Missed health signals between clinical visits are quietly driving one of healthcare's largest cost centers. Credible estimates put the annual U.S. cost of care gaps — medication nonadherence, missed follow-up, avoidable utilization, and unmanaged chronic conditions — at $530B to over $1 trillion, with JAMA research pegging broader care-delivery waste at $760B–$935B annually. For Medicare and Medicaid populations specifically, the exposure is concentrated and costly: $26B+ in avoidable Medicare readmissions alone, $100B–$300B in medication nonadherence, and $451B in economic impact from health disparities tied to access, transportation, food, housing, and trust gaps.

The root cause isn't a lack of data infrastructure — it's a blind spot in when data gets captured. EHRs are built to record what happens during a clinical encounter. They're structurally weak at capturing the daily barriers patients face between those encounters — the missed dose, the skipped meal, the canceled ride to a follow-up — until those frictions have become an ED visit or readmission. This is the "temporal gap": SDoH and quality-of-life signals exist, but they're stale, incomplete, or buried in notes by the time a care team can act on them.

Rxperius Health closes this gap with a Collect / Score / Act architecture purpose-built for continuous, event-triggered patient data capture outside the four walls of the clinic:

Critically, Rxperius is designed to complement, not replace, existing EHR infrastructure (Epic, Oracle Health, MEDITECH) — plugging the temporal blind spot these systems weren't built to cover, rather than competing for the system-of-record position.

Chronic disease — diabetes, heart disease, COPD, kidney disease, behavioral health — remains the single largest driver of total U.S. healthcare spend, and these are disproportionately Medicare and Medicaid-managed populations that require more frequent, real-world visibility than a quarterly office visit can provide. Rxperius targets the organizations financially accountable for these outcomes — ACOs, Medicaid MCOs, Medicare Advantage plans, IDNs, CINs, and state agencies — with a national data layer that gives them earlier visibility into patient friction before it becomes a downstream cost.

Active engagement with Duke University Medical Center - Population Health Department, alongside priority expansion into other NC health systems (Piedmont Health and Ballad Health), position Rxperius to demonstrate measurable reductions in avoidable utilization in exactly the settings where care gaps are most acute and least visible today.

The bottom line: Care gaps aren't missing ICD-10 codes — they're missing care signals. Rxperius Health finds those signals before they become negative outcomes, giving Medicare and Medicaid stakeholders a national, continuous, patient-reported risk layer that today's clinical systems simply weren't designed to capture.