What ships today, and what the next five services are worth
Low-value advanced imaging ships today as 11 measures on the claims ledger. Expand II adds non-imaging services as clinical content on the same feed, the same ledger, the same rails and the same contract. Dollars below are per 100,000 attributed lives at Vol III §9 defaults. Unshipped services are marked modeled.
What ships today — imaging
Measure library on the claims ledger. Retained figures are the Zipf split of the Route A imaging pool through the dollar model.
Shipped imaging measures and modelled retained value per 100,000 attributed lives| Service | Status | Retained / 100,000 lives |
|---|
Imaging for non-specific low back pain within 6 weeks lvi-lbp-imaging | Ships today | $173,848.12Modeled |
Head imaging for uncomplicated headache lvi-headache-imaging | Ships today | $86,924.06Modeled |
Head imaging for syncope lvi-syncope-imaging | Ships today | $57,949.38Modeled |
Preoperative chest radiography before low-risk surgery lvi-preop-cxr | Ships today | $43,462.03Modeled |
Preoperative echocardiography before low-risk surgery lvi-preop-echo | Ships today | $34,769.63Modeled |
Preoperative stress testing before low-risk non-cardiac surgery lvi-preop-stress | Ships today | $28,974.69Modeled |
Imaging for uncomplicated acute rhinosinusitis lvi-sinusitis-imaging | Ships today | $24,835.45Modeled |
Cardiac stress testing/imaging in asymptomatic patients without cardiac risk factors lvi-asympt-cardiac | Ships today | $21,731.02Modeled |
Carotid artery imaging in asymptomatic patients lvi-carotid-asympt | Ships today | $19,316.46Modeled |
CT/MR abdomen-pelvis repeated within the episode window lvi-repeat-ctap | Ships today | $17,384.82Modeled |
Advanced imaging for uncomplicated musculoskeletal pain within the conservative-therapy window lvi-msk-early-mri | Ships today | $15,804.38Modeled |
Next five services — Expand II
Ranked by modelled spend share inside the twenty-service non-imaging set. Adding a service is configuration, not a new architecture.
Next five Expand II services, not shipped, modelled retained value per 100,000 attributed lives| Service | Status | Retained / 100,000 lives |
|---|
PSA screening in men aged 75 or older lvs-psa-over-75 | Not shippedModeled | $175,109.95Modeled |
Cervical-cancer screening in women aged 65 or older with adequate prior screening lvs-cervical-over-65 | Not shippedModeled | $87,554.98Modeled |
Percutaneous coronary intervention for stable coronary disease lvs-pci-stable-cad | Not shippedModeled | $58,369.99Modeled |
Arthroscopic surgery for knee osteoarthritis lvs-knee-arthroscopy-oa | Not shippedModeled | $43,777.49Modeled |
Spinal fusion for lumbar stenosis without spondylolisthesis lvs-spinal-fusion-stenosis | Not shippedModeled | $35,021.99Modeled |
Ten-year unrebased compounding
LEAD runs 1 January 2027 through 31 December 2036 without rebasing. A reduction achieved in year two keeps paying through year ten. Figures below use a 5% discount rate (central case) on the imaging-beachhead retained stream. LEAD Model Overview Source Register · retrieved 2026-08-19.Modeled
Year-2 reduction, remaining term 9 years: undiscounted $4,725,000.36 · present value $3,918,186.99
Willingness to pay rises with remaining term
A buyer prices rationally against remaining benchmark term. This is the weakest link in the chain: it is an untested behavioural assumption, not a measured procurement fact. Remaining-term present value is amortised across the original ten-year term, which is conservative: a one-year remainder is still divided by ten.Modeled
Tolerable annual price at 10 years remaining: $425,660.67 · at 1 year remaining: $52,500.00
Modelled net-revenue retention — low / central / high
Planning model, not a published claim. Content expansion and remaining- term compounding are combined. The behavioural assumption at the centre is untested.Modeled
Modelled net-revenue retention, low central and high cases| Case | Discount | New services | NRR |
|---|
| Low | 8% | 0 | 104%Modeled |
| Central | 5% | 1 | 154%Modeled |
| High | 3% | 2 | 184%Modeled |
