Database Architect Streamlines Healthcare Access, Saving Millions

In a pivotal move to enhance healthcare access, Vishal Kumar Jaiswal, a Senior Manager of Software Engineering at Optum, has developed a modular database blueprint that significantly aids multiple state marketplaces. This innovative system not only streamlines healthcare enrollment processes but also helps states save millions in operational costs.

Jaiswal’s work has been instrumental in Colorado’s ability to operate independently of the federal platform, allowing the state to avoid substantial annual fees. His database design supports a high volume of transactions, ensuring that working families can secure affordable medical coverage without facing delays or privacy concerns.

Transforming Healthcare Enrollment

The journey began in 2012 with the implementation of the Affordable Care Act, which mandated that states create digital marketplaces capable of handling large enrollment numbers while adhering to stringent privacy regulations. Many states struggled, but Colorado’s system, bolstered by Jaiswal’s design, processed applications efficiently and effectively. In 2023, Colorado achieved a record enrollment of over 220,000 users, the highest since the marketplace’s inception.

“The system secures sensitive personal information while maintaining response times under one second, even during peak loads,” Jaiswal noted, highlighting the reliability of the architecture.

The modular design of the database allows states to tailor affordability rules and Medicaid eligibility without overhauling the core components. For instance, Massachusetts utilizes the same platform to manage State Wrap premium assistance and unified enrollment for both private insurance and MassHealth, showcasing the adaptability of Jaiswal’s work.

Cost Efficiency and Independence

Independent state marketplaces can avoid user fees associated with the federal platform, which amounted to 2.75% in 2023 and 2.2% in 2024. This financial independence enables states to allocate more resources towards outreach and consumer support. Colorado’s independent exchange, for example, has completely sidestepped these costs, while Jaiswal’s optimizations have transformed processing times from days to mere minutes.

Massachusetts has also reaped benefits by shifting from lengthy batch processes to real-time transactions, significantly reducing staff workload and call center wait times. This improvement has allowed families relying on subsidies to resolve issues more quickly, ultimately enhancing their access to necessary coverage.

The unified platform connects consumers, insurance carriers, state agencies, and navigators, simplifying billing, eligibility verification, and compliance reporting. States adopting this model can redirect administrative costs towards enhancing customer support rather than merely maintaining infrastructure.

A Blueprint for National Impact

The architectural design of these marketplaces impacts not only individual states but also the national landscape of healthcare enrollment. With national sign-ups reaching 24.2 million in 2025, the systems developed under Jaiswal’s guidance exemplify how effective database architecture can drive significant improvements in healthcare access.

By decoupling core components from state-specific regulations, this design allows for rapid policy updates and operational efficiency, whether states operate their own sites or utilize the federal platform. This flexibility is crucial as many states still rely on HealthCare.gov, while others pursue independent routes.

Since 2021, Jaiswal has led a transition to a cloud-based microservices architecture, enhancing scalability and minimizing data inconsistencies by 97%. This modern approach allows for automated monitoring and problem identification, ensuring uninterrupted service during traffic spikes and compliance with shifting regulations.

Investing in Future Talent

Beyond his technical achievements, Jaiswal has dedicated over 2,000 hours to training more than 100 database professionals. His focus on healthcare-specific challenges emphasizes the importance of secure, scalable database practices in maintaining privacy and regulatory compliance.

His patented data lake design and innovative consent management systems have been recognized as groundbreaking in the field of healthcare data handling. Jaiswal is also an active reviewer for international conferences on artificial intelligence and healthcare technology, contributing to the establishment of standards in database design for regulated industries.

Enabling Effective Healthcare Policy

Through the implementation of ACA marketplaces across several states, Jaiswal’s database design has become integral to U.S. healthcare policy. As healthcare regulations evolve, his work provides states with the tools necessary to manage costs efficiently and improve operational reliability.

The system currently supports millions of Americans who depend on state exchanges for healthcare coverage. For example, Massachusetts enrolled nearly 390,000 individuals in recent open enrollment periods. These figures represent real families gaining access to essential medical care, thanks to the robust infrastructure created by Jaiswal.

“A flexible, secure, and efficient database foundation is not only a technical achievement—it is a national blueprint that helps states control costs, streamline operations, and keep coverage within reach for millions,” Jaiswal concluded, underscoring the far-reaching implications of his work in transforming healthcare access.