By Ryan Bosch, MD, FACP, Chief Health & Informatics Officer
As state Medicaid agencies adopt modular, specialized systems to meet Centers for Medicare and Medicaid Services (CMS) requirements, they gain flexibility but lose a single, unified view of their data. Each module stores and organizes data in its own way, which makes it efficient for generating reports from that specific system, but harder to combine and use data across systems.
Meaningful data-to-action insights, especially in population health and value-based care, only emerge when data from multiple modules and external systems is brought together in a shared, structured format. When data is integrated in this way, it enables broader analysis, deeper insights, and more coordinated action. Acentra Health, an AWS Advanced Partner, serves numerous state Medicaid programs, federal agencies, and commercial clients. We address the multi-system data analysis challenge through our Unified Data Platform (UDP) built upon a unique cloud-based data foundation designed to support scalable, cross-domain analytics while preserving operational flexibility.
Managing a Medicaid program’s performance requires both operational awareness and a longitudinal perspective. Leaders must use data to answer questions like:
Is eligibility determination accurate and occurring within required timeframes?
Are prior authorizations correct, and are they being managed efficiently?
Are claims processing smoothly or encountering delays?
Are providers legitimate, and are they being paid accurately, and on time?
Acentra Health’s UDP, powered by our own proprietary data model and the AWS secure cloud infrastructure, is designed to help answer these questions, supporting timely reporting, service line benchmarking, and predictive analytics for Medicaid programs.
Acentra Health's UDP goes well beyond legacy data warehouse aggregation. With the cross-linking and depth of our Whole Person, Whole Population (WP2) model, our UDP focuses on population and person perspectives to generate insights that can drive targeted interventions that improve health outcomes, such as care and disease management programs. This AI-ready solution, with structured data aggregated from multiple modules, also provides traditional retrospective analytics and trend reports.
Acentra Health's UDP Solution solves the fundamental challenges of modular data:
The complex data model imprinted on the cloud-based unified platform translates data to information from numerous disparate Medicaid modules through carefully curated pipelines. Think of data as the raw currency. Once it is refined and standardized, it can be relied upon to inform programs and policy.
Healthcare requires data compliance, lineage tracking, and access control. Our UDP incorporates:
Role- and attribute-based controls
Logical separation of data and application
Data lineage visibility and provenance
Alignment with HIPAA, MARS-E, and other healthcare-specific security frameworks
As an AWS Advanced Partner, Acentra Health leverages the AWS secure, scalable cloud infrastructure as the backbone of the UDP Solution while maintaining ownership of the architecture design, core modeling, and governance that powers the solution.
There is no need to wait for custom reports. The UDP enables states to pull self-service analytics for the majority of reports they need. This allows them to answer operational questions quickly, without needing to rely on IT or data teams for ad-hoc builds. It means data-to-action insights are readily available for busy teams to access as needed.
The UDP Solution was purpose-built with the following healthcare capabilities:
Modern Data Architecture: Leverages the advanced AWS data capabilities including SageMaker technologies and optimized storage with Aurora databases.
AI-enabled Data Model: The WP2 data model imprinted on the UDP Solution enables all data to have the lineage and links to be both real-time queried by visualization calls and AI-ready for connecting to various service line GPTs.
Enhanced Data Performance: Improves data ingestion speed and fidelity, while optimizing storage structure and strengthening security.
Healthcare-Specific Features: Supports Fast Healthcare Interoperability Resources (FHIR) standards, HEDIS, Medicare Stars ratings requirements (STARS), Clinical Quality Measurements (CQMs,) Enterprise Master Patient Index (EMPI), patient-matching capabilities, and the handling of specialized data like geospatial information.
AI-Powered Analytics: Integrates modern business solutions using model context protocols directly with AWS data services to generate clinical, operational, and financial insights that drive program actions to help Medicaid programs improve outcomes.
Medicaid requirements continue to evolve, yet states still need to modernize. In partnership with AWS, our UDP is the modernization solution that is transforming the market. Our clients are ready for CMS interoperability mandates, value-based care initiatives, and new federal reporting requirements that demand a flexible, yet powerful, data solution.
Acentra Health's Unified Data Platform does more than just meet client compliance and deliver analytic performance. Our UDP has become the new standard for data-to-action, leveraging powerful new technology tools in the AWS ecosystem. The Acentra Health UDP activates advanced Machine Learning and AI applications to make recommendations that get real results. Because when resources are scarce, having the right data solution makes all the difference.
Reference: AWS Public Sector Blog: Transforming Medicaid: Crafting a robust data strategy with AWS for operational efficiency by Vignesh Srinivasan, Liz LeBreton, and Pramod Halapeti , May 1, 2025