METHODOLOGY
What PULL Is
PULL is an independent research platform covering healthcare purchasing, Medicaid, Medicare Advantage, social care, and value-based care.
The goal: Identify which organizations are most likely to survive procurement, renewal, audit, and financial scrutiny.
This is not: An index of the most innovative companies, most impactful companies or the most popular companies.
This is a review process designed to evaluate whether an organization can hold up when real healthcare dollars, contracts, and accountability are involved.
Organizations Cannot Pay For Inclusion
Organizations cannot pay for inclusion, ranking, placement, upgrades, scores, or favorable coverage. Commercial relationships do not influence scoring.
How Organizations Are Selected
Organizations are selected because they are relevant to healthcare buyers.
Selection signals may include:
Health plan adoption
Provider adoption
State procurement activity
Medicare Advantage activity
Medicaid activity
Investor interest
Reader recommendations
Founder submissions
Industry attention
Not every organization in a category is reviewed.
Pull does not attempt to cover the entire market.
How Organizations Are Evaluated
Organizations are evaluated using a standardized scorecard.
Core categories include:
Needs Alignment
Expenditure Transparency
Savings Estimation
Break-Even Logic
Risk & Sensitivity
Communication & Packaging
Equity Impact
Vendor Watch reviews may also evaluate:
Contract Readiness
Evidence Strength
Operational Scale
Renewal Durability
Financial Durability
Implementation Burden
Audit Survivability
PMPM Impact
Quality Impact
Regulatory Alignment
The goal is to make the reasoning visible.
Two reasonable analysts may reach different conclusions using the same information.
What Evidence Is Used
Pull relies primarily on publicly available information.
Examples include:
Health plan documents
State procurement records
CMS guidance
Contracts
Financial disclosures
Company materials
Whitepapers
Conference presentations
Academic research
Public interviews
News coverage
Not all evidence is weighted equally.
Highest Confidence
Public contracts
Procurement records
CMS documents
Health plan documents
Regulatory filings
Moderate Confidence
Company case studies
Whitepapers
Conference presentations
Investor materials
Lowest Confidence
Marketing claims
Unsupported ROI figures
Anonymous testimonials
Pull evaluates the strength of the evidence supporting a claim, not the size of the claim itself.
How Reviews Change Over Time
Organizations are reviewed continuously.
As new information becomes available, organizations may be:
Upgraded
When evidence improves.
Examples:
New contracts
Better outcome data
Stronger renewal evidence
Independent validation
Downgraded
When evidence weakens.
Examples:
Contract losses
Failed renewals
Poor outcomes
Audit concerns
Retained
When the original thesis remains supported.
Removed
When the organization no longer meets inclusion standards.
Removal does not mean an organization failed.
It means the evidence no longer supports inclusion.
How Often Reviews Occur
Pull conducts ongoing monitoring throughout the year.
Formal reviews typically occur:
After major contracts
After acquisitions
After funding events
After policy changes
After significant new evidence emerges
Organizations may be updated at any time.
Corrections and New Evidence
Organizations may submit:
Corrections
Public documents
New evidence
Updated information
Submitting information does not guarantee a score change.
Any revision must be supported by verifiable evidence.
Accountability
Pull keeps prior assessments whenever possible.
Organizations may move up.
Organizations may move down.
Organizations may remain unchanged.
When a material conclusion changes, Pull will document why.
The goal is to improve as better evidence becomes available.
What Pull Is Not
Pull is not:
An investment advisor
A credit rating agency
An actuarial firm
A legal advisor
A procurement authority
Every score reflects an interpretation of publicly available information at a specific point in time.
Readers should perform their own diligence before making purchasing, investment, contracting, or policy decisions.
THE NORTH STAR:
Healthcare does not fund social impact alone.
Healthcare funds organizations that can survive procurement, renewal, audit, and financial scrutiny.
Every Pull scorecard begins there.