Every figure on this page comes from production systems FHIRFabric designed, built, and operates. Not benchmarks. Not projections.
A large payer operating across seven legacy systems needed a unified FHIR-native member identity layer before CMS-9115-F enforcement. FHIRFabric built a deterministic deduplication engine with configurable survivorship rules — resolving 387K duplicate records across 2.4M members with 99.3% precision.
FHIRFabric delivered the full Patient Access API, Provider Directory API, and Payer-to-Payer API suite three days before the CMS enforcement date — SMART on FHIR authorization, US Core R4 profiles, and audit logging live from day one.
End-to-end Payer-to-Payer implementation: FHIR Bulk Data export from the old payer, secure transfer, import at the new payer, and member consent management — covering 64,300 members and 4.7M FHIR resources with full CMS audit documentation.
Managed a major profile upgrade across a live production environment — migrating US Core versions, upgrading CARIN BlueButton, and onboarding 340+ third-party applications through the transition. Zero app-breaking incidents.
FedRAMP-aligned infrastructure for 3.1M Medicaid beneficiaries, processing 71M FHIR API calls per month. P1 incidents resolve in 56 minutes. CMS compliance reporting fully automated. 24/7 SRE coverage.
Before any CMS API works correctly, member identity has to be clean. We build deduplication and golden record governance before API development begins — not during.
Civil monetary penalties are real. We build every implementation on a deadline-first schedule — working backwards from enforcement with hard gates and no-slip milestones.
Medicaid environments have stakeholders whose approval you need but whose timelines you don't control. We've learned how to maintain momentum regardless of external dependencies.
CMS requires audit logs. HIPAA requires access logs. State agencies want dashboards. We instrument every deployment for compliance reporting from day one — not as an afterthought.
Every major upgrade surfaces a long tail of third-party apps with varying maturity. We've built onboarding playbooks that handle 80% efficiently while providing white-glove support for complex integrations.
Real operational differences in service availability, IAM constraints, and networking affect architecture decisions. Seven Medicaid deployments have taught us what works before it hits production.
Health plans navigating CMS-9115-F and CMS-0057-F with complex legacy data environments. We bring the FHIR engineering depth so your team focuses on member outcomes, not infrastructure.
State agencies with federal CMS oversight and complex beneficiary populations. Seven prior Medicaid implementations mean we understand your constraints before the kickoff call.
Hospitals modernizing legacy HL7 v2 infrastructure toward FHIR R4 — enabling SMART on FHIR apps, analytics, and interoperability without replacing existing workflows.
We'll come prepared with experience relevant to your environment, your deadlines, and your constraints.