Healthcare Value Analytics Suite
Unified Claims and Clinical Analytics for Measurable Healthcare Value
Governed Healthcare Data, Embedded Insights & Faster Decisions
Healthcare is embracing interoperable, cloud ready analytics that lift quality, experience, and value based performance. With growing FHIR adoption and modern data platforms, payers and providers can finally connect claims, clinical, SDoH, and operational data to enable timely, in workflow decisions across care and administrative journeys.
Tata Elxsi’s Healthcare Value Analytics Suite unifies multi source data on a governed FHIR ready foundation and delivers Member/Patient 360, population health, cost and utilization, and network performance analytics. Prebuilt Stars and HEDIS modules and value based care insights streamline reporting, while embedded guidance in EHR, UM, and RCM turns insights into measurable improvements.
Carenection - A Telehealth portal to help hospitals offer remote consultations from clinicians
Business Challenge - From Fragmented Data to Measure‑Ready Insights
Health plans and providers are increasingly unlocking value from claims, EHR, and SDoH data, yet challenges remain in consistently converting fragmented sources into fully trusted and governed analytics. As pipelines, lineage, and MDM mature and interoperability standards like FHIR/HL7 gain traction, organizations are steadily building more connected, insight‑ready ecosystems. At the same time, quality and VBC programs (Stars/HEDIS, MIPS, ACOs) are evolving toward digital quality, creating opportunities for more timely, auditable, and harmonized reporting. Strengthening data trust and embedding analytics into everyday workflows will be key to sustaining scalable, cloud‑driven value.
What We Do
Data Platform Modernization
- Migration to cloud-based data lakes and warehouses
- Implementation of scalable big data platforms (Snowflake, Databricks, Innovaccer)
- Real-time data ingestion and streaming pipelines
Data Engineering Services & Data Product Management
- Data Curation, Consolidation & Exchange with internal/external systems
- Enterprise Data Management (Data Stores, Data Access Layers etc.)
- CMS/BCBSA/Medicaid Data Exchanges (Risk Adjustment/MRF/ACA/RCNI etc.)
Data Governance & Strategy
- Master Data Management (MDM), Reference Data Management (RDM)
- Data cataloging and lineage tracking
- Compliance frameworks (HIPAA, HITRUST, GDPR)
Interoperability
- Patient Access / Provider Access / Payer-to-Payer / Developer Portal
- FHIR/HL7-based API integrations (CMS 0057 mandates for Electronic Prior Auth)
- Cross-system data harmonization
Data-centric Mandates
- Payer: Risk Adjustments, HEDIS/NCQA, NPR, NDW, FFE/SBE exchange integration,
Provider Directory refreshes, Medicaid Enrollments, Network Transparency etc. - Providers: MIPS / APM Reporting, Clinical Quality Measure (CQM) updates, eCQM
certification, IPPS/OPPS Rules, Risk Adjustment Factor (RAF), ACO/MSSP Reporting etc.
Patient & Member 360 Platforms
- Unified patient/member data view
- Integration of clinical, claims, and social determinants data
- Personalized engagement dashboards
Operational Analytics for Payers
- Claim Analytics for Payment/Denial/Suspension insights
- Provider & Network Management Analytics
- Cost & Utilization Analytics (High $, High Cost Claimants, PMPM Trends, ED & Drug Utilization etc.)
Operational Analytics for Providers
- RCM/Claim Payment/AR/DSO Analytics
- Staff Productivity/Scheduling Insights, Patient Flow & Throughput
- Supply Chain Optimization, Provider Performance Dashboards etc.
Value-Based Care & Clinical Quality Analytics
- Member-Provider Attribution analytics
- Shared Savings/ACO/EOC Program Monitoring insights
- ED Utilization, Mortality, Readmissions, Post-Discharge, Lab/Imaging TAT etc.
Population Health Analytics
- Chronic Disease Management insights
- Risk Stratification Models
- Preventative Care & Screening Analytics
- Care Program Evaluation / HEDIS / NCQA reporting
Healthcare Value Analytics Framework
Our technology modernization framework helps healthcare organizations build a scalable, interoperable, and insight-ready analytics ecosystem. It connects multi-source healthcare data, strengthens governance, enables secure interoperability, and transforms trusted data into operational, clinical, and value-based insights for payers and providers.
Build a Trusted, Unified Healthcare Data Foundation
Unified Data Foundation
Integrate claims, clinical, SDoH, and operational data through secure ingestion, engineering, quality checks, harmonization, and governed cloud-based data platforms.
Interoperable Access and Exchange
Enable FHIR and HL7 based interoperability, API driven data access, patient and provider exchange, and seamless integration across portals, tools, and third-party applications.
Analytics and AI Activation
Deliver cost, quality, risk, population health, member and patient 360, and revenue cycle insights through advanced analytics and AI driven decision support.
Why Tata Elxsi?
- Design-led activation embedding analytics into workflows for adoption and impact.
- FHIR-first interoperable foundation unifying claims, clinical, and operational data.
- Cloud-ready accelerators and adapters enable faster deployments, reduced integration risk.
- Privacy-by-design governance: encryption, role-based access, audit-ready compliance reporting.
- Outcome-focused delivery: co‑creation sprints, measurable milestones, continuous optimization.
Information Hub
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How do HL7, FHIR, and DICOM standards support interoperability?
These standards define protocols and data formats that allow different healthcare systems to communicate effectively. HL7 focuses on structured data exchange, while FHIR streamlines information sharing through web-based resources and APIs. DICOM standardizes the management of medical imaging data. By adopting these frameworks, organizations ensure consistent data interpretation, reduce integration complexities, and improve compliance. Collectively, they enable more seamless health IT interoperability, promoting better collaboration among stakeholders, enhancing patient outcomes, and facilitating faster innovation across the connected ecosystem.
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How does the suite ensure FHIR/HL7 interoperability and compliant health data exchange for payers and providers?
The suite implements FHIR/HL7‑based APIs and SMART‑on‑FHIR patterns to ingest, normalize, and share data across EHRs, care‑management, UM/RCM, and analytics systems, enabling member/patient 360 and cross‑system harmonization. Reference architectures from major clouds detail how FHIR pipelines and operational stores support patient/member insights, virtual health, and care coordination at scale.
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How do you address data quality, data governance, lineage, and audit readiness for Stars/HEDIS reporting?
We enforce data cataloging, lineage, MDM/RDM, and privacy‑by‑design controls so payers and providers can produce auditable, measure‑grade datasets for HEDIS/Stars and VBC programs. NCQA’s Digital Quality Transition highlights the need for governed, multi‑source clinical data; industry programs like NCQA Data Aggregator Validation (DAV) demonstrate how validated clinical streams increase trust and reduce manual verification in quality submissions.
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Which payer analytics and provider analytics use cases are supported?
Common use cases include cost & utilization analytics, network/provider performance, risk adjustment, fraud/denial analytics, revenue cycle analytics, Member/Patient 360, population health analytics, and quality/VBC dashboards with forecasting. Market analyses show healthcare analytics scaling toward ~$160B by 2030 and U.S. payer analytics growing at ~21.5% CAGR - driven by value‑based models and AI‑enabled reporting - so suites that cover these use cases align with where spending and demand are headed.
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What deployment options help us realize value quickly on leading health data platforms?
Organizations typically adopt a cloud‑ready approach (e.g., lakehouse/data‑cloud patterns) so FHIR‑converted clinical/claims data flows into governed models, Power BI/embedded UX, and API‑driven activation. Reference blueprints from major platforms show how care‑management analytics pipelines, HL7/FHIR support, and unified data/AI services accelerate time‑to‑value for payer and provider workflows.
