Program Audits

Virginia Birth-Related Neurological Injury Compensation Program

Only 47% funded. $55M in admin costs. Families of severely brain-injured newborns were promised lifetime care — what did the fund actually deliver since 1988?

Primary Care First — Did It Actually Pay PCPs More?

CMS promised 35% more revenue. Data shows 8–12% average uplift. States with the sickest patients had the lowest participation. A data-driven audit of the 5-year model.

Vaccine Injury Compensation Program (VICP) — Federal

$5.6B paid since 1988. You can't sue vaccine makers — this is the only path. Average 5-year wait, 20-25% to legal fees, SIRVA dominates claims. Where does the money go?

340B Drug Pricing — The $54B Subsidy Nobody Tracks

Hospitals buy drugs at 25–50% discount but bill patients full price. $54B in covered purchases. Savings required to reach patients: zero. A data-driven audit of the biggest drug pricing loophole in American healthcare.

Florida Birth-Related Neurological Injury (NICA)

Florida's parallel program — larger fund, similar structural underfunding concerns. Actuarial analysis and administrative cost comparison to Virginia.

In development

CMS ACO / MSSP — Who Gets the $1.8B in Shared Savings?

Medicare created 480 savings clubs. Physician-led ACOs earn 2× more savings per beneficiary than hospital-owned ones. The benchmark reset penalizes success. CMS kept $1.9B of the $3.5B generated.