Case Study | Healthcare | AI and Data Engineering

Fortune 25 payer cuts manual data effort by 90%

Brillio's agentic data management platform unified fragmented provider data into a trusted, FHIR-aligned Member 360.

Download as PDF 29th January, 2026
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How agentic data management fixed a broken data foundation Bullets:

  • A Fortune 25 healthcare payer struggled to build a reliable member view from fragmented, inconsistently formatted provider and practitioner data. 
  • Manual cleansing, reconciliation, and relationship mapping consumed team bandwidth before any meaningful analytics or care insights could begin. 
  • Brillio re-architected the data ecosystem using Databricks-native components and its composable agentic platform, ADAM, to automate and standardize pipelines. 
  • The result: 90% less manual effort, 3x faster ingestion, and Member 360 time-to-insight accelerated by 50% across the enterprise. 

Turning unreliable data into a foundation for better care decisions 

Challenge

For a Fortune 25 healthcare payer, data is the operating system. Provider engagement decisions, care insights, and day-to-day operational choices all depend on it. But for years, that operating system was running on corrupted inputs. 

Provider and practitioner data arrived from multiple sources: health network databases, provider systems, shared drives, and enrichment files. Each source spoke a different format. None of them told a consistent story. Before a single analyst could run a query or generate a care insight, teams had to spend hours in manual cleansing, reconciliation, and relationship mapping, just to get the data to a point where it could be trusted at all. 

The consequences compounded over time. Confidence in the data eroded. Insights slowed. Teams found themselves debating whether a number was right rather than deciding what to do with it. The organization lacked a complete, reliable Member 360 view, the kind of unified picture that connects a member to their providers, their care history, and their network relationships in one place. 

What made this particularly difficult was scale. With data arriving from sources including Health Net, Portico, DBFS directories, and external enrichment files, the volume and variety of inputs made manual intervention not just slow, but unsustainable. The organization needed a solution that could standardize at scale, preserve auditability, and not collapse under the weight of its own complexity. 

Solution 

We partnered with the client to rebuild the data foundation from the ground up, re-architecting the ecosystem using Databricks-native components anchored by Brillio ADAM, its composable, tech-agnostic agentic platform designed to help enterprises adopt, scale, and govern AI with confidence. 

The first change was ingestion. Data from every source, health networks, provider systems, shared drives, enrichment files, and DBFS directories, was configured for automatic ingestion into Databricks upon file upload, eliminating manual handling at the entry point. 

From there, our team implemented a Medallion architecture built on Delta Live Tables. In the Bronze layer, raw data was captured and validated for structure and schema consistency. As data moved into the Silver layer, it was transformed into FHIR-compliant models, enriched, and standardized into reusable templates. ADAM’s configurable Data Quality framework was embedded here, running 43 business and quality validation rules continuously to assess accuracy, completeness, and reliability. Issues were flagged in real time, so only trusted data advanced. 

Clean data from the Silver layer was then aggregated into the Gold layer, where Delta tables and materialized views supported analytics, reporting, and downstream consumption. Streaming pipelines moved data seamlessly across all three layers, reducing latency and cutting wait times for insight access. 

To surface the relationship intelligence the Member 360 view required, we integrated Neo4j, a graph database that modeled and visualized connections between members, providers, and practitioners in ways that traditional relational models could not replicate. Governance and monitoring dashboards were embedded directly into the architecture, providing end-to-end visibility into data flow, quality metrics, and audit trails. 

Measured outcomes across speed, quality, and governance Bullets:

Outcomes

  • Manual data processing effort dropped by 90%, freeing teams from reconciliation work to focus on analytics and decision-making.
  • Data ingestion and transformation ran 3x faster, compressing the time between data arrival and analytics-ready availability across the pipeline.
  • Provider data quality scores improved by 80%, giving analysts and care teams reliable inputs they could trust without manual verification.
  • Time-to-insight for Member 360 analytics accelerated by 50%, enabling faster provider engagement decisions and care-related operational choices.
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What embedded governance made possible at scale

Rather than adding governance after the fact, Brillio built monitoring, audit trails, and quality dashboards directly into the architecture. With ADAM managing discovery, quality, and operations, the platform became easier to manage, easier to scale, and significantly more resilient as data volumes and sources grew.

Embedded Quality Controls

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Accompanying text: Automated quality validation rules embedded directly inside the pipeline to ensure only trusted data advanced to analytics.

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