Healthcare Admin Overview

Purpose: This page summarizes the Healthcare admin workflow, active metric automation, reviewed candidate metrics, publication readiness, and the next governance decision.

At a Glance

Active Automated Metrics	Reviewed Candidate Metrics	Current Rollup Status	Publishing QA Decision	Public Grade
3 CMS NHE, BLS Medical Care CPI, Census Coverage	1 HC-MET-004 cost-related delayed or forgone care	INTERNAL_REVIEW_READY PASS=2, CHECK=1, FAIL=0	INTERNAL DASHBOARD REVIEW READY Candidate metrics are visible but not active rollup.	Not assigned No final public grade should be shown yet.

Healthcare Admin Workflow

Step	Admin Function	Current Role	What to Check
020	Metric Source Review	Evidence review	Confirm source URLs, source ownership, extraction difficulty, metric mapping, and review status before using a source in public-facing metrics. Use the Source Decision Ledger for accepted/rejected/active/candidate decisions.
030	Requirements-to-Metrics Traceability	Traceability review	Confirm that each Healthcare requirement has one or more supporting metrics, and that metrics are not being used without a clear requirement relationship.
040	Healthcare Metrics Refresh	Operational refresh	Run status checks, dry runs, and full metric refreshes. This is the place to rebuild Healthcare metric JSON outputs.
050	Publishing QA	Publication gate	Review whether the latest Healthcare metrics are safe for internal review, public beta, or final public release. Candidate metrics should be visible here but should not silently change the active rollup.
060	Report Card Status	Report-card readiness	Check whether Healthcare congressional report-card data files exist, whether they have been built, and what ETL outputs are still missing.

Active Automated Metric Snapshot

Metric	Status	Current Interpretation
HC-MET-001 – CMS National Health Expenditures	PASS	CMS NHE is suitable for the current internal Healthcare metrics dashboard.
HC-MET-002 – BLS Medical Care CPI	CHECK	The extractor preserves the last good value when the BLS API is rate-limited. This is acceptable for internal review, but should be clearly marked if shown publicly.
HC-MET-003 – Census Health Insurance Coverage	PASS	Census coverage values are suitable for the current internal Healthcare metrics dashboard.
Healthcare Metrics Rollup	INTERNAL_REVIEW_READY	Good enough for admin review and dashboard integration testing. Do not assign a final public grade yet.

Reviewed Candidate Metrics

Metric	Source	Candidate Values	Decision	Caution / Next Action
HC-MET-004 Cost-related delayed or forgone medical care among adults	CDC/NCHS NHIS Adult Summary Health Statistics Dataset 25m4-6qqq	2024 primary: 7.4% did not get needed care due to cost 2024 context: 8.6% delayed care due to cost	Reviewed candidate Not active rollup	Approve or revise the paired/caution source definition before promotion. This is a post-2019 adult-only NHIS source and should not be silently merged with the older 1997-2018 all-person Health, United States series.

Future Metric Development Roadmap

This roadmap separates current active automated metrics from future Healthcare metric work. Future rows are not current dashboard failures. They are candidates that should move through source review, field mapping, extractor QA, rollup integration, and publishing QA before becoming active dashboard metrics.

Stage	Metric / Workstream	Status	Recommended Action
Active Rollup	CMS NHE, Census Coverage, BLS Medical Care CPI	Internal review ready	Continue using the rollup dashboard for internal review. Do not assign a final public grade until additional review is complete.
Reviewed Candidate	HC-MET-004 – cost-related delayed or forgone care	Candidate preview	Review and approve the paired/caution definition before active rollup promotion.
Next Candidate	Medical debt burden	Source review needed	Review Census/SIPP source stability, downloadable tables, and whether it can be automated cleanly.
Next Candidate	Life expectancy / avoidable mortality / outcome measures	Source review needed	Use official CDC/NCHS and/or OECD sources, but keep domestic outcome and international comparison definitions separate.
Future	International comparison metrics	Future phase	Use after domestic baseline metrics are stable, because international comparisons require careful normalization and explanation.
Future	Congressional accountability metrics	Report-card dependency	Coordinate with Report Card Status after Healthcare issue classification, audit exports, and leaderboards are built.

Recommended Next Sequence

Order	Task	Reason
1	Confirm Publishing QA candidate awareness	HC-MET-004 should appear as a candidate, not as an active rollup metric.
2	Use the Source Decision Ledger for HC-MET-004 approval language	The source definition should be approved or revised before any active rollup promotion.
3	Use Healthcare Metrics Refresh for controlled active-rollup updates	Run dry runs before full runs. Confirm that the rollup remains at least internal-review ready.
4	Build Healthcare report-card ETL outputs to review/output folders	Report-card files should be reviewed before copying into public Healthcare data folders.

Important File Locations

Purpose	Path
Healthcare metrics scripts	G:\voicetocongress.com\40 - Top Issues\020 - Healthcare\_issue_support\metrics\scripts
Healthcare metrics QA summaries	G:\voicetocongress.com\40 - Top Issues\020 - Healthcare\_issue_support\metrics\qa
Healthcare metric review files	G:\voicetocongress.com\40 - Top Issues\020 - Healthcare\_issue_support\metrics\review
Healthcare public metric JSON	G:\voicetocongress.com\40 - Top Issues\020 - Healthcare\40 - Metrics\App_Data
Healthcare admin functions	G:\voicetocongress.com\90 - Admin\110 - Master Control Panel\Healthcare

Page version: 2026-05-13-v3-active-and-candidate-metrics