MSP Recovery, Inc. is a healthcare reimbursement recovery and data analytics company that focuses on recovering improper payments for Medicare, Medicaid, and commercial health insurers using proprietary algorithms and data analytics.

# Company Overview: MSP Recovery, Inc.

## Business Model
MSP Recovery, Inc. is a healthcare reimbursement recovery and data analytics company focused on identifying, recovering, and preventing improper payments for Medicare, Medicaid, and commercial health insurers. They utilize proprietary algorithms and data analytics tools to scan vast datasets for potential recovery opportunities and work collaboratively with healthcare payers, providers, and patients to enhance reimbursement processes.

### Key Services
1. **Claims Recovery**: 
   - **Method**: The company operates under Contracts with Assignors to pursue recovery rights related to healthcare claims. They receive irrevocable assignments through Claims Cost Recovery Agreements (CCRAs).
   - **Customers**: Over 160 Assignors across the Medicare, Medicaid, and commercial insurance segments.
2. **Data Analytics**: 
   - Develops algorithms to analyze historical medical claims data, identifying trends related to waste, fraud, and abuse.

### Revenue Generation
- The company makes money primarily through a performance-based fee structure, where they retain a significant portion of recovery revenues while sharing a portion with Assignors.
- As of December 31, 2024, the firm holds rights to recover the Billed Amount of approximately $1.591 trillion (with about $380 billion as the Paid Amount). Potentially recoverable claims are assessed at around $87.7 billion.

## Financial Details
- **Revenue**: The company has reported no substantial revenue and continues to face financial uncertainty due to significant net losses.
- **Accumulated Deficit**: As of December 31, 2024, MSP Recovery has an accumulated deficit of approximately **$446.1 million**.
- **Cash and Cash Equivalents**: The company had around **$12.3 million** in cash and cash equivalents.
- **Net Cash Used in Operations**: Approximately **$16.1 million** was used in operations for the fiscal year ended December 31, 2024.
  
## Employee Structure
- **Total Employees**: Approximately **78 full-time employees** as of December 31, 2024.
  
### Growth and Expansion Initiatives
- The company is focussed on expanding its Assignor base, developing new healthcare claim recovery strategies, and monetizing its data analytics technologies.
- Plans to offer certain software applications as separate products to enhance revenue streams.

## Challenges and Risks
- Future growth heavily relies on the ability to secure additional Assignors and successful recoveries from claims, amidst increasing competition and regulatory uncertainties.
- Potential impacts from governmental investigations into past practices affecting company reputation and operational focus.

MSP Recovery, Inc.'s unique approach leverages data analytics to disrupt traditional healthcare reimbursement systems, targeting a significant market within the Medicare and Medicaid segments while navigating infrastructure and regulatory challenges.

The company is a leader in healthcare data analytics and claims recovery, specializing in recovery solutions for improper payments made by Medicare, Medicaid, and commercial insurers.

# Company Overview

## Business Segment
The company operates within the healthcare industry, focusing primarily on recovery solutions for Medicare, Medicaid, and commercial insurance claims. It is a leader in healthcare data analytics and claims recovery, utilizing sophisticated algorithms to identify and recover improper payments made by Medicare, Medicaid, and private insurers.

## Services Offered
1. **Claims Recovery Solutions:** 
   - Assists in identifying and recovering funds owed to Medicare and Medicaid for improper payments made.
   - Utilizes proprietary algorithms and data analysis to identify waste, fraud, and abuse in healthcare claims.
  
2. **Chase to Pay Model:** 
   - A near real-time analytics platform designed to improve payment accuracy at the point of care.
   - Aims to prevent improper payments by identifying the correct primary payers before claims are submitted.

3. **Recovery Services:** 
   - Provides services to other parties to assist in identifying and pursuing recoveries on claims.

4. **LifeWallet Ecosystem:** 
   - A comprehensive data ecosystem for the organization of medical records, improving patient care and aiding recoveries.

## Customer Base
- The company has **over 160 Assignors** with which it has entered into assignment agreements. This includes healthcare providers, Medicare Advantage Organizations (MAOs), and Managed Service Organizations (MSOs).
 
## Employee Count
- As of December 31, 2023, the company employs approximately **88 employees**. It also utilizes specialized contract and part-time employees.

## Financial Metrics
- The company has a **potentially serviceable market exceeding $150 billion** annually.
- As of December 31, 2023, the company has designated claims valued at approximately **$1,544 billion in total billed amount**, with expected recoveries indicating approximately **$88.9 billion in Paid Value of Potentially Recoverable Claims** (PVPRC).
- The company has yet to generate substantial revenue from its recovery model but has primarily relied on claims recovery service fees.
  
## Revenue Generating Mechanisms
- Revenue is derived from recovery rights obtained through irrevocable assignments from Assignors.
- Contracts typically obligate the company to share a portion (usually 50%) of the net proceeds from recoveries with the Assignors.
  
## Challenges
- The business is heavily influenced by changes in healthcare laws and reimbursement models, primarily due to the complexities of the Medicare Secondary Payer (MSP) Act.
- The company faces hurdles regarding securing future recoveries, as its growth depends on its ability to expand its claims portfolio through effective data analytics.

## Summary
The company is positioned as a disruptor in the traditional healthcare reimbursement system by integrating data, analytics, and legal claims recovery into a cohesive model that targets improper payments across Medicare, Medicaid, and private payers. Its operations are supported by a robust technology platform and critical relationships with a diversified customer base while being subjected to various regulatory and operational challenges within an evolving healthcare landscape.

MSP Recovery, Inc.

10-K / April 16, 2025

10-K / April 15, 2024

10-K / April 16, 2025

Company Overview: MSP Recovery, Inc.

Business Model

Key Services

Revenue Generation

Financial Details

Employee Structure

Growth and Expansion Initiatives

Challenges and Risks