Health Chain

Health Chain is a health data management platform company founded in 2019 that specializes in helping healthcare payers manage clinical, claims, and administrative data. The company's platform is built natively on FHIR (Fast Healthcare Interoperability Resources) standards to enable unified member data access across payer organizations.

The platform addresses common payer challenges including fragmented data sources, CMS compliance mandates, HEDIS and Star Ratings performance, and risk adjustment accuracy. Health Chain's approach centers on creating a single source of truth for member data that can be accessed by utilization management, care management, quality, compliance, and analytics teams. The company's proprietary Centaur™ technology provides AI-driven data reconciliation, enrichment, and validation.

Health Chain holds CMS compliance certifications and NCQA certification, positioning it specifically for Medicare Advantage and Medicaid managed care organizations. The company maintains memberships with HL7 and demonstrates FHIR R4 readiness, reflecting its standards-based technical approach to healthcare data interoperability.

Organizations should consider Health Chain when facing CMS interoperability mandate deadlines, struggling with fragmented member data across multiple systems, or seeking to improve quality metrics like HEDIS and Star Ratings through better data access. The platform is particularly relevant for payers undergoing digital transformation initiatives that require modernizing legacy data infrastructure.

Engagements typically involve platform implementation to replace or augment existing data management approaches, with ongoing managed services for compliance maintenance. Organizations can expect a focus on both regulatory requirements and operational business value from unified data access.

Health Chain operates exclusively in the healthcare payer segment with specific focus on Medicare Advantage and Medicaid managed care compliance requirements. The platform addresses payer-specific challenges including risk adjustment accuracy, HEDIS measure reporting, prior authorization workflows, and CMS interoperability mandates. All product capabilities are designed around payer operational needs rather than adapted from other industries.

The company demonstrates deep healthcare regulatory expertise through its CMS compliance and NCQA certification, and maintains active participation in healthcare standards organizations including HL7 membership.

The ideal client is a regional or national health plan with 100,000+ members, multiple data sources requiring integration, and teams across care management, utilization management, and quality that need coordinated access to member data. Organizations facing CMS compliance deadlines or Star Ratings performance challenges will find particularly relevant capabilities.