How States Can Reinvent Medicaid Intelligence with Interstella

by David Wetherelt

Medicaid is being reshaped by one undeniable reality. States are no longer judged by how much data they collect. They are judged by how effectively they use it to drive outcomes, reduce disparities, and prove value to CMS.

Every state has built or inherited a massive Medicaid data warehouse. But the question today is whether those warehouses can support the demands of modern Medicaid programs like 1115 Waivers, DSRIP, and HRSN initiatives. Most cannot. They were engineered for reporting, not real-time intelligence. They were built for storage, not action.

Interstella was built for action.

The Challenge: Medicaid Needs Real-Time Intelligence, Not More Data

Medicaid populations rely heavily on community programs, behavioral health providers, social service organizations, and housing agencies. These are the systems that actually see risk as it emerges. Yet most state data warehouses only receive delayed echoes of these events through monthly encounters and stale files.

This gap cripples state programs:

• 1115 Waivers cannot measure impact in real time.

• DSRIP programs cannot show improvement until long after interventions happen.

• HRSN efforts cannot track housing, food insecurity, or transportation risk when it matters most.

• Value based care models cannot distribute funds accurately or fairly.

• Equity initiatives cannot see risk in context.
  

Interstella solves this by connecting state data systems with the real-time community footprint that traditional warehouses miss.

The Interstella Approach: Bring Community Intelligence to the State Level

Interstella does not replace a Medicaid warehouse. It modernizes it.

The Linqsys 2.0 platform delivers a real-time intelligence layer that takes local HIE feeds, behavioral health data, care management workflows, and SDOH inputs and converts them into AI-ready, analytics-ready Intelligent Assets.

This creates the Whole Person Intelligence that modern Medicaid programs require.

And it works without ripping out existing state systems. Instead, Linqsys integrates cleanly with:

• Regional and statewide HIEs

• SDOH platforms

• Housing support systems

• Community based organizations

• Behavioral health EHRs

• Care management tools

• Hospital and clinic networks

• Emergency departments

• Correctional health systems where allowed
  

Interstella acts as the refinery that transforms these inputs into something a Medicaid warehouse can finally use.

1. Real Time Feeds Replace Month Old Data

States do not need to wait 30 days to find out a member was admitted to the hospital, entered a homeless shelter, relapsed, dropped out of treatment, or disengaged from care.

With Linqsys, states receive refined and normalized community data in real time. The platform has been validated at massive scale. At a large HIE client of Interstella, for example, processes nearly one billion inbound messages per year and demonstrated the durability and performance of the Linqsys architecture.

This allows Medicaid programs to intervene before small risks become expensive crises.

2. Data Refinery as a Service Makes Medicaid Data AI Ready

Traditional data warehouses can store data. They cannot refine it. They cannot cleanse it, validate it, enrich it, or make it ready for predictive analytics.

Interstella’s Data Refinery as a Service solves this by converting raw data into Intelligent Assets, complete with validation logic, error correction, normalization, metadata tagging, and FHIR-native structuring.

The warehouse suddenly receives:

• Clean data

• Usable data

• Standardized data

• Longitudinal records

• AI ready assets

• Real time population signals
  

This is the foundation for next generation Medicaid intelligence.

3. Whole Person Intelligence for High Need Populations

High cost and high need members do not live within the four walls of a doctor’s office. Their outcomes are shaped by:

• Housing stability

• Behavioral health access

• Substance use patterns

• Social support

• Transportation access

• Community risk indicators
  

Interstella integrates with a wide range of SDOH and care coordination vendors to absorb all of this contextual data into a unified Whole Person Intelligence profile.

This gives states the power to:

• Track HRSN risk in real time

• Predict avoidable emergency department use

• Identify crisis patterns

• Improve maternal health outcomes

• Measure the impact of housing support

• Strengthen care management targeting

• Reduce inequities

• Increase the effectiveness of 1115 programs
  

  

It is not magic. It is architecture designed for the real world.

Why This Matters for 1115 Waivers, DSRIP, and HRSN

CMS is tightening the screws. States must justify every dollar and demonstrate measurable improvement. Interstella enables states to show value instead of simply describing activity.

For 1115 Waivers

States can measure member impact in real time. Not quarterly. Not annually. Now.

For DSRIP and Delivery Reform

Providers gain immediate visibility into performance, care gaps, and opportunities for improvement.

For HRSN

States can finally track social risk at the same speed it changes.

For Value Based Payment

Accurate data produces fairer payments and fewer disputes.

For Equity

Whole Person Intelligence exposes disparities early and makes interventions measurable.

Interstella gives states the operational intelligence needed to justify renewal, secure CMS approval, and demonstrate value to taxpayers.

Why States Choose Interstella

Cloud native and AI native from day one

Linqsys was built for real time pipelines and FHIR first design.

Engineered by HIE veterans

The platform reflects everything the industry learned over the last 15 years.

Scales to true statewide volumes

HEC validated the architecture at billions of messages per year.

No lock in

States retain full data ownership. There is no hostage taking, no proprietary formats, no penalties.

Works with existing systems

We sit beside the data warehouse. We do not replace it.

Future proof for AI

Interstella delivers clean FHIR ready assets that plug directly into future analytics or AI copilots.

The Bottom Line

States do not need bigger data warehouses. They need smarter data ecosystems. They need intelligence, not storage. They need to see members as whole people, not data fragments. They need outcomes, not activity logs.

Interstella delivers the intelligence layer that Medicaid has been missing.

When states are asked to prove value, Interstella gives them the architecture to do it.