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Healthcare Data Insights
In-depth guides, tutorials, and best practices for database design, data architecture, and healthcare data modeling.
Showing 13–18 of 38 posts
Logical Data Models for Healthcare Risk Adjustment: Accuracy, HCCs, and CMS Reporting
CMS disallowed $4.2M in risk-adjusted payments because your data model couldn't prove HCC documentation. Here's how to build audit-ready risk adjustment models that track encounters, validate diagnoses, and survive RADV audits.
Logical Data Models for Healthcare Claims: Accuracy, Adjudication, and Payments
Your claims data warehouse reconciliation doesn't match the 835 remittance files. Counts are off. Paid amounts differ. Here's how to build claims data models that track the complete adjudication lifecycle and maintain financial accuracy.
Logical Data Models in Healthcare: Members, Claims, Providers, and Compliance
Your healthcare data warehouse has members, claims, and providers. But when compliance asks for HEDIS reports, your model breaks. Here's how to build logical data models that handle retroactive eligibility, claim adjustments, and regulatory compliance.
Why Your "Perfect" Logical Model Still Produces Bad Metrics
You spent months designing a logical data model. Your ERD is pristine. Then the metrics report lands on the CFO's desk—and nothing matches. Here's why even the best logical models produce garbage metrics in healthcare, and how to fix it.
Data Warehouse Design Patterns: Star vs Snowflake Schema
Compare star schema and snowflake schema designs for data warehouses with practical examples and guidance on when to use each pattern.
Healthcare Interoperability: HL7 FHIR Data Models
Understand HL7 FHIR resources and implement healthcare interoperability data models for patient data exchange and system integration.
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