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%
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.