What Magpie Health Analytics does

Magpie Health Analytics, Inc. is an SBA-registered small business founded in 2014 and headquartered in Baltimore, Maryland, that provides data analytics, program integrity, and AI-enhanced oversight services to U.S. federal healthcare agencies. The company operates as a trusted subcontractor on Centers for Medicare & Medicaid Services (CMS) and Department of Health and Human Services Office of Inspector General (HHS-OIG) contracts, and holds a GSA Multiple Award Schedule (#47QRAA19D005A) that enables direct federal procurement.

The company's offerings are organized into three integrated service lines: (1) Program Integrity & Risk Adjustment, providing subject-matter-expert-driven modeling, audit support, encounter data processing, RADV and CMS CPI audit assistance, and AI/ML tools for anomaly detection and improper payment risk scoring across Part C, Part D, ACO, and value-based care programs; (2) Health IT & Data Engineering, modernizing legacy analytics platforms through Snowflake data warehouse architecture, AWS-native data pipelines (Glue, S3, Lambda), infrastructure-as-code, CI/CD, and SAS-to-Python/SQL migrations; and (3) AI-Enhanced Oversight & GenAI Tools, deploying RAG-based generative AI for regulatory research and audit preparation, autonomous AI agents that retrieve data and generate rules, and NLP/ML for fraud detection and forecasting.

Magpie monetizes through quote-based, multi-year professional services contracts and recurring task orders awarded under its GSA MAS Schedule, with revenue sourced exclusively from U.S. federal healthcare buyers. The team is led by President and Chief Data Scientist Bil Westerfield and includes former government analysts, policy experts, and cloud engineers, and the company maintains thought leadership content on Medicare Advantage analytics and legacy code modernization to support its sales-led, relationship-driven federal go-to-market motion.

Name

Magpie Health Analytics

Legal name

Magpie Health Analytics, Inc.

Website

https://magpiehealthanalytics.com

Company type

Private

Founded year

2014

Operating status

Operating

Headcount range

1–10 employees

Short description

Magpie Health Analytics is an SBA-registered small business providing AI-enhanced analytics, risk adjustment, and data engineering services to U.S. federal healthcare agencies, primarily CMS and HHS-OIG. It supports program integrity, fraud detection, and legacy modernization through cloud-native and GenAI platforms.

Ownership category

akta.pro rank

Product category

Government Healthcare Program Integrity Analytics

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

Health Data, Vital Statistics & Population Health Informatics (BPAIAJAM)

akta.pro secondary industry

Cost of Care, Spend Analytics & Financial Performance Management (HLACAHAJ)

Keywords

• Healthcare risk adjustment
• Medicare program integrity
• Government healthcare analytics
• Encounter data processing
• Fraud detection analytics

Headquarters

HQ city

St. Petersburg

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Infrastructure, Operations, Marketing or Sales

Revenue model

1. Federal Government Contracting: Revenue generated through subcontracting on CMS and HHS contracts. The company is a trusted subcontractor providing data-driven oversight, policy-aligned analytics, and modern infrastructure to federal agencies.
2. GSA MAS Schedule: Direct government procurement through GSA Multiple Award Schedule (#47QRAA19D005A), enabling federal agencies to purchase services directly.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels3 records

Core offering

Magpie Health Analytics is a mission-focused small business that provides data-driven oversight, policy-aligned analytics, and modern cloud-native infrastructure to federal healthcare agencies, primarily CMS and HHS-OIG. The company delivers three integrated service lines: SME-driven risk adjustment modeling and program integrity analytics, data engineering and platform modernization (Snowflake, AWS-native pipelines), and AI-enhanced oversight tools (RAG/GenAI, NLP/ML, AI agents) for fraud detection, regulatory research, and legacy system modernization.

Product overview

Magpie Health Analytics offers a unified portfolio of three integrated service lines for CMS and HHS agencies: (1) Program Integrity & Risk Adjustment provides SME-driven modeling, audit support, and oversight analytics for risk adjustment, RADV, and payment error analysis; (2) Health IT & Data Engineering delivers modernization of data pipelines, platforms, and program data using Snowflake, AWS services, and cloud-native engineering; and (3) AI-Enhanced Oversight & GenAI Tools deploys RAG-based AI, autonomous agents, NLP/ML, and GenAI for fraud detection, regulatory research, audit preparation, and code conversion. These offerings work together as an integrated full-spectrum solution, supporting federal healthcare oversight from risk adjustment modeling to secure front-end platforms for data submission and performance tracking.

Differentiator

Problem solved

Functional benefit

Products and services

• Program Integrity & Risk Adjustment

Named customers2 records

Segments2 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability10 records

Feature11 records

Partnerships

One partnership is on record.

• GSA (General Services Administration)coreChannel Partner/ Reseller/ DistributorMagpie holds GSA MAS Schedule #47QRAA19D005A, enabling federal agencies to procure their services directly through the GSA marketplace. This is a critical government contracting vehicle that establishes Magpie as an approved vendor for federal healthcare analytics services.

Scale indicators2 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• ICF International: Large federal consulting and digital services firm with a substantial federal health practice serving CMS, HHS, and other agencies. Overlaps with Magpie on health analytics and modernization but operates at much greater scale across multiple federal verticals.
• Optum: Massive health services and analytics arm of UnitedHealth Group with deep federal health analytics work. Comparable to Magpie in risk adjustment, encounter data analytics, and AI for healthcare oversight, though vastly larger and commercially focused.
• Booz Allen Hamilton: Major federal consulting firm with deep CMS and HHS-OIG work, including analytics, fraud detection, AI/ML, and modernization. Comparable capabilities to Magpie in federal health analytics and oversight, though vastly larger and more diversified across federal agencies.

Direct peers

• Abt Associates: Federal research and consulting firm with a substantial federal health practice serving CMS, HHS, and state Medicaid agencies on policy analysis, program evaluation, and analytics. Comparable to Magpie in serving federal health agencies with analytical and oversight services.
• Avalanche Health (formerly Avaap): Federal healthcare IT and ERP services firm serving CMS, HHS, and other federal health agencies. Comparable to Magpie in federal healthcare focus, IT modernization services, and data engineering capabilities for federal health programs.
• Softrams: Small federal IT services firm specializing in healthcare, AI/ML, and cloud solutions for CMS and other federal health agencies. Closely comparable to Magpie in size (similar small business profile), customer base (CMS focus), and AI/GenAI delivery capabilities.
• Datavant: Health data analytics and connectivity platform focused on linking and de-identifying health data for research, oversight, and compliance use cases. Comparable to Magpie in health data infrastructure work serving federal and regulatory customers.
• Mathematica: Non-profit research and analytics organization serving CMS, HHS, and other federal health agencies on policy research, program evaluation, and data analytics. Comparable to Magpie in serving CMS/HHS with health analytics and policy expertise, though at significantly larger scale.
• NORC at the University of Chicago: Independent research organization conducting health policy research and population-level analytics for CMS, HHS, and other federal health agencies. Comparable to Magpie in federal health analytics, population-level data work, and program integrity research.
• Health Fidelity: Risk adjustment analytics company providing NLP-based chart retrieval and HCC risk adjustment for Medicare Advantage plans and providers. Comparable to Magpie in risk adjustment focus and AI/ML use for healthcare analytics and payment accuracy.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Magpie Health Analytics