The Pilot Program
Florida & Texas Dual-State Pilot
A 12–18 month pilot deployment across two states representing diverse healthcare landscapes, provider types, and Medicare populations.
Pilot Coverage Area
2 States, 8.8M+ Combined Medicare Beneficiaries
4.7M Medicare beneficiaries
2nd largest Medicare population
4.1M Medicare beneficiaries
Largest uninsured population
Why Florida
Second-largest Medicare population in the United States
High concentration of safety-net hospitals and Medicare Advantage plans
Significant utilization variation across urban and rural providers
State-level policy environment supportive of healthcare innovation
Why Texas
Largest uninsured population, creating acute cost-containment pressure
Extensive rural health system network requiring scalable solutions
Rapid population growth straining existing healthcare infrastructure
Strong academic medical center ecosystem for research partnership
Deployment Timeline
Pilot Systems (Months 1-6)
Initial deployment to safety-net hospitals, rural health systems, and high Medicare-mix providers in FL and TX.
- Partner identification and onboarding
- EHR integration assessment
- Baseline metrics collection
- Initial model deployment for administrative workflows
Expansion (Months 6-12)
Broader deployment across participating systems with standardized integration kits.
- EHR-agnostic integration kit deployment
- Clinical workflow model activation
- Workforce optimization module rollout
- Interim outcomes reporting
Evaluation (Months 12-18)
Comprehensive outcomes evaluation informing national expansion strategy.
- Full cost-savings analysis per beneficiary
- Model retraining on outcome data
- National expansion readiness assessment
- Congressional reporting and policy brief
Evaluation Metrics
Cost per Medicare Beneficiary
Primary outcome measure tracking reduction in per-capita spending across pilot systems.
Administrative Cost Ratio
Percentage of total operating expense attributable to administrative functions.
Average Length of Stay
Inpatient LOS tracking, adjusted for acuity and case mix.
30-Day Readmission Rate
Readmission reduction through predictive discharge planning.
Utilization Variance
Reduction in unexplained geographic and facility-level variation.
Clinician Administrative Time
Hours per week spent on documentation and non-clinical tasks.
Financial Projections
Estimated Cost Impact per Facility
Preliminary per-facility savings projections based on published healthcare AI research, comparable CMMI demonstration outcomes, and NHAIEF target KPIs. Actual results will be determined by independent evaluation.
Projections below are modeled for a mid-size safety-net hospital with 250 beds, 40% Medicare payer mix, and $350M annual operating budget.
Administrative Automation
$2.1-3.5M
Prior authorization, claims processing, denial management, and coding accuracy improvements
60% of projected savings
Workforce Optimization
$800K-1.4M
Predictive staffing, reduced agency nurse reliance, and documentation time reduction
20% of projected savings
Utilization Management
$500K-900K
Reduced avoidable readmissions, length-of-stay optimization, and duplicate test prevention
15% of projected savings
Quality Improvement
$200K-400K
Reduced penalties (VBP, HRRP), improved care transitions, and post-acute optimization
5% of projected savings
Total Estimated Annual Savings
$3.6-6.2M
Per mid-size facility (250 beds, $350M operating budget)
Per Medicare Beneficiary Impact
$800-1,400
Annual per-beneficiary cost reduction at pilot sites (against $13,600 national average)
Participation Cost Transparency
What Participation Costs Your Health System
NHAIEF provides core infrastructure at no cost during the pilot phase. Health systems should budget for the following internal commitments.
Foundation Model Access
All validated AI models provided free to pilot participants during the pilot phase and for three years following pilot completion.
EHR Integration
NHAIEF provides pre-built adapters and dedicated implementation engineers. No custom development required from the health system.
Staff Time Commitment
Designated project lead (0.5 FTE), clinical champion (0.25 FTE), and IT liaison (0.25 FTE). Fellowship programs can fulfill the clinical champion role at no cost.
Data Governance Preparation
IRB or privacy board review of data use agreement. NHAIEF provides template DUAs and HIPAA-compliant data pipelines; internal legal review is the system's responsibility.
Risk & Liability
Risk Mitigation Framework
NHAIEF has structured the pilot to minimize operational, legal, and clinical risk for participating health systems.
Clinical Liability
All AI models are deployed as decision-support tools only; no autonomous clinical decision-making. Clinical staff retain full authority over patient care. Models are validated through the sandbox before any patient-facing deployment.
Data Security
All data pipelines are HIPAA-compliant with end-to-end encryption. Patient data remains on-premise or in the system's existing cloud; only de-identified aggregate data is shared with the foundation.
Vendor Dependency
Open-architecture design with no proprietary lock-in. Health systems retain full ownership of their data and can discontinue participation at any time with 90-day notice.
Performance Shortfall
If KPI targets are not met within the agreed timeline, the foundation conducts a root cause analysis and proposes corrective action. No financial penalties for health systems; exit terms are clearly defined in the partnership agreement.
Regulatory Compliance
Models are designed to comply with existing FDA guidance on clinical decision support software. Foundation maintains regulatory monitoring and provides compliance updates to pilot sites.
Workforce Disruption
AI tools are designed to augment, not replace, existing staff. Workforce transition planning and retraining are integrated into implementation. No reduction-in-force is required or recommended as part of the pilot.
Financial Projection Disclaimer
All financial projections are preliminary estimates based on published research, comparable federal programs, and conservative modeling assumptions. Actual savings will vary by facility size, payer mix, current operational efficiency, and implementation fidelity. Independent evaluation will determine realized cost impact at each pilot site.
Technical Requirements
Integration & Infrastructure
NHAIEF provides EHR-agnostic integration kits and dedicated technical assistance. The following outlines what participating health systems need and what the foundation provides.
Health System Requirements
EHR Environment
Any ONC-certified EHR system (Epic, Cerner/Oracle Health, MEDITECH, Athenahealth, or equivalent). NHAIEF provides pre-built integration adapters for major platforms.
Data Standards
Ability to exchange data via FHIR R4 APIs or HL7v2 interfaces. Systems not yet FHIR-capable receive technical assistance grants to upgrade.
IT Infrastructure
Standard enterprise network with secure API endpoints. No specialized hardware required — models run on NHAIEF cloud infrastructure with data remaining on-premise or in the system's existing cloud environment.
Data Governance
Institutional IRB or privacy board approval for de-identified data sharing. NHAIEF provides template data use agreements (DUAs) and HIPAA-compliant data pipelines.
Staff Commitment
Designated project lead (0.5 FTE minimum), clinical champion, and IT liaison. Fellowship programs can fulfill the clinical champion role.
Foundation-Provided Infrastructure
Integration Kit
Pre-built EHR adapters, API connectors, and deployment scripts for major platforms. Includes automated testing suite for integration validation.
Cloud Compute
NHAIEF-managed cloud infrastructure (FedRAMP-authorized) for model inference. Health systems do not need to procure or manage AI compute resources.
Data Pipeline
HIPAA-compliant, encrypted data extraction and de-identification pipeline. Supports both real-time inference and batch processing workflows.
Monitoring Dashboard
Real-time performance monitoring, model drift detection, and outcomes tracking dashboard accessible to pilot site leadership and clinical teams.
Technical Support
Dedicated implementation engineer assigned to each pilot site for the duration of deployment, plus 24/7 production support for live integrations.