Challenge
The client, a leading healthcare compliance team, was struggling to analyze 16M+ CMS Open Payments records published annually. Their existing process required 30+ hours per week for manual compliance reporting and lacked visibility into:
• Which companies and physicians received the highest payments
• Geographic spikes in spending
• High-risk drug payment patterns
This made it difficult to detect anomalies and meet audit requirements efficiently.
Objective
AffinityCore partnered with the client to design and implement an interactive analytics platform that:
- Consolidated multi-year CMS Open Payments data
- Delivered Tableau dashboards for intuitive visualization
- Leveraged Snowflake and Big Query for scalable backend processing
- Automated compliance reporting and anomaly detection
The goal was to reduce manual effort, improve transparency, and enable faster risk identification.
Industry: Healthcare
Approach
• Integrated multi-year CMS Open Payments datasets (16.1M+ records, $13.18B in payments).
• Modeled entities across companies, physicians, specialties, and payment types.
• Built dashboards for spend analysis, trends, geographic insights, and high-risk categories.
• Implemented automated refreshes, anomaly detection, and compliance reporting templates.
Implementation:
Data Collection:
Gathered 12 months of historical dispensing data
Forecasting Model:
Applied consumption trends to predict 3-month demand
Reporting:
Automated reports showing current stock, weeks of coverage, and reorder quantities
Integration:
Linked reports to procurement workflows for faster approvals
Expertise Provided by AffinityCore
Front-End: Tableau for interactive dashboards and visualization
Back-End: Snowflake and BigQuery for scalable data processing and storage
Results
Data Coverage:
Analyzed 16M+ records representing $13.18B in payments
Risk Detection:
Flagged 1,800+ physicians with annual payments above $50K; detected 580+ high risk drug-related payments
Operational Efficiency:
Reduced compliance reporting time by 92% (from 30+ hours/week to under
3 hours/month)
Automation:
Delivered 100% automated refresh and reporting pipelines, enabling custom report generation 10× faster
Transparency Impact:
Identified Top 25 companies responsible for 61% of payments and highlighted
7 states accounting for 49% of national volume
