OBBBA's work requirements take effect January 2027. Urban Institute projects up to 10.1 million Medicaid enrollees will lose coverage — most of them actually qualify for a medical frailty exemption but can't document it in time. ClinicalSwipe is the marketplace that connects licensed physicians to the cases that need review.
In Arkansas's 2018 experiment, 95% of people who lost coverage actually qualified — they just couldn't document it. OBBBA is that at 50× scale.
Projected Medicaid loss among people whose self-reported health inhibits their ability to work, under low-mitigation state scenarios.
Projected Medicaid loss among people living with a disabled family member they may serve as caregiver for.
Projected Medicaid loss among self-employed enrollees — states cannot automatically verify 1099 income.
Your medical license is an asset. Put it to work reviewing medical frailty cases between patients — from anywhere, on your schedule.
Cases arrive matched to your specialty (psychiatry, PMR, addiction medicine, IM, cardiology, neurology). Full patient record, timeline, and prior documentation pre-loaded.
Approve, modify, or reject. AI drafts the attestation citing specific OBBBA criteria — you review the draft against the patient's record, sign, and submit.
$49–99 per attestation depending on specialty + complexity. Paid weekly. Reach Expert tier by quality score → set your own rate up to $149/review.
At 5 hours per week of review time and an average of 10 attestations per hour, a Network-tier physician earns $2,500–5,000/month. Expert-tier earns $5,000–8,000. Founding Authority tier (like Dr. Josh Emdur) sets the standards and reviews supervise.
Every frail member who churns off your plan is lost capitation. Every uninsured patient at your FQHC is uncompensated care. Attestation at scale is the cheapest insurance you'll buy this year.
At $49 per attestation and an average $4,800/year risk-adjusted capitation per expansion member, retaining 1,000 frail lives costs you $49,000 and protects $4.8M of capitation revenue.