H22publishedNPD release 2026-04-09

Network adequacy gauge

Empirical endpoint-liveness rate compared against the 85% network-adequacy implied ceiling in Medicare Advantage regulation.

Headline

Empirical FHIR endpoint liveness vs the 85% Medicare Advantage network-adequacy implied ceiling: L7 unauthenticated-read 90.3% (ABOVE), L5 CapabilityStatement conformance 85.4% (AT), L6 SMART well-known 81.6% (BELOW). Gauge sampled across 2,974 distinct FHIR-REST hosts in the NDH.

2.7K / 3.0K = 90.35%

Regulatory ceiling (implied)85.0%
L7 unauth Practitioner read90.3%
L5 CS conformance85.4%
L6 SMART well-known81.6%

unit: percent

What this means

Regulators

Empirical FHIR endpoint reachability (90.3% L7) clears the 85% MA network-adequacy implied ceiling on BASIC reachability, but SMART discovery (81.6%) sits below it. If policy adds SMART conformance to the adequacy frame, the floor moves.

Payer data teams

Technical reachability ≠ regulatory adequacy. The 85% ceiling concerns active-provider share, not endpoint liveness. Don’t substitute one for the other; use both as independent signals.

Researchers

This gauge maps technical reachability ONTO a regulatory proxy. The mapping is defensible but imperfect. Treat the comparison as illustrative, not regulatory-equivalent.

Null hypothesis

Measured endpoint liveness matches or exceeds the 85% regulatory ceiling.

Denominator

All FHIR-REST endpoints declared in the NPD bulk export at the pinned release.

Data source

`ainpi-probe` crawler results joined to the `Endpoint` resource table.

Notes

The 85% network-adequacy ceiling is the implied minimum active provider share under Medicare Advantage adequacy rules (42 CFR §422.116). This comparison maps 'adequacy' onto technical reachability and conformance — NOT onto the regulatory definition itself, which concerns whether a sufficient share of the network is active, not whether its FHIR endpoints respond. Interpret as: if consumers assume the FHIR directory surface offers a regulatory-equivalent conformance floor, that assumption holds only on unauthenticated basic reachability (L7 90.3%) and collapses on SMART discovery (81.6% vs 85%). Probe methodology: 2,974 distinct FHIR-REST hosts, one endpoint per host, stratified by host-fingerprint, via ainpi-probe L0-L7 with 1 rps per host rate limit and 10s connect / 30s read timeouts.