Logo
Data Management & Quality2025-02-20T10:43:23+00:00

Reliable Data. Seamless Interoperability. Scalable Impact.

Unlocking the Power of Clean Data for Scalable Outcomes

Health Plans face growing pressure to leverage the abundance of data available to them for better decision-making, compliance, and member outcomes. Yet, data trapped in silos or riddled with inconsistencies can limit the potential to drive real impact.

The Challenges Health Plans Face with Data Infrastructure

curatedreports
Siloed and Disconnected Data Ecosystem

Healthcare data exists across a maze of systems: core administrative processing tools, EHRs, member portals, and external payers and 3rd party organizations. These fragmented silos limit visibility into a unified member record, making it challenging to derive actionable insights or power downstream analytics.

unlocking_full_value_of_interoperability
Barriers to Interoperability and Compliance

With mandates like CMS-0057-F Interoperability and Prior Auth Final Rule for FHIR APIs, interoperability is no longer optional. Yet, legacy systems struggle to connect with modern architectures, creating bottlenecks in data sharing and compliance readiness.

reliability_data
Inconsistent and Unreliable Data

Inconsistent, incomplete, and duplicate records introduce inaccuracies that derail effective decision-making. A lack of visibility into the various data processing pipelines leads to errors that often go undetected until they surface in compliance audits, reporting, or operational workflows

How We Solve Data Management & Quality Challenges

Transforming Data into a Strategic Asset

Our Health Data Management Platform (HDMP) supports clean, reliable, and ready-to-use data that drives impact across all aspects of the care continuum.

Our HDMP’s robust data ingestion and processing capabilities enable payers to ingest, process and make diverse data sources and formats available for consumption from one standardized data model—whether that be claims, clinical, administrative or provider data— without the maze of countless custom ETL processes.
Through advanced Data Processing and Data Observability, we detect anomalies, alert Payers to data processing errors, unify disparate data formats in FHIR, and ensure every dataset meets quality benchmarks. The result? Reliable data that fuels accurate reporting, better member engagement, and smarter decision-making.
We simplify CMS compliance with a FHIR-native data model to not only support FHIR APIs for bi-directional data exchange, but also establish an enterprise-wide analytics and consumption architecture that empowers all corners of the health plan with the data required to accelerate transformation.
Health-Data-Management-Platform

Why It Matters

With a FHIR-native Health Data Management Platform, Payers can achieve:

Enhanced compliance with interoperability mandates

Standardized architectural pattern for analytics & data consumption

Reliable data for more targeted and impactful interventions

Scalable infrastructure to enable more real-time engagement in care delivery

Interested in how we address other critical payer challenges?

Achieve Total Data Clarity and Control

Optimize reimbursements with comprehensive, real-time and accurate risk profiles.

Quality-Performance

Improve STAR ratings and HEDIS performance with precision in care gap closure.

Health-Management

Engage members and providers effectively to manage risk while delivering data-driven care.

Let’s Build a Smarter Data Ecosystem Together

Ready to unlock the full potential of healthcare data? Let’s discuss how we can empower Health Plans with infrastructure that scales and performs.

Perspectives by Health Chain

Leveraging Technology Partners to Accelerate Different Stages of the CDI Value Chain

Clinical Data Integration (CDI) offers tremendous value for health plans, but it's a complex process with diverse needs at each stage.

Data Variability and Standardization: Key Hurdles in Effective CDI

Conquer data variability, the biggest hurdle in CDI! Discover how Health Chain's Centaurâ„¢ platform tackles data inconsistencies & unlocks actionable insights for better member care & financial performance.

Demystifying the Maze: A Deep Dive into the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) for Health Plans

The Centers for Medicare & Medicaid Services (CMS) finalized the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) in January 2024.

Explore Problems We Help Payers Solve

Problems We Solve
Data Management & Quality
Problems We Solve
Maximizing Risk Adjustment
Health-Management
Problems We Solve
Population Health Management
Health-Plans
Problems We Solve
Utilization
Management
Quality-Performance
Problems We Solve
Quality
Improvement
CMS
Problems We Solve

CMS
Compliance

Go to Top