The first leg of the Prefix idea comes from this article in from November of 2018 in the Wall Street Journal outlines the fundamental problems in state finance in the U.S. today.
The thrust of the article is that Medicaid will crowd out every other state service, and this crowd-out is not that far down the road. States will simply not be able to tax enough to cover their share of Medicaid.
At the same time, Medicaid (and Medicare) have an entire program dedicated to measuring payment error. The process looks like this:
Medicaid pays for health care for our most vulnerable citizens, including 65 percent of the nursing home population, is an existential threat to state finances and public university systems, yet has an entire program for measuring its payment errors - that are 10 percent of nearly 600 billion annually
We sensed there had to be a technology opportunity in this odd set of facts.