The Promise

The Operating System for Value Resolution.

Zoadigm is the operating system for value resolution in specialty medicine. We translate clinical pathways into accountable payment, prompt settlement, and clinically grounded risk boundaries that oncologists and payers can trust — so practices are measured on what they can control, not on volatility they cannot.

Tier 01Clinician
Determines the path
Tier 02Pathway
The clinical pathway · the unit of value
Tier 03Settlement
Determined accurately
HL7 FHIR R4 Native IHE Dynamic Care Planning HIPAA Compliant Durable Execution Engine Episode-Based Settlement HL7 FHIR R4 Native IHE Dynamic Care Planning HIPAA Compliant Durable Execution Engine Episode-Based Settlement
The Problem

The Misalignment Is Breaking Community Oncology

~2/3
of Medicare oncology revenue tied to drug administration — IRA negotiation compresses Part B economics from 2028
Unpriced
coordination labor — triage, navigation, planning, monitoring — in most oncology contracts
6–14 mo
of claims runout before reliable reconciliation — the next contract year is already underway
1,748
community oncology clinics closed, acquired, merged, or in financial distress since 2008 (COA)

Value-based care doesn't work because the contract is misaligned with the clinical pathway. Population-level budgets are imposed on the pathway-level work practices actually do. Providers are accountable for costs they don't control. Coordination labor goes underpriced. True-ups arrive too late to matter.

Add Part B drug-pricing reform on top of a misaligned contract, and community oncology is in an existential crisis. Nearly 1,750 practices closed, acquired, merged, or in financial distress in a generation. The survivors treat active oncology patients on contracts where the math was broken before the first claim ever settled.

Fixing community oncology means fixing the contract — starting with the unit of value.

The Answer to the Crisis

MASON 3.0:
The Payment Model that Aligns Pathway With Payment

MASON — Making Accountable Sustainable Oncology Networks — rebuilds value-based oncology on the right clinical and economic model. Clinical pathways define value. Payment follows the pathway, not a population average. Coordination labor is compensated. Risk is bifurcated so practices are held accountable only for what they control.

Designed by Dr. Barbara L. McAneny and reviewed by PTAC, MASON is the payment model. Zoadigm is the technology that operationalizes it.

Oncology Payment Categories

Risk-adjusted episode budgets derived from the specific clinical pathway — not population averages.

Itemized Fee-for-Value

Payments for triage, new patient management, and data stewardship — coordination work finally compensated.

Risk Bifurcation

Medical volatility is separated from operational performance. Volatility is insured. Performance is rewarded.

Real-Time Settlement

Continuous tracking against Oncology Patient Category (OPC) budgets — live visibility replacing the 6+ month true-up delay.

Below: how the Zoadigm Open Value Health Network makes this executable.

Healthcare System Layers

Four Layers Built. The Fifth Is Missing.

Healthcare IT has matured four foundational layers. The fifth — Value Resolution — is what specialty medicine has been waiting for. Zoadigm builds it on its Open Value Health Network (OVHN) operating system.

Already in the market
Layer 01
Record
EHRs · Claims Adjudication
Layer 02
Insight
Analytics · Population Health
Layer 03
Interop
FHIR · HL7 · TEFCA
Layer 04
Engagement
Patient & Provider Facing Apps
The missing layer
Layer 05

Value Resolution

Healthcare's first dedicated settlement layer for specialty medicine.

01
Coordination

FHIR-native event stream and durable workflow engine. Every coordination task completes — triage, referral follow-through, authorization. No dropped handoffs.

02
Intelligence

AI agents work for clinicians using a semantic model of each episode. Digital twins project cost and outcome. The network learns — but never determines settlement.

03
Settlement

Episodes settle deterministically against a Computable Contract Addendum — measured against an Oncology Payment Category target, from an event log both payer and provider independently reproduce.

Built on The Zoadigm Open Value Health Network (OVHN)
Agentic AI — In Active Development

Pathway-Level Value Needs Pathway-Level Execution.

MASON places accountability at the pathway level — dozens of decision nodes per patient, continuously, across hundreds of active episodes. That's the scale agents work at.                     Clinicians determine the path. Agents help execute it. Settlement follows deterministically.

01
Scribe
Documentation Support
Turns clinician notes into structured data. The Care Plan stays current. Documentation burden falls.
02
Monitor
Clinical Signal
Surfaces early deterioration signals to the care team — before a patient becomes a crisis.
03
Referral
Network Routing
Recommends high-value in-network specialists and closes the referral loop for the care team.
04
Authorization
Prior Auth Support
Handles or eliminates the need for prior authorization. Days of delay eliminated.
05
Pathway
Pathway Guidance
Surfaces pathway alignment and adaptation options as the patient responds. The clinician decides.
The Flywheel

Continuously Learning Practices. Increasing Returns to Knowledge.

Every episode executed on the Zoadigm OVHN improves the next one. Pathways, cost models, and workflows compound into shared intelligence that every new practice and payer inherits.

  • Millions of episodes refine pathway and payment category models
  • Network-wide outcomes close the Learning Health System loop
  • Risk bifurcation sharpens with every settlement cycle
  • Agents adapt to each practice's patterns
  • Both Payers and Reinsurers gain from administrative simplification and actuarial precision.
A Positive-Sum Ecosystem

Built for Every Participant

MASON 3.0 on the Zoadigm OVHN creates aligned incentives where every stakeholder wins.

Clinicians

Itemized, cost-based payment for the coordination work they already do. Autonomy preserved. Patients first. Agents take the administrative friction.

Payers

Settle against the clinical pathway — where clinical performance separates from medical volatility with increasing precision. Reproducible settlement. No more retrospective true-ups.

Reinsurers

A cleanly segregated risk asset — medical volatility — priced from an immutable event log. Parametric contracts that were previously impossible to underwrite.

Patients

Safer, more coordinated care. Proactive triage within one hour. Financial transparency from day one. A care team always watching — augmented by agents that don't sleep.

For Payers and Reinsurers

Settlement Built for Auditable Trust

The three capabilities that turn a value-based contract from a spreadsheet argument into an executable financial instrument.

Rail 01 · Contract-as-Code

Computable Contract Addendum

A legally incorporated, machine-executable specification of your value-based contract — versioned, hashed, and reproducible.

Both parties recompute settlement from the same claims data. Interpretation disputes and six-to-twelve-month true-ups become obsolete.

Versioned FHIR-Aligned Reproducible
Rail 02 · Determinism by Design

Deterministic Contract Logic

Advisory AI and determinative settlement are architecturally separate. Agents draft and surface variance. Humans decide.

Attribution, episode windows, corridors, and quality gates execute deterministically from the versioned CCA. Same data, same rules, same number.

Audit Trail No Model Opacity Versioned Rules
Rail 03 · ACO / TCOC Integration

Clean TCOC Nesting

Specialty episodes nest inside existing Total Cost of Care (TCOC) arrangements — with each party accountable for risk they can actually manage. Specialists bear the pathway. The payer bears population-level spend.

Specialists don't absorb volatility they can't control. Payers don't guess at pathway economics they can't see. The decades-long specialist/payer mismatch problem, solved at the contract seam.

Aligned Risk No Double Counting ACO-Ready
Foundation Built · Path to Scale Committed

The substrate is built. The model is federally vetted. The pilot and network are committed.

Most healthcare-IT projects skip or approximate the data-and-workflow foundation. Ours is in production and validated against millions of records — and the deployment path that turns it into MASON-on-Zoadigm is queued behind it.

01 Foundation Built · Validated
Federally reviewed

MASON payment model PTAC · CMMI advisory

Reviewed & endorsed by the Physician-Focused Payment Model Technical Advisory Committee — the federal panel that vets new payment models for CMMI consideration.

02 Path to scale Committed · In motion
Pilot site

Founding clinical practice Where MASON gets hardened

The MASON model originated here under Dr. McAneny. ELT and pathway-analysis tooling already validated against active oncology operations; the pilot will work the kinks out of MASON-on-Zoadigm in production.

Network committed

Community-oncology network Where MASON scales

One of the largest independent community-oncology alliance in the U.S., committed to MASON-on-Zoadigm rollout. Once the pilot is hardened, the network is the deployment surface.

Our Trajectory

What's Built. What's Being Built. What's Next.

Built & Operating
  • Production ELT: clinical + claims data to validated FHIR and terminologies at scale
  • Validated across millions of patient records from prior customer engagements
  • Semantic layer over the normalized FHIR substrate
  • Complex cohort and pathway analysis and tooling
In Active Development
  • Oncology agents supporting the operation of the MASON clinical and payment framework
  • Model Context Protocol (MCP) integration binding agents to the semantic layer
  • Computable Contract Addendum and OPC-based settlement logic
  • Virtual Account ledger for unadjudicated claims tracking
Organizing
  • Launch pilot with committed community oncology practice
  • Commercial payer and self-insured employer contracting partnerships
  • Reinsurance partnerships supporting the MASON model
  • Oncology Network alignment

The distributed workflow and FHIR data-infrastructure foundation above is the layer most healthcare-IT projects skip or approximate. It is built, running, and customer-validated. The MASON agents and settlement layer in active development are a focused build on top of it.

Ready to Align Pathway With Payment?

The data foundation is built. The launch pilot is committed. We're recruiting design partners across commercial payers and reinsurance to shape the settlement and risk layers against real contracts. If our thesis fits your strategy, we should talk.