tracking
- A closing review and handover
Build-Operate-Transfer
Stand a capability up, run it, and hand it back when you’re ready to own it.
What you get
- A capability designed to be owned by you
- A period of operation under agreed terms
- Documentation, training and knowledge transfer
- A defined handover date and conditions
Everything we do in healthcare enablement
Ten service areas, from planning a system to running it for years. Most engagements start in one and grow into the others.
Health IT implementation
Systems that go live and stay live.
- EHR, HIM and revenue cycle systems
- Configuration and integration
- Testing and cutover
- Go-live support
Integration & data migration
Moving and connecting what you already have.
- Interface and API work
- Data conversion and validation
- Legacy system retirement
- Reconciliation and sign-off
Managed operations
Operations run for you, to a standard.
- Revenue cycle and back-office services
- Service levels and reporting
- Quality and compliance controls
- Continuous improvement
Program & project management
Large work, kept on track.
- Program office and governance
- Planning, risk and dependency tracking
- Vendor coordination
- Executive reporting
Build-operate-transfer
A capability that becomes yours.
- Operating model and design
- Period of operation
- Training and documentation
- Handover plan
Security, privacy & continuity
Safe and available by design.
- Access control and monitoring
- HIPAA and NIST-aligned controls
- Backup and recovery planning
- Vendor risk documentation
Rural & community health enablement
Capability for organizations with thin teams.
- Technology and operations planning for small hospitals and clinics
- Shared services models
- Grant and program support
- Telehealth and remote care operations
Public-program & Medicaid operations
Work that depends on eligibility and reporting rules.
- Eligibility and enrollment support operations
- Reporting and documentation workflows
- Compliance tracking
- Case and workload management
Change management & training
People who use what you built.
- Adoption planning
- Role-based training
- Super-user programs
- Post-go-live support
Reporting, governance & outcomes
Knowing whether it is working.
- Service-level and outcome dashboards
- Governance meetings and decision logs
- Risk and issue management
- Closing reviews
How an engagement runs: start with one mandate, not a master agreement
You see the scope, the measures and the first deliverable in writing before work begins.
Shape
Define the mandate, the outcomes, the measures and the boundaries.
You get
A scope, measures and a delivery planBuild
Implement the system, set up the operation or stand up the program.
You get
A working system or operation, tested and documentedRun
Operate under agreed service levels with regular reporting.
You get
Service reports and an improvement backlogHand over
Transfer knowledge and ownership, or continue under a renewed agreement.
You get
Playbooks, training and a signed handover
Who we enable
Hospitals and health systems
The problem
Systems to implement, operations to stabilize and too few people to do it all.
A good first project
One system or one operation, scoped with measures.
Rural hospitals and community health centers
The problem
Big mandates and funding, with small technology and operations teams.
A good first project
A readiness review and a prioritized plan.
Health plans and public-program operators
The problem
New reporting and eligibility rules that need operations to change quickly.
A good first project
A managed operation or a defined compliance workflow.
Physician groups, MSOs and startups
The problem
Growth that outpaces back-office capability.
A good first project
A build-operate-transfer for one function.
Is your mandate ready for a delivery partner?
If you cannot tick most of these today, scoping comes before signing.
- The outcome is written down in one or two sentences.
- Measures and service levels are agreed before work starts.
- You know who inside your organization owns the result.
- Data and system access needs are listed.
- Security and privacy terms, including a BAA where required, are ready.
- There is a named plan for handover or renewal.
- Staff who will use the result are involved early.
- You can say how you will tell if it is working after six months.
Three questions to ask your team on Monday
- 01
If this work went wrong, who would own the result today?
- 02
What would a successful handover look like, and when?
- 03
What does “working” mean six months after go live?
If the answers are slow or different in every room, that is where we start.
Check our thinking before you call us
We publish how we read the rules and give away the tools. Judge the depth for yourself.
- Tool
HIM technology readiness scorecard
A starting point for any implementation.
- Download
HIM technology readiness self-assessment
A workbook with a 90-day readiness plan.
- Article
Medicare EDI and HIPAA transactions explained
The plumbing behind every claim, in plain language.
- Article
Agentic AI in US health systems: a governance checklist
How we think about governed work with AI.
What if our need does not fit any of your capabilities?
That is what this page is for. Describe the mandate and the outcome you need, and we will tell you plainly whether we are the right partner, and if not, who might be.
Will we lose control of the work?
No. Scope, service levels, reporting, named people and audit rights are written down, and there is a defined path to bring the work back in-house.
What is build-operate-transfer?
We build a capability, run it under agreed terms for a period and hand it to you with documentation, trained people and clear conditions, so ownership moves without a cliff.
Do you work with small and rural organizations?
Yes. We start with a readiness review and a prioritized plan, so spending follows the biggest gain.
Which systems do you implement?
We work across EHR, HIM and revenue cycle platforms and the integrations around them. We scope the specific systems with you and are open about where another specialist is a better fit.
How do you protect PHI?
Under a written agreement, including a business associate agreement where HIPAA applies, with access controls, logging and the minimum necessary data.
How is an engagement priced?
By scope and outcome, agreed in writing. Managed work is priced against service levels, not hours. We begin with one defined mandate so you can see results before widening.
Start with one mandate. We will scope it in writing.
Tell us what needs doing and what a good result looks like. We will tell you how we would deliver it, how we would measure it and how you would take it over.
Please do not send patient information. Describe the situation without identifying anyone.