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CMS Concierge - Maintenance ROI Calculator

The Real Cost of Compliance: Keeping It Running

Achieving and maintaining CMS-0057-F compliance is a standing operational program — an annual security & certification commitment, plus the specialized roles that keep your FHIR® APIs, workflows, and data platform current. Below, see what it costs to manage this infrastructure in-house each year, and how those costs change when Smile runs it for you.

1 Your organization

A few details so the estimate reflects your plan. Everything below is adjustable.

Helps route your inquiry — doesn't change the estimate.

2 Annual cost to maintain in-house

An annual security & certification commitment plus the core staffing to keep it running. Defaults are Smile internal benchmarks & AON Radford comp — all adjustable.

Security & certification — annual $260,000
HITRUST/SOC consulting & annual applicationThe annual certification you pay for
$
Security audit, team & risk-management overheadAudit + security team, HR & risk management
$
Operational drivers — core staffing $331,533
Core staffing subtotal$331,533
What that ≈1.95 FTE is made of
Platform & integration
FHIR Developer 0.25Application / Integration Analyst 0.25Solutions Architect 0.10
Reliability & infrastructure
Site Reliability Engineer 0.15Database Administrator 0.20Network Engineer 0.20System Administrator 0.20DevOps Engineer 0.20
Data
Data Analyst 0.15
Security operations
Security Ops Engineer 0.10Security Ops Lead 0.10Security Analyst 0.05
Total annual maintenance$591,533

3 Procurement

Tells us whether the fastest path to compliance is one you already own.

⌁
Already committed to the cloud?
By the way…
If you hold a Microsoft Azure Consumption Commitment, Smile can be purchased through Azure Marketplace — putting budget you've already committed to work, with no new vendor procurement cycle.
100%
Microsoft Azure — full commitment can be allocated
The MACC math: a $250,000 Smile purchase applies $250,000 — 100% — straight to your committed Azure spend. No discount, no proration. It doesn't lower the price; it uses budget you've already set aside.
Your Personalized Estimate

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Your estimated annual maintenance cost
$591,533/ year
An annual security program + ≈ 1.95 specialized FTEs
Maintain it yourself$591,533
In-house program
Smile Managed Services$250,000*
Smile runs it
$341,533 Estimated savings per year — with hiring, retention & regulatory-change risk owned by Smile.
Maintaining it yourself costs 2.4× the Smile Managed Services price.
*Estimated cost for internal planning only — not a formal quotation. Based on a standard ~500,000-member plan at a flat scale.
Compliance maintenance is a standing program, not a project. Smile Managed Services absorbs all of it — the certification burden and the specialized team — for a single predictable fee.

See your number stress-tested.

Book a complimentary CMS Readiness Gap Review. We'll pressure-test these assumptions against your actual stack and walk through the managed path.

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Thank you, a Smile specialist will reach out to set up your CMS Readiness Gap Review.


About this estimate. The in-house figure combines an annual security & certification commitment ($260,000 — HITRUST/SOC application plus audit, security team & risk-management overhead, confirmed by Smile's security team) with core staffing of ≈1.95 FTE to maintain a CMS-0057-F solution, benchmarked to AON Radford healthcare-technology compensation. It is maintenance-only — it excludes initial build and software licensing by design. *The Smile Managed Services figure is a budgetary maintenance price for a standard ~500,000-member plan at a flat scale, and excludes hosting; it is for internal planning and estimation only — not a formal quotation. Final pricing varies with plan size and scope. © 2026 Smile CDR Inc. (Smile Digital Health).