Decision Log

Oct 14, 2026: Pending items P-1 to P-3

Decided by: Norman ("Make v3 with my recommendations"). Carried out in: deck v3 and business plan v3. Changes: v3 change log. These items came up while checking sources for v2.

ID	Question	Decision	Why
P-1	Update the Houston office rent input?	Number unchanged; wording fixed Rent stays $320K (8,000 SF x $40/SF all-in). Slide 12 and plan 7a/7c now say how it was built and cite both market reports.	$40/SF all-in is above Transwestern Q4 2025 full-service asking rent ($33.56 metro; $37.54-39.42 in Sugar Land and Far West). Even at $45/SF, breakeven moves only from ~$106 to ~$107 per wRVU.
P-2	Update the MD2 Houston concierge fee?	Yes: $26,000 a year Not the "about $25,000" first suggested.	MD2's own Houston page lists $26,000 a year ($2,167 a month). No source supported $25,000. The 2022 $24,000 is now labeled as the launch price. Benchmark only; no model numbers change.
P-3	Mention Houston Methodist's Brockman gift?	Yes Slide 8 Capital bullet: record $110M Brockman gift (2026), $10M to OB/GYN. Plan competition and funding rows updated with sources.	Shows Methodist can fund a women's health push fast, which supports moving first. The $10M figure comes from InnovationMap; Houston Methodist's release names the OB/GYN women's health fund without an amount.

The new tower name (Brockman Centennial Tower, 2027) is in the plan but not on slide 8: a sixth bullet did not fit.

Oct 14, 2026: Dr. Sami's deck feedback

Decided by: Norman ("we'll take your recommendations on all of them"). Based on: the feedback analysis. Carried out in: deck v2 and business plan v2. Changes: v2 change log.

ID	Question	Decision	Why
D-1	Apply the proposed wording changes (slides 3, 7, 8, 12, 14, 16, 19, 22, 23) and the matching business plan text?	Yes All of them, plus the small "other findings" fixes on slides 8, 15 and 16.	Fixes the Methodist MFM claim, the sFlt-1/PlGF label window, and explains the terms Dr. Sami asked about.
D-2	New slide-11 palette, or keep brand colors?	New palette Navy, deep teal, rust, charcoal header bands with word labels; neutral "Year" pills. Slide 10 matches.	The old colors blurred together on a projector and for color-blind viewers. Word labels mean color is never the only cue.
D-3	Add CPT 2027 as a sixth "why now" force?	Yes Slide 3 now lists six forces; the business plan's Payment row adds it.	The end of the global OB package makes the whole postpartum year billable visit by visit. It strengthens the plan's main story.
D-4	Reframe connected-care revenue for Texas Medicaid?	Yes Texas Medicaid: S9110 + 99091 with prior auth. Medicare and commercial keep the RPM codes.	Texas Medicaid does not pay the Medicare RPM codes. This revenue was already outside the base case, so no totals change.
D-5	Drop the revenue claim for the app-guided pelvic floor trainer?	Yes Clinical step only.	Texas Medicaid does not pay RTM codes, and BCBSTX calls home devices not medically necessary. Medicare RTM is a small add-on at best.
D-6	Slide 12: show the conservative hospital case as its own row?	No, keep it in the caption	Dr. Sami found the table hard to read. A simpler table with a plain caption answers that; another row would add clutter.
D-7	Find URLs for the deck sources that have no link?	Yes Found links added to deck v2 and the business plan v2 source list; any not found are listed in the change log.	Every citation should be clickable.

Versioning rule (decided Oct 14, 2026)

Never edit a released version. Every change makes a new numbered file (deck-v3.html, business-plan-v3.html, ...), and every version stays in the folder. The change log records what changed in each version and why.