Midwest Regional Health Plan

Zero Copy, Zero Compromise: How a Midwest Health Plan Unified 359M Claims Records Without Migrating a Single One 

A Midwest regional health plan serving more than four million members had a data architecture problem that was becoming a business problem. The longer it persisted, the more it cost — in licensing dollars, in governance exposure, and in the unified view of claims data that three separate portal teams couldn’t obtain. 

1

The Challenge

The health plan processed claims for members, providers, and employees — 359 million records totaling 250 GB of Salesforce platform storage. That data lived in Health Rules Payor (HealthEdge), the plan’s claims adjudication system, and was surfaced to Salesforce through External Objects. The approach worked at lower volumes. At scale, it generated high-volume query overhead that drove licensing costs upward with no clear ceiling, while member, provider, and employee portals each operated without a shared, unified claims view. 

Growing data volumes made it clear the architecture couldn’t scale. Escalating costs made it urgent. And governance gaps — no consistent data lineage, no unified auditability across portals — added a compliance dimension the organization couldn’t afford to defer.

2

The Solution

Argano’s Salesforce experts deployed Data 360 to replace the External Object integration entirely, building an enterprise-grade architecture designed to eliminate query overhead without disrupting the portal operations that members, providers, and employees depended on daily. 

The approach centered on zero-copy integration: Argano connected the health plan’s Azure PostgreSQL environment directly to Data 360 with no data migration and no duplication. All 359 million claims records became accessible from the source, consuming no Salesforce storage and generating none of the query overhead the previous architecture had accumulated over time. Automated ingestion pipelines were built with full Data 360 data model mapping, and every portal claims component was migrated to the new architecture with complete behavioral parity — every function that existed before continued to operate exactly as users expected.

3

The Results

The health plan went live on the new architecture and immediately eliminated all 250 GB of External Object storage — along with the ongoing licensing and query costs it carried. For the first time, a single enterprise-grade claims layer served the member, provider, and employee portals from one governed source of truth, with full data lineage, traceability, and portal-layer security built in. Every record is traceable. All access points are auditable. The governance gaps that had accumulated for years are closed. 

  • 250 GB External Object storage eliminated at go-live
  • 359M+ claims records now served via zero-copy integration — no migration, no duplication 
  • Unified claims view across member, provider, and employee portals established for the first time